Califonia Bountiful

Diagnosis: Delicious

March/April 2020 California Bountiful magazine

Chef works to elevate hospital food

Santana Diaz, executive chef for UC Davis Health, displays a celebratory meal for new parents. Menus feature local ingredients and change with the seasons. Photo: © 2020 Manny Cristostomo

Rarely, when someone asks what you want for dinner, is the answer "hospital food."

The stigma of visually bland, drab-tasting meals on plastic trays may be prolific, but Santana Diaz—the executive chef for UC Davis Health—is working to change the preconceptions surrounding hospital food and help heal patients through locally grown ingredients.

Diaz is breaking the stigma of hospital meals, bringing farm-to-fork style and ingredients to those who may need it most, serving entrées like braised beef short ribs. Photo: © 2020 Manny Cristostomo

A farm-to-kitchen journey

Going back generations, Diaz's family has raised cattle and hogs, but his path to feeding people led him to working in the kitchen rather than on the farm. He began his culinary career as a busboy at a small Marysville restaurant. Through college, he worked at the front of the house, gaining valuable customer insight that he used when he began cooking professionally.

Moving to the Bay Area, he guided hotel and department store kitchens in high-volume fine dining before launching farm-to-fork fare for the new San Francisco 49ers' Levi's Stadium. One stadium led to another and back home, to Sacramento, where he opened the Golden 1 Center, with 90% of ingredients originating from the surrounding 150 miles.

When he was offered the chance to open a third stadium in Southern California, Diaz went in a different direction.

"I wanted to help have a bigger impact in the food world I've grown up in for the last 25 years," he said, "and what better place than where you're trying to heal people through food?"

For a decade, the academic health system UC Davis Health has been working to bring less processed and more local and sustainable food to the staff, visitors and patients of the UC Davis Medical Center. These efforts have been focused most recently under their R.E.A.L. food-service program, which stands for responsible food procurement, education, active community engagement and less waste.

"Teamwork makes the dream work" is one of Diaz's favorite mantras. His team, including Daniella Xiong, serves roughly 6,700 meals a day. Nearly 1,500 of those meals are served to patients in their rooms. Photo: © 2020 Manny Cristostomo

Rising to the challenge

However, scaling a farm-to-fork ethos to an institutional food-production scale poses logistical challenges—primarily labor and cost. They're the kind of obstacles Diaz faced and overcame in his work with the stadiums—except hospitals, unlike sports, don't have an offseason.

"This is a very significant food operation in our city—a 365-day, 24/7 operation that never closes," Diaz said.

The teaching hospital serves roughly 6,700 meals a day, with close to 1,500 meals being served to patients in their rooms. The remainder nourish visitors and staff through in-house catering and three cafés for an average of 2.4 million meals served per year.

Diaz realized numbers like that can have quite an impact on the region's producers and community. But to refresh the menus and combat the stigma of hospital food with dishes such as Cajun trout and chilled rice salad, Diaz would have to rely on a bolstered team, education and the decade-long relationships he's formed with farmers and ranchers during his career.

By engaging his Food and Nutrition Services team of employees through opportunities and education—such as learning how to clean and cut a whole salmon into portions—Diaz finds they embrace the art and benefits of making something from scratch.

"Taking what we can out of worldly cuisine and applying our local bounty to it is a phenomenal opportunity to showcase what's available," Diaz said. "Everyone is seeing the value and really taking pride in what is going on."

Nearly half of UC Davis Medical Center's food purchasing budget is spent on local products. For example, fresh fish and caviar, provided by nearby Passmore Ranch, provide the foundation for Diaz's seared sturgeon¬†entrée. Photo: © 2020 Manny Cristostomo

Redefining comfort food

However, UC Davis Health has one challenge many large venues do not. The most important diners—the patients—are ill.

"In the hospital, nutrition is critical for healing," said Sky Baucom-Slavin, registered dietitian and patient services manager for UC Davis Health. "They're just very ill, and that increases the body's need for calories, protein, vitamins and minerals to help with the healing process, and that comes from food."

Baucom-Slavin noted that in addition to patients wanting familiar comfort food when not feeling well, many patients have little appetite or are nauseous. Others may be on one of 38 special diets, including low-sodium and low-fat, spice restrictions, or meals fit for the most finicky patients of all—kids.

For pediatric patients, Diaz plans to swap out processed chicken nuggets this spring for house-made nuggets from an air fryer. He doesn't see the goal as eliminating the proverbial chips and soda. Instead, he seeks to offer and educate people on alternatives, such as bubbly water or beet chips.

Prior to Diaz coming on board in 2017, Baucom-Slavin said the approach was to design a menu around the most restrictive diets and deliver those dishes to most everyone. Now, she's seen small changes having a big impact.

"We've replaced all our frozen vegetables, with the exception of corn, with fresh vegetables," Baucom-Slavin said. "The quality is naturally enhanced, just by making that change."

Baucom-Slavin also credits Diaz with a gift for building flavor into a dish and thinking about the whole plate, down to the garnish.

"We eat with our eyes," Baucom-Slavin said. "That's important."

Diaz pauses amid the flurry of activity in one of three cafés at UC Davis Medical Center. In all, his team serves about 2.4 million meals a year. Photo: © 2020 Manny Cristostomo

Healthy roots

None of it would be possible, Diaz said, without the relationships he's built.

"The reality is, with our regional farmers here, we're blessed to be in California," Diaz said. "I've been on almost every farm and every ranch that we're ordering from. So when we're ordering from these places, we know they have good food practices."

When Diaz began, he focused on local seafood and produce procurement, boosting the share of the hospital's food purchasing budget spent on local products from 16% to nearly 50%—with more than 70% of produce now coming from local sources.

Working directly with the farmer benefits both. Recently, preparing for winter, Diaz pulled hospital data on how many pounds of butternut squash the kitchen went through in the previous years, broke that down by week and asked his farmers and produce distribution company if they could deliver the quantities needed, appropriately spaced throughout the season. They could—and did.

When a farm ends up with excess product, UC Davis Health offers a venue that can provide relief—finding, for example, a use for a farm's oversupply of mandarins one year.

"That was almost 4,000 pounds of mandarins, and we were able to take that off their hands and move it because our volume is huge," Diaz said.

When Diaz's rice farmer took on the task of growing 60,000 pounds of black beans annually for the hospital, Diaz says other local chefs got wind of the new crop and reached out to see if the farmer could do a little more for their restaurants.

Through these organically developing relationships, multiple eateries are able to provide fresh, local products and a farmer can expand offerings in coming seasons, safely assured of a guaranteed buyer.

Ultimately, Diaz hopes people see UC Davis Health's efforts as an adoptable approach, encouraging other hospitals and large institutions to work closely with regional farmers and ranchers for the betterment of their clients and the community.

That becomes more likely as the program gains national attention. The health system was recently recognized on the Good Food 100 Restaurants list for 2019, the first and only health system in the nation to earn that distinction.

"We're just using clean food as a way of providing medicine to our patients," Diaz said.

For who doesn't want the proverbial bowl of chicken soup when they're sick—freshly prepared with local chicken and vegetables, of course.

Matt Craggs

Michael Passmore is one of many local farmers and ranchers providing ingredients for the hospital's menus. Photo by Micah Albert/courtesy of Passmore Ranch

Fish fit for fine dining

UC Davis Health is the only hospital program in the nation named as a Smart Catch Leader by the James Beard Foundation.

"Our procurement of fish and seafood being responsibly sourced and sustainable to the environment, these are important things to UC Davis Health," said Santana Diaz, executive chef of UC Davis Health.

Diaz said accolades such as these, and the entire teaching hospital's farm-to-fork program, wouldn't be possible without the chef's longtime relationships with local farmers and ranchers, such as Michael Passmore, founder of Passmore Ranch.

Located in Sacramento County, Passmore Ranch raises and provides fresh fish and caviar for chefs, specializing in white sturgeon, steelhead trout, catfish, silver carp, and black and striped bass. The farm also recently launched a commercially available line of caviar.

"This is the same fish that's being served in The French Laundry, some of the finest restaurants in the country, and Santana and UC Davis Health have made it a priority to put that level of quality and nutrition on their plates," Passmore said.

By working together, the hospital and the ranch both benefit, and nutritious foods reach those whose meals may need it the most.

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