Background, goals, and objectives

Healthcare institutions are increasingly incorporating farms and gardens in their programming. A recent survey identified 26 hospital farm and garden sites in early 2016, and observations in the field suggest that this number has grown rapidly over the past two years. These programs provide a wide ranges of services to associated healthcare institutions and greater communities, including, but not limited to, access to fresh fruits and vegetables, nutrition education, opportunities for volunteers to engage in physical activity, promotion of environmental stewardship, and horticultural therapy.

The Farm at St. Joseph Mercy Ann Arbor, established in 2010, is believed to be the first hospital-based farm in the state of Michigan. The Farm was established to promote the health of the community by being a model of good nutrition and influencing how food is produced and distributed. Nearly all of the food on The Farm is grown in three hoop houses, and garden plots are also available for hospital staff. Through The Farm, the hospital hopes to lead by example and promote healthy food, healthy lifestyles, and environmental sustainability.

Because The Farm at St. Joe's and other farms and gardens associated with healthcare institutions (from here forward, hospital-based farms) are pioneers in a new field, they are faced with numerous unique challenges. Some examples include the following: How can insurance companies be billed for time that patients spend on the farm? How can hourly hospital staff volunteer at the farm without their time being counted as overtime? How can hospital clinics utilize farm produce without proper refrigeration and kitchen space?

Despite many hospital-based farms experiencing similar challenges, a formal system by which hospital-based farms could share experiences and build collaborations does not exist. Such a system could help hospital-based farms learn from one another and more effectively and efficiently serve their communities. Therefore, the overarching goal for this Master's Project is for students to develop systems to enhance knowledge sharing and collaboration among hospital-based farms. Such systems may include one or more of the following:

• Creation of a web- or video-based toolkit describing the program at The Farm at St. Joe's to help other institutions that are developing their own programs. The Farm receives numerous calls from such interested institutions, so this tool would allow for greater efficiency and effectiveness in responding to these requests.
• Updating of previously written review of farms in healthcare2 to include the many more programs that have been implemented since its publication in 2016, as well as thorough dissemination of the updated publication.
• Development of a formal network of hospital-based farms. Ideally, it would include mechanisms to structure continued knowledge sharing and collaboration.
• Organization of the first ever Farms in Healthcare conference. Nothing compares to bringing people together in one place to talk and learn together. This would hopefully continue as a regular event.
• Other creative ideas determined relevant through the students' research

Theoretical justification, social benefit, or significance

Hospital-based farms have a tremendous opportunity to positively impact staff and patients at their associated healthcare institution, as well as the greater community. They represent a much needed cultural shift in healthcare, from one focused on treating disease to one that promotes wellness. However, as described above, their impacts could be much greater if hospital-based farms came together to support one another in overcoming the novel challenges each is likely currently facing on its own.

This project would have long-term significance for the field of hospital-based farming, as well as for the present and future healthcare institutions and communities impacted by these farms. The development of innovative information-sharing tools, a professional network, and an annual conference would facilitate synergistic interactions among current hospital-based farms, as well as lower barriers that prevent potential future hospital-based farms from taking shape. With these new opportunities for support and collaboration, hospital-based farms would better meet their goals of improving the health and well being of those they serve.

Specific activities and duration

Specific student activities will depend on which specific projects students decide to undertake. Activities may include the following:

• Participant observation at The Farm at St. Joe's
• Interviews of staff at The Farm at St. Joe's
• Development of webinar, video, or other dynamic teaching tools
• Web-based investigation of hospital-based farms
• Interviews with staff at hospital-based farms identified through web-based investigation
• Development and dissemination of review of hospital-based farms
• Development of structures for ongoing knowledge sharing and collaboration
• Organization and implementation of first annual Farms in Healthcare conference

Integrative approach

This project requires collaboration among students with varied knowledge bases and skillsets and includes content related to agriculture, nutrition, environmental sustainability, healthcare, education, and social psychology. Students will need to develop and conduct interviews; analyze quantitative and qualitative data; develop effective evidence-based learning tools using relevant technology; utilize graphic design programs; create structures to guide and facilitate social networking; and/or organize a conference that meets the needs of participants, as indicated by their research.