, Heritage writer
Falls Prevention Awareness Week starts September 22. This 1942 cartoon from the Kaiser Richmond shipyard newspaper Fore ’n’ Aft illustrated remarks from Secretary of the Navy Frank Knox about industrial accidents on the World War II home front. “We have no time to train replacement workers… We cannot afford to permit accidents to encroach upon that bare minimum of time.”
Falls were among the largest contributors to shipyard accidents, which overall accounted for approximately 5 percent of employee absenteeism. But campaigns around safety education and rule enforcement made a difference – the frequency and severity of accidental injuries dropped 50% from 1941 to 1942, an improvement unsurpassed by any major industry in the United States.
These days, Kaiser Permanente still seeks to reduce fall-related injuries, for both employees and patients.
An injury-free workplace is an essential ingredient of high-quality, affordable patient care. Kaiser Permanente has set the goal of eliminating all causes of work-related injuries and illnesses. “Slip, trip, and fall” prevention is part of a comprehensive workplace safety strategy, designed to keep employees safe and create a workplace free from harm.
A focus on patient safety comes from the “No One Walks Alone” program – pioneered at the San Diego Medical Center and adopted at the Moanalua Medical Center in Hawaii – where the number of patient falls was reduced by more than half. And last year, the Kaiser Permanente Washington Health Research Institute contributed an editorial accompanying the latest JAMA study about preventing falls among seniors.
For 10 tips on preventing falls, see this infographic.
Short link to this article: https://k-p.li/2QKLYlj
, Heritage writer
During World War II, American industrialist Henry J. Kaiser’s job was building ships to win the war. Everything else — the housing and transportation infrastructure required to accommodate the influx of workers, even the incredible health care program that is his greatest surviving legacy — was a secondary, but necessary, part of the deal. And it was accomplished with a remarkable level of respect and cooperation between labor and management.
In an article titled “Class Bitterness Most Serious Problem for Labor, Management” in the Oakland Tribune September 9, 1943, Kaiser said “There is no such thing as labor relations. There are only human relations. You are dealing with people, not impersonal problems of finance or electronics. There are three sides to every argument — your side, my side, and the right side.”
Cooperation was pragmatic. Since Kaiser’s approach to building ships — like products in an assembly line — was new and evolving, there was an urgent need for innovation and shop-floor creativity. Workers were always coming up with more effective and efficient approaches, and rewards ranged from War Bonds to the right to christen a ship.
This cooperation was the task of Labor-Management Committees, established in early 1942 at the behest of the War Production Board. When the committees were first set up, some saw it as a plan by industry to throttle unions, but the WPB directive stated “The plan is not to further any special interests of any group nor to promote company unions or to interfere with bargaining machinery.”
Since production improvement involved many things besides mere mechanics, the committees also concerned themselves with many other matters, such as housing, food, transportation and morale. Valuable suggestions were shared with other shipyards, and by the end of 1944 over 3,000 ideas had come forward that saved an estimated $45 million and 31 million labor-hours.
Today’s health care worksite may not be the war-driven frenzy of the Kaiser shipyards, but it still relies on worker wisdom to serve Kaiser Permanente members through its unit-based teams. These are groups of frontline employees, managers, physicians and dentists whose work brings them together naturally and who collaborate with one another to improve member and patient care. The Kaiser Permanente Labor Management Partnership’s UBTs continue the tradition of healthy competition and innovation to achieve results.
Recent examples of successes include a UBT at Kaiser Permanente’s Capitol Hill Medical Center in Washington, D.C., that adjusted to a big jump in Kaiser Permanente member enrollment and improved patient care at the same time; a team at Colorado’s Ridgeline Behavioral Health which reduced the number of unnecessary Emergency Department visits while still ensuring patient care; and a Sacramento pharmacy that helped members reduce wait times.
Henry J. Kaiser’s vision of labor-management cooperation was channeled by Harry Caulfield, MD, a previous Executive Director of The Permanente Medical Group, when Dr. Caulfield described the first National Partnership Agreement signed in 1997: “When we work together, then we’re able to progress together. But without each other, neither one of us will be able to accomplish anything near what we could accomplish together.”
Top photo courtesy of the National Park Service, Rosie the Riveter/WWII Home Front NHP, RORI 5049_Box 4-02
Short link to this article: https://k-p.li/2wCB3kt
, Heritage writer
The space was christened “Garfield’s Café” to honor our founding physician and Kaiser Permanente’s long-standing commitment to nutrition as a component of good health. The menu features a wide variety of healthy options, ranging from oatmeal to daily paninis, veggie bowls and salads. The architects of this new café hope patrons will also sink their teeth in history of Kaiser Permanente and the Northwest region.
The space is near a display mounted in 2015 that includes key moments in Kaiser Permanente history in the Northwest. Oversize panels on the café wall highlight Dr. Garfield and the programs in the Portland area during World War II to feed the home-front workforce. These include photos of “Victory Gardens” in the worker-housing projects and employees dining at the huge Kaiser Oregonship cafeteria at St. Johns in 1942.
A large photograph of Dr. Garfield at Contractors General Hospital in the remote Mojave Desert is captioned with a quote from a 1980 letter to the 12,000 members who were part of his Total Health Care Program:
“Remember, good health is a way to get more out of your life — more energy, more enjoyment, more potential, more purpose, more life.”
Also, perhaps another cup of coffee and tasty bowl of oatmeal!
Short link to this article: https://k-p.li/2Oxlkue
, Heritage writer
The eyes didn’t have it.
In 1967, artist Emmy Lou Packard created a stunning mural, “Peaceable Kingdom, the Garden Before the Fall of Man,” for the Kaiser Industries’ flagship Oakland headquarters. A prankster, she slyly swapped out the glass eyes of the lion and the lamb, but got into trouble.
“Taxidermy eyes removed because patrons were uncomfortable with the eyes watching them over the bar,” she lamented on one of her sketches.
For 38 years, that bas-relief mural has rested in storage, but this spring it was briefly displayed in its full glory. The work of art is a reminder of Henry J. Kaiser’s support for the arts, a focus that lives on in Kaiser Permanente hospitals and facilities.
“Peaceable Kingdom” was 6 feet tall and 26 feet long, composed of 16 panels cast in basaltic concrete and carved before fully set, and portions were sandblasted for texture.Packard, an activist as well as artist, had worked for Henry J. Kaiser before — in 1944 and 1945 she’d been an illustrator for the weekly Kaiser Richmond shipyard newspaper Fore ‘n’ Aft, injecting messages of feminism and tolerance in the medium read by a new and unconventional workforce. With this mural commission for an unconventional industrialist, she continued making powerful artwork advocating for a better world.
The 28-story Kaiser Center was built in 1960 on the site of the former Holy Names College on the shore of Lake Merritt as the world headquarters for Kaiser Industries and affiliated companies. This conglomerate produced over 300 products, including steel, aluminum, Jeep vehicles — everything from gravel to guided missile components. It had a combined $1.5 billion in assets, employing 76,000 people in 17 states and 5 foreign countries. The gently curved Kaiser Center was a modern classic, designed by Welton Becket and Associates showcasing Kaiser’s many building materials.
In 1967 — the same year Henry J. Kaiser died — the elegant Mirabeau Restaurant opened on the 3rd floor, looking over the stunning 3-acre rooftop garden. The interior was designed by noted local architect Henrik Bull, who commissioned Packard to create the mural for the cocktail lounge’s back wall.
Packard prepared a colorful description explaining her mural’s message:
The lion lies protectively shielding the lamb, but the lamb has tiger eyes to preserve the balance of nature in the Garden …
The cat and dog and mouse, traditional enemies, live peacefully together, and the cat eats grapes while protecting the mouse in the curve of its tail …
A horned creature somewhat like the triceratops and the stegosaurus combined lurks under the giant fern … he is called militasaurus, and will flourish for a while after the Fall, but like others of the Mesozoic era, will become extinct because he is over-armed …
In 1980, the Kaiser Center underwent a major remodel, and the mural panels were taken down and gifted to the Oakland Museum of California. The Mirabeau continued operation until 1984. Also in the Kaiser Center, on the 28th floor with a sweeping view of Lake Merritt, was the Kaiser Executive Dining Room which opened in 1960.
When Kaiser Industries imploded, the dining room was replaced by the members-only Lakeview Club in 1984. But as business lunching evolved from martinis to kale salads, membership dropped, and it closed in 2000.
In June 2018, Packard’s son Don Cairns and other family members inspected the mural in storage at OMCA. Cairns had watched his mother make it years ago, and remembers seeing it when dining at the Mirabeau. Thanks to the able stewardship of OMCA, the panels are as clear and strong as the day they were taken down. And Packard’s family could once again see the dream of the cat, and the dog, and the mouse, living together in peace.
Short link for this article: https://k-p.li/2N1D2oZ
Credit for all OMCA images: A80.35 Emmy Lou Packard, Untitled (Fauna & Flora Mural), 1967. Concrete with embedded glass. Collection of the Oakland Museum of California. Gift of Kaiser Aluminum & Chemical Corp.
, Heritage writer
A new car so inexpensive you could buy it with cash at your local gas station?
This was a consumer pipe dream during World War II – yet Henry J. Kaiser, despite being preoccupied with running the largest shipbuilding effort of the home front, simultaneously pursued postwar public needs such as transportation, housing, and health care – the last being his most enduring legacy.
Henry J. Kaiser’s efforts to produce an affordable car always point to the humble but inexpensive “Henry J“ launched in 1950. But there’s a deeper story that demonstrates Kaiser’s commitment to using new materials — aluminum and magnesium — to create an American “people’s car” 7 years earlier.
Light metals intrigued Kaiser. He proposed building a West Coast aluminum plant in 1941, but instead Alcoa was given the government blessing, and Kaiser wouldn’t get into the aluminum business until 1946. But he did venture into magnesium manufacturing, and in late 1941 was producing the exotic metal in a plant near his Cupertino, California aggregate quarry.
In early 1943, Henry J. Kaiser entered into a contract with Karl K. Probst and Rollin N. Harger. Probst is considered the “Father of the Jeep,” having designed it as a consulting engineer for the Bantam Car Company in 1940.
The arrangement was classic Kaiser — hiring skilled professionals to develop products that met a current government need as well as an anticipated broader public need. The contract specified creating both a “Jeep Junior” and a “Kaiser Car” (sometimes referred to as the “Kaiser Kar”) passenger vehicle.
The logic behind that pairing was explained in correspondence from Probst and Harger:
We feel so keenly the necessity of building the jeep coincident with the passenger car because the jeep is justified as a war necessity which satisfies us for our activities and enables us to employ such key men as are essential to both projects which we otherwise could not do.
By May, the contract had expanded to include 6 jeep models, ranging from 1,000 to 1,300 pounds for the U.S. War Department.
No civilian passenger cars were manufactured during World War II, so it was big news in June 1943, when Kaiser announced his intention to produce a $400 car (the average price of a new car in 1941 was over twice that) — so affordable, it could be bought with cash and available at gas stations.
“I’m aiming for a market that present cars reach only third- or fourthhand,” Kaiser said.
The car would be very lightweight due to using magnesium for the frame and engine. The powerplant was in development, described in press accounts as a 16-cylinder air-cooled two-cycle radial engine projected to develop 80 horsepower. This was around the same time Kaiser was considering a Dymaxion car with radial engine power. In 1950, Kaiser would choose a similar engine for his proposed personal civilian aircraft.
Meanwhile, the lightweight jeep began receiving good reviews at its August testing at the military’s Aberdeen Proving Grounds. Kaiser’s contract with Probst & Harger was revised; the Kaiser Car’s intended exotic radial engine was replaced with the less expensive conventional 4-cylinder Continental engine.
Probst & Harger was also asked to produce a “midget car” to be sent to Permanente’s workshops for further modification, as well as a “farm vehicle” — identical to the military jeep but allowing “such modifications as we consider necessary… to result in a general utility vehicle.” This was the middle of the war, and Kaiser anticipated the American public’s thirst for such machines.
On October 3, 1943, Probst & Harger submitted drawing #5129 for the “Kaiser Car.”
In December 1943, the Henry J. Kaiser Company entered into a memorandum of understanding with the Hudson Car Company (manufacturer of, among other vehicles, the 1954 Nash Metropolitan), detailing Kaiser’s development of 6 jeep prototypes (4 larger, 2 smaller) under contract with the Army Ordnance Research Department and anticipating volume manufacturing should the prototypes be selected for production.
But by mid-1944, things began to unravel. The military didn’t pick his lightweight jeeps — at least partly due to a shortage of aluminum — and Kaiser went to court against Probst & Harger to restrain them from disclosing details of the vehicles developed under contract with Kaiser.
The American public, eager for an affordable new car, would have to wait until July 25, 1945, when Kaiser-Frazer motors was founded, leading to the much-anticipated 1950 release of the “Henry J.”
Thanks to UC Berkeley’s Bancroft Library for materials used for some of the research in this article – Henry J. Kaiser papers 1873-1982, BANC MSS 83/42c, Cartons 18 and 122.
Short link to this article: https://k-p.li/2K6bOMW
, Heritage writer
Father’s Day is a time to celebrate the bond between father and child. In this sweet telegram from Henry J. Kaiser to his son Edgar during World War II, he pays tribute to that bond. At the time, Edgar was in charge of the three Kaiser shipyards in the Pacific Northwest.
A ship went sailing out, and at it’s helm–one lone young man, very young. He sailed his ship so very near the land, and on occasion ventured forth as a child might wade out and out just a little farther–to see how far he dares to go. This lone pilot went ahead, out and out–until one day he said “no man must go to sea alone.” So first he added his first born–a little man–a character–who was destined to grow and grow. Then as to sea they went, another and another to his crew he added. As rough the sea became, he was not daunted–still another to his crew he added, and another. One more little man–to whom he gave his name. So all, they forged ahead never fearing. And so today when the sea is furious, waves high and going might tough; the captain cannot leave to see the little man receive Portland’s highest honor.
And so tonite, when every light goes out–and you are left alone–just whisper “dear God, I thank you for my Dad, and it’s a job I’ve done of which he’s proud.” And then more gently say “dear Lord, guide me every day to make my city, Portland, proud of me.”
16R-S Henry J. Kaiser
Short link to this article: https://k-p.li/2MrBqFU
, Heritage writer
Although newspapers and popular magazines covered the remarkable feat of providing industrial health care for World War II home-front Kaiser shipyard workers, a review in the prestigious trade publication Architect and Engineer was endorsement on a different level.
A&E was considered one of the “most important professionally oriented architectural magazines” in California’s history. Their May 1945 article, with cover photo, gushed about the aesthetic and practical features of this hospital that was handling 1,500 patients a day.
While Kaiser Permanente founding physician Sidney R. Garfield helped plan many early Permanente Foundation hospitals and clinics, the huge expansion to the preexisting Fabiola Hospital in Oakland was designed by Palo Alto–based architect Birge Malcolm Clark. The A&E review comments:
If, as he has stated, Dr. Garfield’s first thought is to prevent illness and keep people well, he has admirably adapted the atmosphere of this institution to that purpose, for on first inspection there is little that is “hospitalish” about the place. The familiar odors that we associate with hospitals are absent.
However, it’s clear that Dr. Garfield had a hand in shaping this facility — the review notes one of his trademark features:
The surgeries were built, schematically, in a circle around a central work and sterilizing area, which permits the patients to enter through exterior corridors, thus avoiding cross traffic. This plan was thoroughly tried out at the Kaiser Hospital in Vancouver and improved in this plant.
The healing features of the design were also noted:
The halls are wide, clean and open to outside air and light; the reception rooms are furnished in good taste in a restrained domestic style; the patients’ rooms are simple, comfortable and attractive; there are outside, lawn covered courts of ample dimensions where convalescents may rest in wheel chairs; and there are sun decks.
This review was published months before the Permanente Health Plan was opened to the public, and the magazine saw the potential for this novel and effective program:
When that day comes thousands will thank providence that the men who built the Permanente Foundation Hospital worked so faithfully.
These buildings were demolished in early 2018, their long service to affordable health care fulfilled. Kaiser Permanente’s new facilities receive professional accolades for LEED environmental compliance as well as aesthetics and community engagement, but it all started with recognition for what’s “not hospitalish.”
Special thanks to librarian David Eifler from the UC Berkeley’s Environmental Design Library for his help in accessing this publication.
Short link to this article: https://k-p.li/2MkB7MH
, Heritage writer
Death and taxes may be certain, but obituaries are not.
Recently, the New York Times published a series of obituaries for special individuals who, for various reasons, didn’t get the one they deserved after they passed on. Here, we are filling a similar gap for an esteemed Permanente physician. Kaiser Permanente Heritage consultant and historian Steve Gilford wrote the following obituary immediately after Dr. Smillie’s death, but it was never published.
Permanente physician John “Jack” Graham Smillie, MD, passed away September 6, 2000, at the age of 83. The pediatrician joined the medical group in San Francisco in 1949 and steadily rose through the ranks of leadership, retiring in 1981. His 2000 book based on extensive research and personal experience, Can Physicians Manage the Quality and Costs of Health Care? The History of The Permanente Medical Group, may well be Dr. Smillie’s most lasting contribution to the Kaiser Permanente medical care program.
Born in Eaton, Colorado, Jack entered University of Southern California’s medical school in 1938. During World War II, he served in the U.S. Army Medical Corps. The military was segregated, but Dr. Smillie convinced his commanding officer to let him integrate their medical unit in the Philippines, becoming one of the first in the U.S. armed forces to do so. Many years after induction, he noticed that the signature on his physical examination was Lt. Sidney R. Garfield. Jack joked he was probably the only Permanente doctor who’d met Permanente’s founding physician while in his underwear.
Dr. Smillie returned to a residency in Pediatrics at USC/LA County Hospital, where he showed a talent for administration. Doctors routinely admitted children with temperatures over 103 degrees and prescribed penicillin, which worked — but was not the best protocol. Dr. Smillie revised policy so that pediatrics residents reviewed each case, which dramatically cut down pediatric admissions. Parents were encouraged to bring children back a few days later to make sure their kids were OK, the hospital made better use of a 35-bed ward, and Dr. Smillie learned that he could reduce the cost of care and improve the quality of care at the same time.
Toward the end of his residency, he was invited to join a glamorous and lucrative practice in Hollywood. Although tempted, he discussed the offer with friend and mentor, Ray Kay, MD, who suggested he consider The Permanente Medical Group. He did, and accepted their offer to work in San Francisco at both the clinic at 515 Market Street and the 35-bed Permanente Harbor Hospital.
In the mid-1950s, Dr. Smillie told Dr. Garfield about a rooming-in concept from the Yale University School of Medicine, which increased physical contact between mothers and newborns. As a result, Dr. Garfield designed the baby-in-a-drawer, allowing the newborn to be moved between a mother and the nursery. The innovation caught the public imagination, and for a while was a kind of trademark of Kaiser hospitals.
Dr. Smillie became assistant physician in chief in San Francisco under Dr. Morris Collen, then served as physician in chief from 1961 through 1971. Dr. Collen recalled that Jack “was fond of saying that his greatest reward from his many years as a practicing pediatrician was seeing the children he had taken care of later bringing their children to him for care.”
In 1977 Dr. Smillie began a 13-year role representing TPMG in Washington, D.C. He was a strong advocate for the Kaiser Permanente health care model, later reflecting “I had an enormous satisfaction in dealing with the patients because I could do anything I wanted without worrying about how much it cost them. They have already paid me and our group for their care and for their hospitalization. And I was free to practice the kind of medicine I had learned to practice … It was a source of enormous satisfaction.”
Short link to this article: https://k-p.li/2slONij
, Heritage writer
Fore ‘n’ Aft, May 12, 1944:
Sunday is Mother’s Day.
Never before has this fitting day of tribute to America’s mothers held the meaning it does in this year of world conflict. Mothers, in addition to their full-time job of loving, are doing the suffering for the boys who do the fighting. Mothers have joined the industrial army to make ships, planes, guns that will give their sons protection and strength.
All blessings to our Mothers.
Short link to this article: https://k-p.li/2IcusC6
, Heritage writer
Deloras Jones graduated from the Kaiser Foundation School of Nursing more than 50 years ago, but she vividly remembers the school’s philosophy of scientific training. In a medical profession long beset by gender inequalities, the program was progressive in teaching the female students “the science of medicine … as physicians were,” said Jones.
Among Kaiser Permanente’s many contributions to health care, it’s important to recognize a legacy of support and respect for nurses. One prime example: Deloras Jones’ alma mater. At the end of World War II, when the health plan opened to the public, qualified nurses were in short supply.
To address the shortage, the Kaiser Foundation established the Permanente School of Nursing (later the Kaiser Foundation School of Nursing) in 1947 to train more nurses. The accredited school graduated its first class in 1950 and offered tuition-free education and training for its first 7 years. California regulations changed in the 1960s, requiring the school to transition from a diploma program to a degree-granting 4-year college. Efforts to connect with one of the local colleges while maintaining an independent identity were unsuccessful, and the last class graduated in 1976.
During its existence, the school graduated 1,065 nurses and boasted numerous accomplishments. It trained a diverse pool of highly skilled nurses (it was the first in California to consistently recruit minority students), and student scores in State Board Examinations consistently ranked in the top 3 of all California programs, including university schools. Watch their stories in this short video.
In January, that impressive legacy was documented in an academic article in Nursing Administration Quarterly, “Kaiser’s School of Nursing: A 70-Year Legacy of Disruptive Innovation.”
The article is the fruit of a legacy project that was launched in 2016 to research, capture and record the history and voice of Kaiser Foundation School of Nursing alumni. What emerged from these early nursing pioneers were inspirational stories about their pride of being part of a new way to provide health care that prioritized prevention, health promotion, and wellness over conventional “sick care” models.
These alumni became Kaiser Permanente’s earliest nurse leaders, educators, and care advocates, advancing new models for integrated patient care. Many graduates pursued advanced degrees and were instrumental in defining expanded nursing roles, including the introduction of nurse practitioners in California.
Kaiser Permanente nurses contributed to make their mark in advancing the field through research, such as the 1999 study “Exploring Indicators of Telephone Nursing Quality” in the Journal of Nursing Care Quality. Telephone nursing was an early effort in what we now call “telemedicine,” and the study resulted in important understandings about the effectiveness of technology-mediated care.
The school was an experiment that had run its course, but it had also enriched the Kaiser Permanente philosophy with a respect and value for the nursing profession as an essential component of group-practice medicine. To the world, it demonstrated the enduring importance of Kaiser Permanente’s leadership in disruptive innovation — in particular, the role of the nurse executive — in reimagining care for future generations. It’s a mission that continues to this day.
Short link to this article: https://k-p.li/2JHnKUV