Serving Diverse Communities in Hospitals and Health Systems

1. Serving Diverse Communities in Hospitals and Health Systems • Edward L. Martinez, M.S. • Linda Cummings, Ph.D. • Lindsay A. Davison • Ingrid A. Singer, M.H.S. • Donna Sickler, M.P.H. • Arsenio DeGuzman, M.P.A. • Marsha Regenstein, Ph.D.

2. The National Association of Public Hospitals and Health Systems (NAPH) • Represents over 100 of the largest metropolitan area hospitals & health systems • Advocates on behalf of safety net hospitals & health systems that share a mission of making their services available to all regardless of ability to pay • The National Public Health & Hospital Institute (NPHHI), the research & education affiliate of NAPH, conducts research into areas affecting safety net institutions, such as health disparities

3. NAPH Members Provide Extraordinary Volumes of Care NAPH members… • Provide over 25 percent of the uncompensated care in the U.S., while representing fewer than two percent of acute care hospitals in the country • Provide nearly 31 million outpatient visits annually. NAPH hospitals average nearly 17,000 inpatient admissions and over 375,000 outpatient visits annually • Provide high proportions of specialized, but often under-compensated, services such as neonatal intensive care, emergency psychiatric care, and burn care

4. The National Association of Public Hospitals and Health Systems

5. NAPH Patient Population Source: NAPH Ambulatory Care Survey, 2001

6. Difference in Ambulatory Care Visits by Race Source: 2001 NAPH Ambulatory Care Survey

7. Patient Deliveries by Mother’s Country of Birth Source: NPHHI Barriers to Prenatal Care Survey, March 2003

8. # Women Speaking a Language Other than English from Selected Hospitals Source: NPHHI Barriers to Prenatal Care Survey, March 2003

9. Percent of Non-English Speaking Diabetic Patients at Selected Hospitals Source: NPHHI Consortium for Quality Improvement at Safety Net Hospitals Survey

10. Addressing Disparities -Serving Diverse Communities

11. Report to DHHS/ Office of Minority Health • To highlight the critical role of safety net hospitals and health systems in expanding access to quality health care to diverse communities • To identify significant strategies and to present findings and lessons learned in a practical and adaptable manner • To focus on the role of executive leadership in providing quality health care to diverse populations

12. Methodology • Structured interviews with key hospital staff • Developed case studies based on: • Interesting work and promising practices in cultural competence • Track record of integrating cultural competence practices into clinical and administrative procedures • Geographical representation • Size of the institution and degree of patient diversity

13. Case Studies Highlighting Cultural Competence Practices • Role of leadership • Clinical care tailored to diverse populations • Community outreach • Workforce training • Language services • Technology

14. Key Areas for Research and Training • Identify the core competencies that make up culturally and linguistically appropriate practices • Develop performance metrics • Measure and monitor performance through self-assessment tools and benchmarks • Identify models of effective practices • Build the case for cultural competence practices internally (strategic planning, staff training and staff development) and externally (patient and community relations and business case)

15. www.NAPH.orgwww.NPHHI.org