Posts Tagged ‘total health’

Old Oakland hospital holds memories of Kaiser Permanente’s dynamic past

posted on June 20, 2014

Rebuilt Oakland Medical Center
to open for business July 1

This is a view of the old Fabiola maternity wing that was to become Kaiser Permanente's first Oakland hospital.

This is a view of the old Fabiola charity hospital’s maternity wing, built in 1923. This structure was transformed into Kaiser Permanente’s first Oakland hospital, opened in 1942.

By Ginny McPartland
Heritage writer

If the walls of Kaiser Permanente’s soon-to-be-replaced Oakland Medical Center could talk, they would tell an epic story with many dramatic chapters.

The structure – cobbled together with many additions over seven decades – might channel the spirit of the Victorian-era nurses who tended to the sick and injured at the Fabiola charity hospital that sat near the corner of MacArthur Boulevard and Broadway from 1887 to 1932.

The first Kaiser Permanente Foundation Hospital, which opened in Oakland in 1942, might also reverberate with the heart-wrenching tales of injured World War II Kaiser Richmond shipyard workers whose lives were saved in a refurbished wing of the old Fabiola hospital.

For 40-plus years, the medical facility radiated with the passion of a wiry, red-headed, daring and dashing surgeon who teamed up with larger-then-life industrialist Henry J. Kaiser to set up an innovative, prepaid health plan, first for Kaiser’s workers and then for the public.

Physician founder Sidney Garfield’s ideas were incorporated into the design of the original Fabiola hospital refurbishing; in fact, over the next two decades he would play an integral role in designing most Kaiser Permanente facilities.

For his part, Henry Kaiser made sure the care Kaiser Permanente delivered was color-blind; the health plan embraced all people, despite the fact other hospitals in the Bay Area were segregated.

View of the maternity ward at Oakland hospital 1945.

View of the maternity ward at the old Oakland hospital in the early days.

Kaiser Permanente pioneer Avram Yedidia tells a memorable story about several local policemen who visited the Oakland Medical Center in 1946 with an eye to join the Health Plan. Yedidia recalls in his UC Berkeley Bancroft Library 1985 oral history:

“. . . The police chief said to me, ‘You know, when we walked through, I saw that you had some Negroes and whites in the same room. I don’t think we like that.’

“As I can recall, I responded, ‘Do you know this plan started that way, with blacks and whites in the shipyards, and that’s the way it goes. They worked together, and they were sick together.’ ” Yedidia told the police chief: ‘Those who don’t like it shouldn’t join the plan.’ ”

Phenomenal growth and change in 70 years

The seed Garfield and Kaiser planted in the war years has grown exponentially into Kaiser Permanente as we know it, with 9.3 million members and its significant presence in the national health care landscape of today.

Sidney Garfield, just 36 years old when he and Kaiser opened the hospital, had a vision for preventive care and total health for Health Plan members – a vision that played out in many ways in Oakland.

After the war ended in 1945, Dr. Garfield focused on improving the health plan’s quality by creating educational opportunities for physicians and nurses, encouraging research, and setting up ways members could learn how to stay healthy.

Avram Yeddia on the day he retired.

Avram Yedidia, Kaiser Permanente health plan pioneer and consulting economist, on the day he retired in 1982.

In 1947, Henry Kaiser and his wife, Beth, established the Kaiser Foundation School of Nursing and soon the halls of the medical center – expanded by then to 230 beds – were bustling with white-capped student nurses and their strict mentors, all clad in crisp white uniforms and sensible shoes.

Among their leaders was the legendary Dorothea Daniels, who set Kaiser Permanente’s high nursing standards in the early years.

Computer age begins

The Oakland Medical Center also witnessed the queuing up of burly, yet well-dressed longshoremen and other Health Plan members who followed the hospital’s version of the “yellow brick road”, a color-coded tape path that led them through the facility to stations where various tests were performed.

Initially called the “Multiphasic,” these screening tests marked the beginning of Kaiser Permanente’s pioneering work in automated laboratory testing and compilation of electronic medical records, and the Health Plan’s foray into the use of computers in the 1960s.

In 1965, the Oakland Medical Center opened its first specialized cardiac care unit with physicians and nurses trained to use the latest heart monitoring equipment to care for patients.

Nurses use monitoring system in cardiac care unit, circa 1965

Nurses use monitoring system in cardiac care unit, circa 1965

In 1970, physicians in Oakland began a progressive nurse practitioner certification program; specially trained nurses were assigned to see patients who needed routine primary care but didn’t need to see a physician unless a problem emerged.

In 1972, the 12-story hospital tower, which was built on top of the wartime structure, was opened. That extra space allowed Garfield to open Kaiser Permanente’s first Health Education Center, the precursor to today’s healthy living centers.

The Oakland patient education facility was stocked with books, pamphlets, films and tapes that patients could borrow to learn how to prevent and manage chronic illness.

In 1980, new radiology services, including ultrasound and CAT scans, opened on the Oakland campus. In subsequent years, hospital officials established a pediatric intensive care unit and new Magnetic Resonance Imaging and Lithotripsy centers on the Oakland campus.

Garfield separates the well from the sick

In 1981, Garfield was instrumental in the opening of a new primary care center, which was part of his mission to encourage members to take measures to stay healthy and avoid chronic disease, such as diabetes, heart problems and cancer.

Sidney Garfield, MD, Permanente founding physician, walking the walk in Mojave Desert near site of Contractors General Hospital, 1980

Sidney Garfield, MD, Kaiser Permanente founding physician, walking the walk in the Mojave Desert near the site of the first hospital he built, Contractors General Hospital, in 1933. Kaiser Permanente photo, 1980

Sadly, in 1984, Garfield died while still working on his “Total Health” research project. His colleagues finished his endeavor, whose results laid the foundation for the organization’s focus on Total Health that continues today.

The hospital tower that allowed Total Health to spread its wings in the 1970s was doomed in 1994 when the state of California passed seismic safety legislation that required a retrofit of the Oakland main hospital building.

Kaiser Permanente officials decided to replace the hospital with the new Oakland Medical Center across MacArthur Boulevard from the original 1972-built tower. The new Medical Specialty Office Building facing MacArthur opened in January: the new Oakland Medical Center will open on July 1.

Garfield’s Total Health philosophy can still be seen in ways great and small at the Oakland Medical Center, right down to a weekly farmers’ market – founded in 2003 – that served as a template for 50 such markets that operate in communities across the nation today. As the historic structure is abandoned and its memories fade, the passion of its original architect will live on.

Garfield summed up his philosophy of Total Health: “Remember, good health is a way to get more out of your life – more energy, more enjoyment, more potential, more purpose, more life.”

 
Photo history of the Oakland hospital

 

 

 

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Celebrated farmer urges Kaiser Permanente doctors to further healthy food traditions

posted on April 5, 2011

By Grace Emery

Heritage correspondent*

Joel Salatin, celebrity farmer. Photo by Rachel Salatin.

When I heard that famed farmer Joel Salatin had come to Oakland to speak with Kaiser Permanente (KP) doctors, I felt like this event almost constituted a brush with celebrity. I wrote my senior thesis on food movements in the Bay Area, and my longtime interest in food politics had introduced me to Salatin and his work to bring sustainable food to America’s tables.** While some may be puzzled at the idea of a “famous farmer,” I leapt at the chance to write about a veritable hero of the food politics world, and I was anxious to learn more about where KP doctors and Salatin crossed paths.

Thanks in part to Michael Pollan’s discussion of Salatin in “The Omnivore’s Dilemma” and his appearance in the 2008 popular documentary “Food Inc.,” Salatin has become a renowned advocate of sustainable food and farming, and somewhat of an icon in the healthy food movement.

During his visit, Salatin, who raises beef, pork, and poultry at his Virginia family farm, Polyface Inc., spoke of the challenges small farmers face at the intersection of healthy food and politics. Locally grown food is often healthier and more sustainable, but small farmers struggle when selling their products to large institutions, preventing the large-scale adoption of a local food system.

Salatin started his visit with a stop at the birthplace of local food sales—the farmers market. Preston Maring, MD, a KP physician in Oakland, Calif., founded the first Kaiser Permanente farmers market at the Oakland Medical Center in 2003, and today there are more than 35 KP farmers markets in several regions, demonstrating Kaiser Permanente’s commitment to total health through nutrition.

After a visit to the market, Salatin spoke to a group of KP physicians on the topic of “Local Food to the Rescue.” His message served to both validate the work Kaiser Permanente farmers markets and hospital cafeterias are already doing, and to inspire Kaiser Permanente officials to supply hospitals with even more locally sourced food.

History of healthy eating

Kaiser urged wartime shipyard workers to eat healthy, even grow their own vegetables, as this 2009 poster illustrates. Design by Pam Zachary, KP Multimedia Department.

Kaiser Permanente has long focused on the link between healthy eating and prevention. Before Kaiser Permanente was synonymous with health care, war workers flocked from all parts of the U.S. to Richmond and Oakland, Calif., where they helped to build ships in the Kaiser Shipyards during WWII. Henry Kaiser quickly realized that to build ships at a fast pace his workers had to be healthy and strong, and that meant they needed to eat nutritious foods. He saw that well-nourished workers translated into less absenteeism, more productivity, and happier employees.

In a 1943 memo written by Cecil Cutting, MD, a founding Permanente physician, there is a clear emphasis on the importance of nutrition. With healthier meals, Cutting hoped to “bring about greater vitality, greater psychological effect and consequently increased productivity.”

In “Ships for Victory, author and historian Frederic Lane discusses the Maritime Commission’s initiative to improve in-plant feeding at America’s shipyards in 1943. Many shipyards received additional funds to provide more hot meals and make sure workers had access to healthy food in the workplace. In the Kaiser Shipyards on the West Coast the emphasis on good nutrition even spilled over into the Kaiser-run child care centers where children were fed three square meals, and mothers could pick up prepared meals when they collected their children at the end of the work day.

After the war when Kaiser established a health plan open to the public, nutrition and prevention were among the core principles. “Kaiser health planners supported concepts of holistic preventive care,” writes Rickey Hendricks in “A Model of National Health Care: The History of Kaiser Permanente.”

A focus on healthy food comes to Kaiser Permanente hospitals

Nutrition education was big in the WWII Kaiser shipyards, as highlighted in this poster created in 2009. Design by Pam Zachary, KP Multimedia Department.

A 1972 article from the publication “Institutions/Volume Feeding” highlights Kaiser Permanente hospitals’ progressive commitment to providing patient meals with higher nutrition at a lower cost.  Hospital dieticians were consulted so that every meal had optimal nutrition and calorie content for a patient’s needs. Kaiser Permanente even began to serve meals with an accompanying pamphlet that explained the nutrition information of the meal so that patients could “begin to learn more about the foods that they eat” while in the hospital.

Quality nutrition was at the center of meal planning, and administration felt that when it came to cost “it was of the utmost importance to separate patient feeding from other food-service activities necessary in a hospital.” While the development of an efficient system came about slowly, Kaiser Permanente never strayed from a focus on the healing power of healthy meals.

Oakland: an epicenter of progressive food movements

In my thesis research on the bay area, I was surprised to find that the city of Oakland has also long been a center of progressive food movements. In the 1970s, the Black Panther Party provided a free breakfast program and other “people’s community survival programs” in Oakland, serving residents hot meals with a side of political activism.

The effort of the Black Panther Party members to address hunger in their community was seen as revolutionary and empowering. Soup kitchens and free breakfast programs drew attention to the fact that the local food system was not currently meeting the needs of the West Oakland community. In “A Panther is a Black Cat,” (1971) author Reginald Majors explains that rather than wait on city officials, residents intended to subvert the power dynamic of the community by taking matters in to their own hands.

The free breakfast program for school children went hand in hand with revolutionary ideals and food became an expression of political power. Majors explains, “The Panthers would be betraying their own beliefs by not pushing a little political orientation along with the grits, bacon, and eggs” they dispensed each morning.

Today there are several West Oakland farmers markets in action that echo these themes of racial empowerment. My thesis focused on several of these markets, like “Mo Better Foods” and “Phat Beets Produce,” which provide both locally grown food and social empowerment within a community many residents believe to be historically disenfranchised.

Kaiser Permanente’s continued progress and inspiration

Given Kaiser Permanente’s nutritional history coupled with Oakland’s revolutionary food movement past, Joel Salatin could not have delivered his somewhat radical message to a better group in a better location. Kaiser Permanente initially focused on healthy food in hospitals, and then on bringing local, sustainable food to the community through the Kaiser Permanente farmers markets in Oakland.

What follows logically is a bridging of those two ideals: bring even more local and sustainable food in to hospital meals. Kaiser Permanente hospitals already bring in over 600 pounds per week of sustainably grown vegetables on patient entrée plates at 21 Northern California Kaiser Permanente Hospitals, and Salatin hopes his talk will encourage them to expand that trend and do even more. When he visited Oakland in January, Salatin said:

“The idea of bringing local food right into the façade of a hospital — there couldn’t be a better match. . . If anyone should lead the way in bringing this nutrient-dense food, food that heals people, heals the soil, heals communities, it should be the hospital. Every sphere of its existence should be healing.”

*Grace Emery is an intern with Kaiser Permanente Heritage Resources. She is a graduate of Whitman College in Walla Walla, WA, and is pursuing a career in public health.

**Grace Emery, “‘Feeding Ourselves’: Power and Participation in West Oakland Food Movements.” Senior Political Science thesis for Whitman College. Winner of the 2010 Whitman College Robert Fluno Award for Best Politics Thesis.

For more about Joel Salatin’s visit to Oakland Kaiser Permanente, http://xnet.kp.org/newscenter/aboutkp/green/stories/2011/021511joelsalatin.html

To learn more about Kaiser Permanente’s green programs:

http://xnet.kp.org/newscenter/aboutkp/green/factsheets/healthyfood.html

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