Here's a paradox. Natividad Medical Center sits in the midst of California's bountiful Salinas Valley, generally referred to as America's “salad bowl” for its bounty of fresh produce. Yet, a few years ago, the medical center faced a crisis as its employee and patient base struggled with the ill effects of rampant obesity and diabetes, all traced in large measure to unhealthy eating habits (in fact, three-quarters of Natividad patients are diabetic or prediabetic).
Natividad is a 172-bed county owned and operated acute care teaching facility in Salinas, one of 19 California Safety Net hospitals that primarily serve un- and underinsured populations.
“We saw this as a call to action to increase access to fresh and local produce in an aesthetically pleasing environment,” says Foodservice Director Cori Thomas.
The department started by revamping the patient and cafeteria menus, incorporating organic produce and fresh (as opposed to canned or frozen) ingredients. Employee surveys were used to ferret out particular likes and dislikes. The result was far fewer fried foods (in fact, the fryers now only fire up once a week, for the “unavoidable” fried chicken day, but all French fries are now baked). There is also a much greater emphasis on a variety of ethnic choices (“The employee base here is very diverse,” Thomas notes).
Thomas also hired a bone fide chef, Bernard Merilos. A veteran of the local restaurant scene, Merilos was near retirement and was looking for a position with a less hectic schedule than the commercial foodservice world, and one closer to his home.
Nutritional information was posted for the different selections to allow customers to make informed choices. And for those who couldn't get to the cafeteria, vending machines with fresh food were placed throughout the facility, complete with green tabs next to the items deemed more healthful.
The menu began incorporating unfamiliar selections — lentil salads, for instance — but they were successful because of careful groundwork. “If you can get people to taste things, to at least sample them, then you can often get them to eat them,” Thomas says. Sales of salads — lentil and otherwise — began to grow.
It was a start but proved inadequate. What was needed was an improved environment. The department secured a limited but workable $350,000 for this project in late 2009 and began work in early 2010. It partnered with local grower and organic produce giant Earthbound Farm for a grant, as well as with local artists, designers, contractors and the hospital's foundation.
The goal of the design team was to convey the idea of access to fresh and local produce, so the new cafeteria was named the Farmers Market. Its color scheme of natural earth tones and its floor pattern were all reflective of the growing fields so close by. Abundant photos of fruits and vegetables add to the subliminal mantra: “eat fresh.”
Meanwhile, the healthy choices on the menu continued to expand, both in number and popularity. Items like salads incorporating fruit (strawberries, for example), crab salad with avocado, a grilled chicken Caesar salad and even a long grain wild rice salad with squash and tofu were introduced and accepted. One particular favorite: a Cajun turkey and melon salad with cantaloupe or honeydew.
“Usually, items with lots of color do well,” Thomas suggests. “So do dishes in which the ingredients are shown to have come from our farmers market” (the market debuted this past March and will operate once a week year-round). Thomas is even experimenting with menuing exotic items like quinoa.
What else? There are fresh fruit smoothies, lots of pasta primavera, fresh herbed tomatoes, roasted vegetables and pizza with fresh vegetables instead of meat.
Each of the vegetable-heavy items are also incorporated on the patient menu. Instead of nutritional data, the cafe posts Weight Watchers points, an easier-to-grasp metric that the customers seem to prefer. It all seems to be working, too, as employee satisfaction with the dining has been around 95 percent (before the changes, it was as low as 70).