Serving a Cultural Mix : Medicine: A Torrance hospital has revamped its patient service to cater to the area’s large Japanese population. Menus, staffing and help lines are all affected.

Miso soup has joined chicken broth and Jell-O on patient trays at Little Company of Mary Hospital, a clear culinary signal that something has changed at one of the South Bay’s largest medical centers.

Beef udon , steamed rice, mandarin oranges and green tea are also offered on a patient menu written in English and Japanese.

Multiculturalism has arrived in the Southern California medical world, as doctors and nurses find themselves treating patients from many races and cultures. And as competition among hospitals increases, facilities are looking at the areas they serve to determine what niches they should fill.

For Little Company of Mary, an obvious choice was the large Japanese community and the growing number of Japanese workers affiliated with offices based in the South Bay.

But more than food has changed since Little Company of Mary embarked four years ago on a program aimed at attracting and treating local Japanese residents. The nonprofit Catholic hospital in Torrance currently offers such services as classes in cardiopulmonary resuscitation taught in Japanese, a telephone help line for Japanese patients and residents, and intensive yearly physicals known as ningen dock for executives of Japanese firms.

Moreover, some hospital staff members and physicians have received lessons in the Japanese language and cultural sensitivity.

Patricia S. Kemalyan, the hospital’s marketing manager, talks emphatically of a need “to be able to help a (patient) through a very fearful experience in their own language.�

The 396-bed facility is a few miles west of the glistening Torrance complexes housing the U.S. headquarters of Honda and Toyota. Nissan and scores of other well-known Japanese firms are nearby.

More than 250 Japanese companies have facilities in the South Bay, according to hospital officials.

Census data underscores the demographic changes, showing the South Bay with 122,580 Asian or Pacific Islander residents, including 37,234 Japanese.

“This is our community,� Kemalyan said. She points to the fast-growing Latino population as well, noting that her facility’s new affiliation with San Pedro Peninsula Hospital will mean a larger number of Latino patients and that officials are studying how to serve them.

Kemalyan thinks that hospitals need to respond to patients who speak little or no English and who find themselves in an emergency room one night unable to communicate with doctors and nurses. Medical workers may stumble as they attempt to ask patients questions, sometimes through a translator, in what is often an emotionally wrenching setting.

“We’re not dealing with whether you want coffee, cream or sugar. We’re dealing with human life,� Kemalyan said.

One example of medical miscommunication is described by Kurt Kimiaki Miyamoto, executive adviser of the hospital’s Japanese program, who came to the United States from Japan 14 years ago. Soon after his arrival, he suffered sharp pains in his stomach late one night and went to an area hospital. He remembers lying in pain in the emergency room for two hours, asking for a pillow but not being understood by those around him.

“I tried to communicate, ‘I have so much pain. Please do something about this,’ � Miyamoto said. “I got so mad at not being able to communicate any feeling. So I left.�

The next morning, he called a Japanese doctor, who ordered tests and treated him for stomach cramps.

A desire to avoid such problems was one reason why Little Company of Mary established a Japanese advisory committee four years ago that includes administrators, Japanese physicians and representatives of the Japan Business Assn.

The hospital began its Japanese menu, staff language classes, a hospital brochure and fact sheet in Japanese, as well as the Japanese help line, which acts as a physician referral line and a translation service.

The hospital has a Japanese-speaking coordinator and nurse on staff. And 28 physicians who use the hospital speak Japanese, Kemalyan said.

In preparing its Japanese program, the hospital surveyed hundreds of Japanese companies in the South Bay area to assess their medical needs, Miyamoto said.

A more recent addition is the ningen dock, wide-ranging annual physical exams for Japanese executives.

The exams, which are done at the hospital, include a 13-page questionnaire and a series of tests, such as chest and upper-GI X-rays, a pulmonary function test, a treadmill test and a gastroscopy. The cost ranges from $595 to $2,000.

The popularity of the ningen dock has climbed steadily, attracting 160 patients in 1991-92 and 135 patients in the first five months of the current fiscal year, Little Company statistics show.

Two large Japanese firms report that employees who have used Little Company’s services are providing good reviews.

“The response has been good. They have Japanese-speaking nurses, and that’s very helpful,� said Stephen Spurgeon, spokesman for the Carson-based Nissan Motor Corp. USA, where some executives have started getting the ningen dock at Little Company.

Little Company is a “high-utilization hospital� among employees at Toyota Motor Sales USA Inc., said Joan Smith, national compensation benefits and systems manager. She said one Toyota employee told her that Little Company’s ningen dock is quite similar to the examination offered in Japan.

Although Little Company has taken the lead in the Japanese community, other hospitals are embarking on similar ventures to meet the needs of different cultures, said David Langness, spokesman for the Hospital Council of Southern California.

“It takes a long time for these types of projects to build trust and confidence, to draw sufficient patient base to pay for what it takes to implement it,� Langness said.

But in Southern California, “providers are being forced to be more pro-active in recognizing the characteristics of the populations that they serve and, in some ways be more responsive to consumer needs,� said Glenn Melnick, associate professor at the UCLA School of Public Health and a consultant at RAND in Santa Monica.

Inglewood’s Daniel Freeman Memorial Hospital, for instance, is stepping up its outreach efforts to the Japanese community and has formed a “sister hospital� relationship with a hospital near Tokyo that will send staff to the South Bay for training early next year. The hospital is also recruiting Japanese-speaking physicians, preparing brochures and establishing its own Japanese help line.

There is also a new interest nationwide in serving Japanese.

Hospitals say the new cultural sensitivity leads to better patient care.

Dr. Robert Nagamoto, an obstetrician who has practiced at Little Company for 30 years, said that his Japanese patients who wake in the middle of the night, needing a pain pill or a laxative, appreciate being able to communicate with a nurse through an interpreter.

And after some Japanese mothers give birth via Caesarean section, they can relax with miso soup.

“As a patient,� Miyamoto said, “If you get sick, you want to eat something you grew up with.�