Kaiser Permanente

Diversity is a Core Value at Kaiser Permanente

Kaiser Permanente is America's largest not-for-profit health care organization, serving 8.1 million members in 9 states and the District of Columbia. An integrated health delivery system, Kaiser Permanente organizes, provides, and coordinates members' care, including preventive care such as well-baby and prenatal care, immunizations, screening diagnostics, hospital and medical services, and pharmaceutical services.

Diversity at Kaiser Permanente is a core value that goes back to its origins. Founder Henry J. Kaiser integrated a diverse workforce in his company’s construction and shipbuilding projects in California and Washington. In providing health care to his employees, Kaiser was on the path that would lead to the creation of a health care organization.

During World War II, Kaiser Permanente health plan membership grew rapidly. In 1945, it was offered to the general public. The organization soon found itself blazing trails, particularly regarding equal opportunity in health care. Despite prevailing segregationist attitudes, the Kaiser Permanente plan had provided care in integrated facilities since the days of the shipyards. However, as the organization started to grow during the 1950’s there was increasing pressure from the medical establishment to do as others were doing—segregate patients. But, Kaiser didn’t believe this was an ethical or a practical way of doing business and he chose to buck the tide. Kaiser believed in hiring the best person for the job, regardless of race, gender, or national origin. Though highly unusual for the 1940’s, Kaiser Permanente employed a Chinese immigrant as chief of pediatrics, who was also a woman. Soon after, an African-American physician was hired.

The emphasis on equal opportunity continued with leaders like R.J. Erickson. Serving as general counsel to the Kaiser Permenente Program, and primarily responsible for the federal employees health benefits program, he was an unwavering advocate and a champion of diversity. His former colleague Ronald Knox, Vice President of Diversity at Kaiser Permanente, says, “[Erickson] was adamant that the organization remain true to its original values of equity and fairness. He was hired early on and worked here for 37 years, and he was always consistent in his reiteration of those values.” In describing the history of diversity at the organization Knox explains, “Today, about 51 percent our total workforce consists of people of color and about 76 percent are women.” The organization “continues to compete aggressively for the existing physicians and other caregivers of color.” However, the pool of minority physicians and nurses is relatively small in comparison to their white counterparts. This disparity is a continuing issue in health care, particularly in communities where language issues are involved. Approximately 5 percent of all physicians in the U.S. are Hispanic with a smaller percentage being bilingual. One of the ways Kaiser Permanente tries to address the gap is to increase the cultural competence of their entire workforce. Another is to increase the pool of minority students entering the sciences.

Radically shifting demographics intensify the need to find new ways to provide culturally competent care, Knox explains, citing Latinos as an example. “In 2001, 49 percent of all live births in California were Latino. Last year that rose to 52 percent. Add to that, the factor of documented and undocumented immigration, that bolsters these numbers. Population demographics are changing, and there is no question that any business that is going to be successful is going to have to have knowledge and expertise on how to best serve this particular population segment.”

Immigrants have their own cultural belief systems, values, and traditions. Some will prefer to communicate in their native language. This can create barriers and affect diagnosis and treatment. Knox agrees. “These factors need to be addressed, especially in organizations dealing with health care, one of the most personal of services. What goes along with [the acknowledgement of] that is having the cultural expertise to create an environment in which people feel comfortable, welcomed, and where their culture is respected. At the same time that also will enable a company to grow its business within that population segment,” says Knox, who adds, “At Kaiser Permanente the resource of cultural expertise is resident in our existing workforce, an advantage many others do not have.”

Multicultural/Staff Associations and Diversity Resources

To increase and disseminate awareness and knowledge of different cultures, Kaiser Permanente has developed a variety of innovative methods and a network of diversity resources, primarily utilizing the expertise of their Multicultural/ Staff Associations and KP minority professionals, who are supported in a variety of ways. Also, the Institute for Culturally Competent Care and the Centers of Excellence in Culturally Competent Care identify, support, and develop effective approaches to the health care delivery system for specific populations. An extensive National Diversity Agenda, an intranet diversity web site, a diversity library, and linguistic and cultural programs are other important elements of Kaiser Permanente diversity programs.

Formed largely on a volunteer basis, Multicultural/Staff Associations have successfully advanced diversity initiatives and strengthened the organization’s ties with the communities they serve while Diversity Councils have been instrumental in the implementation of key components of the National and Regional Diversity Agendas. Multicultural/Staff Associations are recognized as a critical part of the organization’s diversity infrastructure and cultural expertise. There are 21 Multicultural/Staff Associations located in different regions throughout the country. These affinity groups are identified typically by race and ethnicity, and several are formed along the basis of sexual orientation.

Multicultural/Staff Associations are Kaiser’s primary linkages to the community and a primary source of cultural expertise. These associations provide expert, culturally specific feedback to physician and administrative leadership on health issues directly affecting the community. They are also used to inform the development of products, services, and marketing strategies to make sure that they are culturally sensitive and appropriate. In addition, Multicultural/Staff Associations are resources for recruitment and retention for employees and the Kaiser Permanente membership community. Some other activities include community fundraisers and walk-a-thons, health fairs, inoculation programs, giveaways, serving on community boards, local and national professional organizations and associations, and participation in national conventions. The associations also contribute to the national handbooks and training resources for Kaiser health providers.

For employees, Multicultural/Staff Associations advocate for programs and approaches that increase the recruitment, hiring, development, and promotion of diverse employees. They also promote and enhance the professional development and networking opportunities for diverse employee groups. For students, the associations help to create pipeline programs often partnering with human resources to sponsor mentorship programs, scholarship programs, Youth Career Days, and School-to-Work activities and programs.

There are three Kaiser Permanente Latino Associations (KPLA’s) spearheading broad-reaching efforts in the large Latino communities of California and Colorado. Over 350 staff members are involved. One of the ways KPLA reaches out is by bringing high quality health care to local communities during annual health fairs. An important public service, since it may be the only opportunity that the uninsured will have to receive care during the year. Like other Multicultural/Staff associations, KPLA, Colorado also gives out several scholarships and participates in several youth outreach programs including summer jobs, internships, school visits, and student excursions to KP hospitals in an effort to interest them in the health care field. Pat Chavez is supervisor of the KP Language Resource Center and President of KPLA, Colorado. Says Chavez, “Our Multicultural/Staff Association community events are so important because they get the word out, especially to youth. We need to get them interested in health care. KP Kids at Work is another type of program. It’s for Kaiser employees with high school kids. We try to get them a summer job here; they get training while earning money. One of our employees here in the Language Resource Center had a kid who came to work with us. He was bilingual, and he took the Language Proficiency Assessment and passed! He was very professional, and he turned out to be a great interpreter. He earned our certificate and is returning again this summer. When he graduates from high school, if he wants to come back, we can help him with college and groom him into a great position. Inroads is another terrific national program for college students in their freshman year; they work for us while they are in school, and they earn salary and school credit.”

At the Language Resource Center, Chavez is also the lead interpreter providing language assistance resources for KP staff and medical information and customer service for all non-English speaking members. The award-winning department also helps create patient information pamphlets, handbooks, and other products. They have also designed a Language Proficiency Assessment, creating a qualitative standard for people with the ability to speak other languages. Chavez clearly enjoys her work. “Kaiser Permanente has great training programs and really take care of their employees. I have been here for 31 years. I grew up professionally here. I am really proud to say where I work and to wear my badge over to the supermarket. My managers here have so much trust in me. They have supported me and promoted me.”

Director of National Workforce Diversity, Andrea Ford Roberts says that Kaiser Permanente is hiring in many different areas, not only doctors and nurses. Job openings include physical therapy, occupational therapy, tech positions, imaging, pharmacy, accounting, and health care management positions. “In many cases, if you are bilingual and bicultural that is a real plus.”

For more information, go to www.kaiserpermanente.org