Urban Agriculture At St. Jude Children’s Research Hospital

The importance of food and diet in healing and medical treatments is becoming much more widely recognized, so it is only natural for hospitals to realize the value of providing local, organic food to their patients. Having a farm onsite adds to the wellness culture, not only by providing nutritious food but also by creating a sensory experience for patients to connect with nature. One such institution getting involved in food and sustainability is St. Jude Children’s Research Hospital. Agritecture interviewed Kevin Krueger, the Procurement and Sustainability Manager at St. Jude, and we learned about the hospital’s urban agriculture initiatives. 

Sustainability Initiatives Take Root

Sustainability efforts at St. Jude initially grew out of individual departmental initiatives. They were passion projects led by individuals, such as the hospital’s recycling program and urban garden. In 2010, the first urban garden was created by converting a vacant lot into a plot with 24 raised beds. Kevin Krueger’s first role as the Procurement and Sustainability Manager was to form a sustainability working group and pull together all of the departmental leaders to make progress towards the hospital’s sustainable development goals. He was able to recognize what areas needed improvement and take on these challenges. 

The hospital farm began as an idea from a chef who was personally excited by the idea of growing food for the hospital. She went to the director of design and construction who then ended up re-purposing concrete slabs to construct 24 raised beds. From there he let the food services team take over. In 2016 when Kevin first started, the garden had a lot of potential but was significantly underutilized. “There wasn't really a plan or vision for the space, and it was tough for the kitchen to plan around the food when they didn't know in advance what they would be receiving. So when I took it over, I was able to connect with our director of design and construction, and also facilities people, and we were able to renovate a small building into office and production space,” Kevin explained. Almost four years later and the garden now contains 72 raised beds in the 2-acre plot. After soil testing was done, they realized they were able to grow in the soil and created in-ground planting areas. There was a small orchard that had been planted, and now more trees have been added bringing the total coverage to 50 trees. They expect the fruit to harvest in 2-3 more years.

The hospital is trying to make the garden more of an amenity accessible to all patients, “On a purely cost level, it can be hard to justify the garden program, so we've always made the case that the garden is also about engaging with people and having green space and stress reduction.” The first farmer's market of the year is hosted out in the garden and there’s a party with live music by the St Jude Band. In 2018 they celebrated their second annual party, which brought out over 1,100 people. This just shows the power of urban agriculture helping to foster community connectivity. “So it's basically a half and half approach. Let's produce as much as we can, but let's also get people in the garden and using the garden.” Running an urban garden is not an easy task, Kevin realized the need to seek help from experts early on. St. Jude now works with a group called Memphis Tilth, whose team manages garden operations as well as their weekly farmer's market.

Challenges Facing Large Institutions 

Working with food vendors through an institution brings up its own challenges that the retail sector doesn’t typically have to navigate. Kevin works closely with large food companies and processors because there are only so many companies that are set up to supply the volume needed at a realistic cost. Last year, St Jude was able to work with Tyson to shift almost all of their high-volume poultry purchases to ‘no anti-biotics ever.’ This was a change to one of their major food items that, “If we tried to go to a smaller producer, in some cases it could easily more than double that item's cost and have a huge impact on our budget. So for me, it's been a learning experience working to try and be an advocate and influence in this more conventional sourcing world, coming from Whole Foods Market where I was working in most cases with more specialized suppliers and distributors. We need to be able to work with these larger companies to achieve meaningful change without costs that wouldn't be realistic.” 

Changes like these to the menu have been overwhelmingly positive from employees, “I've been approached many times by people I don't know and I've never met that are just excited about these changes. This was especially true after we brought in Impossible Burgers and added to our menu.” St Jude introduced the Impossible Burger by setting up a pop-up station in the cafeteria which attracted a line cutting across the cafe, serving more than 300 plant-based burgers that first day. Being a research hospital, many employees are coming from grad school or college who are used to the idea of food service pushing the envelope which creates a higher demand for bringing in innovative products and keeping up with new trends.

With these shifts in demands also comes increased costs, “I'm not a believer in the idea that we can achieve the change we need in the current market without incurring some costs. The food supply chain that we have now doesn't account for externalities at all in most cases. So it's simple logic that paying a little more is how you address these costs that society otherwise has to bear in the form of polluted air and water, loss of biodiversity, and similar impacts.” Kevin explains, “I think as an industry we can eventually move to change the whole equation, but as it stands now, if we want to be leaders in pursuing change then there's going to be a cost and we have to reach a point where we acknowledge the importance of these things and write them into our budget the same way we do anything else.”

Agritecture conducted a customized workshop with St. Jude hospital with strong participation from architecture, design and construction, and facilities members. Agritecture informed on all the benefits that come with integrating urban agriculture into design, such as reduced sick-days. “If every hospital administrator understood the impact we could have by bringing greenery into our offices, I think everyone would be doing it.” 

On any urban campus, bringing in agriculture is extremely worthwhile. We just need to make the information available to the right decision-makers. For hospitals, the core function is healing people, so it's hard when what you're proposing is seen as being outside the core function of the entity. 'Hospital food' has a reputation because it's been seen as incidental to the core functions of a hospital, but now we're seeing more expectations in hospitals around food tasting good and contributing to an overall positive experience in addition to just meeting minimum nutritional needs. Hopefully we'll see expectations around food being nutritious food. Hopefully the projects we are starting to see on hospital campus are the start of a similar change in expectations for design in the hospital environment and a realization that bringing greenery into the built environment can improve the patient and employee experience which serves the core function of a hospital. 

What’s Next For Urban Agriculture at St. Jude?

Kevin hopes to bring some additional food production into their new buildings using hydroponics, “We want to make more intensive use of the space that we have. We've planted more functional landscaping with fruit trees and berry bushes that are tied into the general landscape, moving away from the use of plants that are purely ornamental.” Increasing local sourcing is also a priority for St. Judes, “We're strongly incentivized to buy from large distributors because they tend to be able to dedicate full-time positions to things like tracking supplier audits and certifications and keeping track of products as they travel from farms to distributors to customers. So I think we need to think about how we can promote small and medium-sized local farms, where everyone is generally multitasking and keeping up with a broad range of responsibilities, without making concessions in critical areas like food safety.” Local farms need better tools and resources so they can reach a point where they are able to meet these standards, without sacrificing anything in the process, some things that groups like the Foundation for Food and Agriculture Research, AgLaunch, and many others are working hard on. 

Forward-looking contracting is one of Kevin’s biggest passions right now; it helps farmers avoid risk when growing the less conventional crops. “One of the biggest issues that I used to continually see is that it was always a chicken and egg, neither retailers nor producers wanted to be the first ones to try something new. Farmers are reluctant to increase their production when they don’t know if they will be able to find a customer for that additional produce when harvest time comes, and retailers are reluctant to promise to buy something in advance without knowing how their needs and customer demand might change in the interim. But with large institutions, we have many items where our usage is extremely consistent and predictable over time and so we can be forward-looking and let everyone know what we need in terms of food safety, and then we can sign agreements where we let farmers know what we'll need months in advance so that they can plan ahead and plant those things right now.”

To connect with Kevin Krueger and learn more about sustainability efforts at St. Jude, follow him on Twitter @kevintkrueger .

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