Total Community Health at Kaiser Permanente

Kaiser Permanente
Oakland, CA

Kaiser Permanente is a health care provider and nonprofit health plan that serves more than 9 million members in nine states and the District of Columbia.

Background
At the core of Kaiser Permanente's mission is a focus on the continuum of health and not just health care. What has not always been central is explicitly talking about that full continuum. That shift was driven by comprehensive brand research asking members and nonmembers what was important to them. Their responses had very little to do with medical care; rather, they focused on relationships, levels of safety and security, and feelings of well-being. Kaiser Permanente leadership recognized the value of communicating how total health is not just the absence of illness but also a positive state that involves mind, body and spirit. To deliver on that promise, Kaiser Permanente deepened its commitment to extend beyond the medical setting to what is happening in the homes, neighborhoods and communities of the people it serves.

Intervention
To facilitate the journey to total health, Kaiser Permanente supports all aspects of a person's well-being and examines every aspect of the organization to determine how it contributes in a positive way to total health. Kaiser Permanente has created programs in both the clinic and the community to support the full continuum of health for members. Exercise as a Vital Sign is an innovative effort in which patients are asked about their level of physical activity and responses are recorded in the electronic health record. If fitness levels are low, patients are counseled on strategies for increasing activity, particularly by walking 30 minutes a day, five days a week. For 25 years, Kaiser Permanente's Educational Theatre Program has used live theater, music and dance productions to teach children and adults about healthy eating, physical activity and self-esteem. Environmental stewardship is also an important part of the total health philosophy, and the organization has committed to reducing greenhouse gas emissions and increasing how much locally produced, pesticide-free food it buys in all of its facilities. Additionally, Kaiser Permanente continues to invest in Community Health Initiatives/Healthy Eating Active Living partnerships, which were first launched in 2004 and focus on prevention of obesity and its related diseases through improved healthy food choices and support for physical activity.

The Result
The Community Health Initiatives have expanded from just three communities eight years ago to more than 40 locales today, supported by a cumulative investment of more than $236 million. In addition, Kaiser Permanente has been a partner for high-profile health initiatives such as “The Weight of the Nation,” the documentary and initiative targeting obesity in America; the Let's Move! initiative Michelle Obama kicked off to end childhood obesity within a generation; and the Partnership for a Healthier America, through which Kaiser Permanente committed to offer healthier hospital food.

Lessons Learned
According to Kaiser Permanente, the most important lesson is that health systems do not have to “do it all” as they evolve into a health provider that extends care beyond the clinical setting. Looking at health through the model of the whole person—mind, body and spirit—removes the artificial distinction of community engagement as “nice to have” and instead positions it as an indispensable part of the organization's care model. A second key lesson is that health systems do not have to go it alone. Kaiser Permanente has advanced numerous community-based services by partnering with subject experts and organizations that benefit from Kaiser Permanente's resources and expertise. Kaiser Permanente was able to create a culture in which people look to health organizations not just for care, but as trusted partners in all facets of total health.

Contact Information
Susannah Patton
(510) 271-5826
Susannah.F.Patton@kp.org

This case study was originally featured in the HPOE guide: 'Engaging Health Care Users: A Framework for Healthy Individuals and Communities,' published September, 2013.