Post on 26-Jun-2015
description
The Globalized Patient Adapting health services for mobile,
migrant and minority populations
Julia Puebla Fortier
Executive Director
DiversityRx – Resources for Cross Cultural Health Care
www.diversityRx.org
DiversityRx: Improving health care for a diverse world
! Policy development
! Research
! Information dissemination
! Education and training
Working with:
! Hospitals and health departments
! Universities
! Phillanthropic foundations
! Government agencies
! International organizations
Scenario:
You have gone to a conference in another country and suddenly you don’t feel well…
Medical tourists Foreign brides International students
Expat professionals
Migrants Indigenous people Foreign workers Refugees
Minorities
Goals of health care
systems
! Preventing disease and promoting health
! Improving quality
! Reducing errors
! Efficiency and cost effectiveness
! Good health outcomes
! Fostering good patient and community relations
Challenge of treating the globalized patient
! Access and appropriate utilization
! Communication barriers
! Different cultural practices or disease constructs
! Discriminatory or insensitive treatment
! Unique issues of mobility: ! Unfamiliarity with regionally prevalent illnesses ! Effects of displacement, trauma, torture,
trafficking
Structural barriers
! Eligibility for health schemes
! Portability of health insurance
! Undocumented status
! Low-income/inability to pay
! Availability/accessibility of health services
How can we achieve health care goals for the globalized patient?
! Practice
! Policy
! Strategic Alliances
! Presentation References:
www.diversityRx.org/HPH-Resources
Practice:
! Language services
! Sensitive and informed care delivery – individual level ! Epidemiological factors, cultural background, social
determinants
! Tailored population services
! Health promotion, disease prevention, disease support
! Cultural support staff
! Intercultural mediators, community health workers, patient navigators
Clinical interventions: one size does not fit all
Challenge: Communication
! Use of telephone, video, mobile technology to link in interpreters from remote locations
! Cost effective and efficient use of resources
! United States
! Japan
Remote medical interpreting
Challenge: cultural differences
! Community representatives trained to explain cultural issues and support mediation between patients and staff
! Belgium
! Germany
Intercultural mediators
Challenge:
! Training for clinical, support and administrative personnel ! Epidemiological context ! Responsiveness to linguistic and cultural issues ! Non-discrimination and rights to health services Qatar: training for medical students and health professionals at Weill Cornell Medical College and Hamad Medical Corporation
Preparing the health care workforce
Practice:
! Portugal: support for professional requalification
! United States: requalification courses and retraining as interpreters and cultural mediators
Career pathways for immigrant health professionals
Policy:
! Regional/International frameworks
! Country level policies
! Professional accreditation
www.diversityRx.org/HPH-Resources
Policy: International Frameworks
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WHO Resolution on Migrant Health and Global Consultation
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Policy:
! Spain: universal access, regardless of status. Demographic health status monitoring
! Australia: Cultural responsiveness framework
! United States: CLAS standards
Country level policies
Policy:
! United States: Joint Commission accreditation of hospitals standards for patient-centered communication
! New Zealand health professionals registration boards requirements for cultural competence
! Canada (Ontario) nursing requirements for cultural competence
Professional accreditation
Strategic Alliances
! Health professional bodies
! Health policymakers
! Cross-sectoral actors
! Community and patient representatives
! Local, national and international non governmental organizations
Collaboration between stakeholders to promote engagement
www.diversityRx.org/HPH-Resources
Strategic Alliances
! Coordinated, comprehensive action
! Institutionalization
! Information about best practices and model policies
! Structural fixes: financing access to social protection
! Insertion into other health agendas
What needs attention
Quality for the globalized patient
! In order for hospitals and health systems to achieve their overall quality goals, they must provide quality services to ALL patients.
! Models from around the world show us that quality health care for the globalized patient – migrant, mobile, minority and other vulnerable populations – is achievable.
! Let’s use their examples to examine our current practices and policies and build strategic alliances to improve access raise health status for all.
An achievable goal
www.diversityRx.org/HPH-resources
Contact: rcchc@aol.com