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© Globalization & Health Care

© Globalization & Health Care. Mary K. Kirkpatrick, RN, EdD Professor & International Coordinator East Carolina University College of Nursing Greenville, NC 27858 USA kirkpatrickm@ecu.edu #252-531-7402.

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© Globalization & Health Care

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  1. ©Globalization & Health Care Mary K. Kirkpatrick, RN, EdD Professor & International Coordinator East Carolina University College of Nursing Greenville, NC 27858 USA kirkpatrickm@ecu.edu #252-531-7402

  2. Objectives After reviewing the power point slides and searching the literature, the learner will be able to: • define the terminology, • identify resources, • consider the policies for global health, and • present an annotated power point presentation.

  3. Terminology • Internationalization-interaction & interdependence of people in different countries • Globalization-worldwide, universal • Universalization-spread of people & cultures worldwide • Westernization-values, behaviors of Western societies Q What is your own personal definition of globalization? ow will globalization affect health care delivery?

  4. Ubiquity of CHANGE • Inevitable • Universal • Pro-active pays • Uncertainties • Stressful What are the pros and cons of globalization on health care? (Herhock et al., 2007)

  5. Globalization & Health Care Globalization is: the product of the emergence of a global economy, expansion of transnational linkages between economic units creating new forms of collective decision making, development of intergovernmental and quasi-supranational institutions, intensification of transnational communications, and the creation of new regional and military orders(Hershock, Mason & Hawkins, 2007, p. 30). Q What is your own operational definition of globalization?

  6. Globalization • Liberal arts • Language • Flexibility • Attitude Acceptance • Communication Q What do you need to do personally to become more globally prepared?

  7. Client Centered (CC) & Culturally Competent Care (CCC) Globally Client centered (CC): Treating person as a whole. CC entails: advocacy, empowerment, respect, self-determination & participation. Steps to CCCAttitudes for CCC • Self awareness Individual respect & • Knowledge acceptance of differences • Communication Inclusive Q What is the stand of the JCAHO re: client centered & cultural competent care?

  8. Client Centered/Culturally Competent Care Globally • Complete 1-3 courses: www.thinkculturalhealth.org/ccnm Nurses’ Courses (3=A; 1=B for 10% of course grade). • The Cross Cultural Education Primer-Harvard Medical School at http://medweb.med.harvard.edu/cccec/teaching/primer/index.htm is excellent. • Both www.hrsa.gov and www.omhrc.gov have excellent resources. • Review Best Practice Guidelines on client centered/culturally competent: www.rnao.org. What policies are being established re: client centered/cultural competence?

  9. CLAS Standardsfor Client Care(National Standards on Culturally & Linguistically Appropriate Services) • 14 Standards; 3 Themes • Cultural Awareness • Language • Organizational Support Q Who is responsible for these standards? What are their implications? Type in CLAS standards at the search site on these webpages: www.jointcommission.org www.omhrc.gov/templates/browse.aspx?/v/=z&lvID=15

  10. What is Global Health? ….. "health problems that transcend national boundaries, that may be influenced by circumstances or experiences in other countries, and that are best addressed by cooperative actions, and solutions; whether they occur in developing countries, countries in advanced transition, or industrialized countries"(UNC-CH, 2007, p.3). Q What is the government’s role in globalizing health care?

  11. Global Immigration & Health Care Access: Sheer numbers Who pays? Use of ER/hospital care Communication-interpreters Need for client centered care Use of CAMS Adherence/compliance Q What is the impact of immigration globally? (Brush, 2008, 40(1):20-25; www.ilo.org;public/english/dialogue/sector/papers/health/wp209.pdf)

  12. Population Shifts: % of population by Race & Hispanic Origin 2000 vs 2050 100 90 80 70 60 50 40 30 20 10 0 % of pop 2000 2050 Q What demographic shifts are occurring globally?

  13. Technology: Global Connections • Mass communication • Sharing media • Global traveling • Advancements Q How will technology impact on health care for you?

  14. Caring Economics: A Global Agenda CARING is big business! Caring is marketing. Caring & outcomes Caring takes time. Caring is a basic human need. Q Is caring a business commodity? (Eisler, R., 2007, Creating a Caring Economics: The Real Wealth of Nations)

  15. Global Health Issues • Health Disparities: mortality & morbidity of poor • Infectious Diseases • More effective health care systems • Tobacco addiction • Terrorism Q What other issues can you identify? See: www.unnaturalcauses.org.

  16. WHO Ranking of Health Care Systems • #1 France • #6 Singapore • #10. Japan • #15. Iceland • #20. Switzerland • #25. Germany • #30. Canada • #37. USA • #61. Mexico • #144. China (www.phobius.com/rankings/healthranks.html)

  17. World Health Indices • Access to health care • Individual profile • Social: education/economics • Environment • Infant mortality • Life expectancy

  18. Infant Mortality Ranking Worldwide • USA 7.09 male deaths/1000 births • UK 5.67 • Canada 5.15 • Australia 5.02 • Switzerland 4.84 • Spain 4.76 • Germany 4.56 • Japan 3.58 • Iceland 3.43 • Sweden 2.92 (Retrieved from www. , 2007)

  19. Worldwide Life Expectancies of Developed Countries MaleFemale UK 78.8 83.1 Australia 78.5 83.3 Japan 78.5 85.5 Iceland 78.5 Germany 77.4 84.4 Malta 77.0 81.9 France 75.9 83.1 Spain 74.5 82.0 USA 74.8 80.1 (17th. in world) Sweden 70.4 78.4 (www.INED.fr/en/pop_figures, 2006; Holtz, 2008, p. 5)

  20. Global Burden of Illnesses Cardiovascular/hypertension Diabetes Cancer Obesity & nutrition HIV/AIDS Tobacco/alcohol addiction Substance abuse Injury/violence Immunizations

  21. Universal INFECTION CONTROL

  22. Religion & Health Care • Viewed differently globally • Many wars occurred in name • of religion • Both positive & negative effects • Spirituality is significant to health. Q How is religion and health care viewed globally?

  23. Issues in Health-Care Policy & Delivery • Cultural competency • Diversity & Workforce • Diversity management • Equity/social justice Q Other health care policies exist. What are they in your area of expertise?

  24. The Quality Pyramid System Outcomes Quality Improvement Evidence-based Practices Q What are the expected outcomes of globalization and health care? Performance Measurement

  25. ìThe future ainít what it used to be.îYogi Berra • Advocates for health are imperative • Society continues to change • Gatekeepers are necessary • Learning to cope is essential Q What do you predict for the globalization of health care?

  26. Management/Leadership/Partnerships • Global partnerships • Government’s role • Philanthropy • Engagement/participation • Transformational leadership Q What will have to be changed in nursing units to promote transformational leadership, transparency management and collaborative partnerships?

  27. Transparent/horizontal Participation • Health People 2015 in various countries • Eight Millennium Development Goals 1990-2015 • United Nations/World Health Organization shifts • Ministries of health • Non-Government Organizations, consumer/ professional/environmental groups • Public/private partnerships & alliances Q What needs to be done to activate clients in health care?

  28. Globalization & Nursing • Cultural diversity • HCP migration • Nursing & Medicine shortages • Service learning • Health careers Q What significant impact will globalization have on the role of the HCP?

  29. Synthesis • Health care systems are in reform globally. • Globalization affects every system. • Inter-professional efforts are needed to improve health care globally. • Health care providers need to prepare, be proactive and collaborate.

  30. Major Journal References • Aiken, L. H. et al., Nurses reports of hospital care in five countries. Health Affairs, 29(3): 43-53. • Aiken, L. H., et. Al. Trends in international nurse migration. Health Affairs, 2004; 33(69): • Alyce, A., Schultz Role of research in recontructing global health care for 21st. Century. Nsg. Admin. Qurtl. 28(2): 133-43. • Berlow, B. & Trigg, D. The coming globalization of health care. ______ 23(6): 24-28. • Brown, T., Cueto, M., Fee, E. The WHO and the transition from international to global public health. Am. Jr. Pub. Hlth, 2006, 96(1): 62-72. • Buchan, J. et al., Internatinal nurse mobility: trends and policy implications. Health Affairs, 2004; 23(3): • Brathwaite, D., Riley-Eddins, E. A. Globalization of health care: culture exposures of nursing students. Jr. of Multicultural Nursing & Health, Winter, 2002, pp.5-6. • Collins, T. Globalization, global health and access to health care. The International Jr. of Health Planning & Management,2001; 18(2): 97-104 • Cutcliffe, J. R., Yarborough, S. Globalization commodification and mass ransplantation of nurses. Prt. British Jr. of Nurs. 16(15): 926. • Nosek, L. J. Globalizations’s costs to health care: How can we pay the bill? Nurs. Admin. Quartl. 28(2): 116-21. • Pruitt, S. D., Epping-Jordan, J. Ed. Preparing the 21st. Century global health care workforce. BMJr., 330(7492): 637. • Simpson, R. L. Global information impact and implication of technology in a global market place. Nurs. Admin. Quartl., 28(2): 144-9. • Simpson, R. L. Toward a new millennium: outlook and obligations for 21st. Century health care technology. Nurs. Admin. Quartl. , 24(1): 94-7. • Scheve, K. F. & Slaughter, M. F. A new deal for globalization. Foreign Affairs, 2007; 34-47.

  31. Major Book References • Holtz, C. Global health care: issues and policies. Boston: Jones & Bartlett, 2008. • Herhock, P D, Mason, M & Hawkins, J N. Changing education: leadership, innovation & development in a globalizing Asia Pacific. Hong Kong: Springer, 2007. • Koop, C E, Pearson, C E, & Schwarz, M R. Critical issues in global health. San Francisco: Jossey-Bass, 2002. • Lee, K. & Yach, D. Globalization & health, Chapter 15 in Merson, M H, Black, R E, & Mills, A J.’s International Public Health. 2nd. Ed. Boston: Jones & Bartlett Publ. • Satcher, D & Pamies, RJ. Multicultural medicine & health disparities. New York: McGraw Hill, 2006. • Spector, R E. Cultural diversity in health and illness. New Jersey: Pearson-Prentice Hall, 2004.

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