If you’ve ever had a colonoscopy, you know there are steps you need to take for one to three days before the procedure, such as adhering to a liquid diet. But what if you don’t understand the instructions because your medical provider doesn’t speak your language? You might show up for your appointment unprepared. And if the procedure goes forward, you could potentially suffer complications, as well as incur a costly expense for the hospital.
This is the type of situation that Fátima M. Rodríguez DrPH ’11, a senior project manager within Kaiser Permanente’s National Diversity Office, is trying to prevent. Her work centers on issues of language and culture, and how they affect care. “When we talk about language access, it’s really about quality of care, patient safety, and health equity—and for many organizations it’s about reducing risk and medical errors,” she says. “Also there are cost savings if you’re able to prevent any kind of negative outcomes by ensuring that people have the kind of information that they need in their language, either verbal or written.”
Rodríguez has worked for Kaiser Permanente— a not-for-profit health plan serving 8.7 million members in nine states and the District of Columbia—for nearly six years, during which time she has also been pursuing her doctorate in public health at UC Berkeley. National Diversity, her department at Kaiser Permanente, provides guidance to the organization on a range of issues related to its culturally and linguistically diverse patients, members, and workforce. “We develop and implement strategies that are people- and systems-focused,” she explains.
Kaiser Permanente has a very diverse membership that speaks more than 130 languages, according to Rodríguez. “We are collecting data on race, granular ethnicity, and language preference in our electronic medical record system because all of these pieces of information help Kaiser Permanente provide more patient-centered, personalized care, which is critical,” she says. “For example, it is very difficult to develop and deliver effective and culturally responsive interventions if you only know that your patients are Latino. What if they’re Latinos from Mexico, or Chile, or Peru? There are a lot of nuances.”
Not only is the make-up of the U.S. population rapidly becoming more diverse, but as a consequence of health care reform, health care systems may be soon be caring for populations they haven’t previously served. “We’re in a unique time in our history,” Rodríguez says. “Issues of diversity are and will continue to be important, and we need to be prepared.”
Rodríguez’s interest in diversity and health care has its roots in her own background. Both of her parents immigrated to the United States from Mexico, and her brother had Hodgkin’s disease at a young age.
“Issues of culture and language have always been very much a part of our lives,” she says. “I’ve had many experiences based on my family’s interaction with the health care system that created this interest in looking at how to improve services, especially those that are provided to individuals who don’t speak English. Many people can relate to having to interpret for parents who are non-English-speaking, and I’ve had to do that for numerous family members. This is not the best way of ensuring transparent and accurate information between patients and providers.”
Her professional work at Kaiser Permanente and her academic work at Berkeley are closely linked. “My dissertation looks at how not only managed care, which is where I work, but also public health departments are addressing the needs of their non-English-speaking patients,” says Rodríguez. “And I think one of the most exciting parts of my research is that, as part of my DrPH program, I’m in both worlds. I have one foot in academia, and I also have a foot right in an organization that is really progressive and is in the forefront of innovation.”
Rodríguez, who will complete her doctorate in December 2011, received her bachelor’s degree from Stanford and her master’s degree from UCLA. “What I wanted to do when I got to Berkeley was to figure out how I could not only influence the field, but also influence how public health looked at issues of diversity and cultural and linguistic competency,” she says. “I knew I wanted to have the research skills, but I also knew I wanted to have leadership skills. That was one of the selling points of the DrPH program.”
She is proud of what she has been able to accomplish so far at Kaiser Permanente: “When I go to my mom’s doctor appointments, and I see the electronic medical record, and they’re asking questions that take into consideration her entire being, inclusive of her language and culture, I know that the work I’m doing at the national level is having an impact.”