August 29, 2014

Healing starts with communication

Kaiser Permanente began to reduce the language barrier in health care with language classes for staff members as early as 1977.

Spanish medical communication instructor Miriam Amor in class, 1974.

Kaiser Permanente has long been a health care innovator. The KP health plan, which served an ethnically diverse population as far back as the WWII shipyards, has always been aware of the need for what is now called “culturally competent care.”

The article “Clases de Espanol en Santa Clara” in the November 1, 1974 employee newsletter KP Reporter described one such program:

"La medicina que estoy tomando para mi condicion no me esta ayudando," says the woman to a pharmacist. "Que es la resulta de mis rayos equis?" asks a patient of a technician. "No me siento muy bien, me siento enfermo," a child tells a receptionist.

Do you know what these people are saying? "The medicine I am taking for my stomach condition is not helping"; "What is the result of my X-ray?"; "I am not feeling well, I feel ill."

These and many more equally important me ages are spoken daily by Spanish-speaking Health Plan members at the Santa Clara Medical Center. Many Mexican Americans who are multilingual may still be unable to express or understand a crucial medical word or phrase. This can be annoying and time consuming to employee but dangerous to an anxious patient.

Communicative Spanish for Medical Personnel, Spanish 50, is the KP Department of Education and Training's attempt to help the staff communicate in Spanish taught by Mrs. Miriam Amor of West Valley College. It is one of six college-credit courses being offered this semester at Santa Clara by the Department of Education and Training under Lorraine Brobst.

Ms. Brobst observed: "Almost every department that comes in contact with patients has someone in the class — Reception, Central Appointment, and this department, as well as Nursing, a psychologist and a doctor."

Southern California’s KP facilities needed multilingual services as well. A 1975 issue of their member newsletter Planning for Health describes a similar commitment to language training:

Off-duty employees at Bellflower Medical Center are taking part in a beginning Spanish conversation course in order to improve communication with Spanish-speaking patients. According to Robert Essink, assistant hospital administrator, "Accessibility of care can be improved by better communication. The purpose of the course is to develop a basic understanding of conversational Spanish, with emphasis on medical phrases."

In addition to the language class, emphasis is on placing Spanish-speaking personnel at key patient contact positions throughout the medical center, and providing Spanish language instructional and procedural signs.

In the current epoch, Federal law — and common sense — requires that patients with limited English proficiency have access to linguistic services at each point of contact in a health care system. To address that challenge, Kaiser Permanente established a “Qualified Bilingual Staff Model” that identifies bilingual staff members of all types (including doctors, nurses, medical assistants, and receptionists), assesses their language skills, and provides them with comprehensive training based on their level of linguistic competency.

As of 2014, over 11,400 staff members in all seven KP regions have trained in the award-winning program (among other kudos, in 2005 it won the Recognizing Innovation in Multicultural Health Care Award from the National Committee for Quality Assurance and was the core program noted in Kaiser Permanente’s 2013 Corporate Leadership Award from the Migration Policy Institute).

Clear communication about health care is a crucial first step toward a successful outcome — and a challenge taken seriously by Kaiser Permanente from its inception.