Is this resilient farm-to-fork system a “proof of concept” for revolutionizing hospital nutrition?

An ambitious program launched by Chief Executive Santana Diaz at the University of California, Davis Medical Center in 2018 aimed to resolve one of healthcare’s most glaring contradictions – malnutrition which affects up to 50 percent of hospital patients worldwide. The farm-to-table chef planned to serve only healthy, organic foods sourced within 250 miles of the three Sacramento area hospitals, with a range of personalized menus for all diets, served around the clock for meet the culinary preferences of medical center staff, patients and visitors who collectively ate 6,500 meals per day.

At best, the program was doomed to be a challenge. By 2019, Diaz and his team had already implemented nearly 70% of the multi-billion dollar food program with local and sustainable sources. Then the pandemic struck.

On February 26, 2020, UC Davis had the first reported case of community spread of COVID-19. On March 3, I was at UC Davis Medical Center to interview Diaz and his team about their groundbreaking program as part of a larger movement to revolutionize hospital food nationwide. On March 13, the World Health Organization declared the outbreak a global pandemic.

Over the next 18 months, the UC Davis program would be modified and reconfigured, with multiple contingency plans to deal with everything from labor shortages, staff receiving additional time off, to challenges of getting foods such as infant formula shipped from other parts of the country. as freight slowed down. But the hospital’s produce, meat and dairy, all purchased under deals with local farms, continued as planned.

“When we launched our farm-to-hospital concept, we could never have anticipated a global pandemic,” Diaz said, “but the pandemic provided proof of concept.”

Unlike UC Davis’ program, the nation’s largest food wholesaler, Sysco Corp, recently turned away customers In certain regions. The CEO of the nation’s second largest food wholesaler, US Foods, has cautioned against the persistence of “headwinds in the supply chain”. The US Department of Agriculture says there is no nationwide food shortage and no widespread disruption has been reported in the supply chain. Yet, resilient small food supply chains have been much better able to adapt.

Our direct relationships with farmers and ranchers were not affected, and all was well.

“Through our efforts to locate our food supply, we had virtually none of the supply chain issues that other hospitals had. Our direct relationships with farmers and ranchers were not affected, and all was well. “said Diaz. That’s not to say the pandemic hasn’t introduced other challenges: the needs of hospital dining rooms literally changed overnight, as all staff-hosted events were canceled and visitors were dropped. completely prohibited from entering hospitals. Yet through it all, UC Davis’ product deliveries have come uninterrupted.

“Obviously we haven’t thought about a pandemic, why sourcing locally or within the state was a good thing,” Diaz said. “It just worked for us, and we know it hasn’t for other large-scale institutional-scale food programs.”

UC Davis has advantages that other hospitals do not; namely, the region is one of the largest agricultural centers in the United States. California has more than 77,500 farms covering 25.5 million acres of farmland and ranches, with 1.5 million acres of farms and ranches producing over 160 crops in the Sacramento area alone. Although not yet widely adopted in large industrial kitchens, the ‘farm to fork’ culture is so prevalent among restaurants and farmers’ markets that it is a cornerstone of the mission. Sacramento tourist office to promote the area.

Panorama Organic Grass-Fed Beef, a collective of 34 independent family ranchers in eight states and operating one million acres of protected land, supplied UC Davis with beef from family farms in California. (Panorama sold its meat division, but not the farm collective, to Perdue in May 2019, and now operates as an independent business under the umbrella of Perdue.)

We need to think about how these food distribution systems that we think are set in stone really are a house of cards.

Kay Cornelius, Panorama’s managing director and fourth-generation breeder, knows that small local farms are less efficient than large wholesalers. During the pandemic, however, this proved to be a saving grace for them and the communities they serve.

“In an effort to be efficient in these national supply chains, you don’t even have a face-to-face conversation with anyone anymore. You just type in what you want and they’ll get it there, ”says Cornelius. “It’s very effective, but it’s very fragile, because if everyone types the same thing all over the country, and you’re the one who’s bypassed, like a hospital, you don’t have any relationship to say, ‘Hey, I really need a little help here.’ “

“We’re building this little system that’s really resilient to the global supply network,” Cornelius said. “We’re only focused on supporting people within our communities and people in a certain region. It’s a really special thing, but it’s not easy. It takes creativity and fluidity. . “

Local farms, which have also struggled with labor shortages but still had crops in the lull between the spring 2020 restaurant closings and the intensification of California’s food aid programs during of the summer, have encountered similar challenges. Jim Durst, who directs Durst organic producers along with his wife, Deborah, is one of the farmers supplying tomatoes and other crops to UC Davis. A long-time advocate for overhauling institutional food systems and a board member of his local food bank, Durst hopes the success of the UC Davis program during the pandemic will prompt other hospitals to follow suit.

“It helps set the blueprint for the future, and maybe the pandemic was a little push to get there. A lot of institutions and even retail are now asking, ‘Where does our food come from? “,” Said Durst. “We have to think about how these food distribution systems that we think are set in stone are really a house of cards, because if anything, anything, in the supply chain gets bogged down or broken down. failure, the whole system fails. “

This system involves not only the food itself and the labor involved in cooking it once it arrives, but also the logistics of getting it from one place to another. It’s a process that also faces tremendous pressure, and not just because of the pandemic. The American Trucking Associations estimates that commercial trucking is short by 80,000 drivers, and to keep pace with increased consumer demand and an aging workforce, nearly one million new drivers will need to be hired. and trained over the next decade. Commercial drivers are exempt from COVID-19 vaccination warrants, which puts them at increased risk of contracting the disease and could make it even more difficult to meet demand.

During a November 3 congressional hearing on “The Immediate Challenges to Our Nation’s Food Supply Chain,” House Agriculture Committee Chairman David Scott (D-Georgia) said that the current shortage of truck drivers is a “barn burner of a crisis that’s waiting to happen.”

As UC Davis extended paid time off for all employees, Diaz found himself writing multiple contingency plans based on how many employees the department could have on a given day, and he had to adjust menu options. daily accordingly. To meet his staffing needs, Diaz was able to borrow culinary staff from the university – staff who would otherwise have been put on leave when the university closed its campuses. Even so, the team often needed to prepare food ahead of time, rather than having it prepared each morning as it had been. So even though the ingredients were local, the food wasn’t as fresh.

“We were entering the winter months [of 2020], six months of pushing the brakes and going back to pre-baked meatloaf and stuff, and it hurt to do that, but I didn’t have a crystal ball, ”Diaz says. “But when the staff realized the food was better before the pandemic, they started to create that demand to get back to a healthier, cleaner and more transparent food program as soon as possible. “

Panorama Organic Grass-Fed Beef, a collective of 34 independent family ranchers in 8 states and operating one million acres of protected land, supplied UC Davis with beef from family farms in California.

While not quite past the pandemic, UC Davis Medical Center is back to its pre-pandemic meal level. However, the event catering has not returned and it is unclear when it will be. The popular wok station, also closed for over a year. The self-serve salad station is gone for good. Diaz says it’s too risky. But a series of fresh, pre-made salads offered a variety wide enough that Diaz says people don’t seem to care. Yet it is ready to get back on track and gain momentum.

Diaz and his team are expanding the program, working with the Greater Sacramento School District, to provide locally sourced foods to students and teachers with the goal of teaching healthy eating and preventing people from needing. to go to the hospital in the first place.

He’s working on a plan to get other UC Davis medical centers to embrace his farm-to-fork program, advising other hospital chief executives and developing a sodium-free seasoning line for them. special diets. He also continues to roll out UC Davis offerings as quickly as possible.

In February, UC Davis Medical Center announced a $ 3.75 billion expansion plan, and Diaz expects the food program to more than double the number of people within a few years. that it serves.

“As the hospital grows, the more important this program will become,” says Diaz. “If we can reach young people, in school or in other areas of their lives, and teach them to eat healthy, maybe we can help some of them to no longer need to be hospitalized. “