UC Berkeley

This dissertation study describes the process of organizational innovation which four Kaiser Permanente medical facilities underwent to launch six culturally competent care (CCC) modules: multidisciplinary and multi-specialty primary care clinic modules staffed from the front desk to the exam room with bilingual, bicultural health care providers and support staff. The CCC modules selected for this dissertation study are open to all patients, but tailored to non-English speaking and limited English-proficient patients of Hispanic or Asian racial/ethnic backgrounds.

The aims of this study are to 1) describe the organizational innovation process of select Kaiser Permanente medical facilities which developed and implemented culturally competent care (CCC) modules for their large non-English speaking and limited English-speaking Hispanic and Asian patient populations experiencing language and cultural barriers in accessing care; and 2) ascertain how physician leaders and administrative leaders who led the CCC module implementation overcame barriers and leveraged facilitators in order to successfully operationalize and institutionalize these modules.

I utilized a multi-site case study design in which a "case" was defined as a CCC module and selected my study sites utilizing a purposeful, criterion-based sampling approach. 22 physician leaders and administrative leaders were interviewed and their responses were qualitatively analyzed utilizing Atlas.ti software. I supplemented the interview data with archival materials collected from each CCC module and conducted site visits to each of the six modules.

The findings from this study illustrate that organizations do indeed follow a staged model for the process of organizational innovation, progressing through the following five stages: readiness to change, awareness of the need to change, identification and selection of changes, implementation of changes, and institutionalization of changes.