Webinar Series Wednesday, June 4, pm CST / 2 pm EST

Transcription

1 Webinar Series Wednesday, June 4, pm CST / 2 pm EST Copyright 2014 ACHI 155 North Wacker Drive, Suite 400, Chicago, IL communityhlth@aha.org

2 The Blue Zones Project is a community well-being improvement initiative designed to make healthy choices easier through permanent changes to environment, policy and social networks. Learn more at bluezonesproject.com Healthways is the proud sponsor of the 2014 ACHI Educational Webinar Series

3 Disclosures Today s session awards 1.0 contact hours. To successfully complete this activity and earn contact hours, participants must attend the entire session and complete the evaluation. ACHI does not endorse any commercial products discussed in conjunction with this activity. Mina Kini, Marjeta Daja and Donna Piket do not have anything to disclose. The Association for Community Health Improvement is a designated provider of continuing education by the National Commission for Health Education Credentialing (MEP3728), the American College of Health Care Executives and the National Board of Public Health Examiners.

4 Improving the Health of Vulnerable Populations Presenters Mina Kini Senior Director Multicultural & Community Health Improvement Texas Health Resources Marjeta Daja Diversity Consultant Multicultural & Community Health Improvement Texas Health Resources Donna Piket Language Services Specialist Texas Health Presbyterian Hospital Dallas Copyright 2014 ACHI 155 North Wacker Drive, Suite 400, Chicago, IL

5 Improving health of vulnerable populations: The Burmese care coordination journey at Texas Health Resources Mina Kini, MS, MSW; Marjeta Daja, MBA, MHA; Donna Piket, MPH

6 Discussion Focus: Texas Health Resources as the system of care Mission, Vision & Values Our Burmese Community in Dallas Organizational Context Project Description Defining Project Objectives and Outcomes Project Process Coordination of Care for Burmese Patients Lessons Learned Next Steps and Advancing the Strategy Resources & Tools Today s Journey 60 minutes

7

8 Coordinating Care 1 Refugee Service Organizations 4 Pediatric Clinic Woman s Health Center Labor & Delivery 2 TEXAS HEALTH DALLAS Newborn COMMUNITY 3

9 Geography

10 Refugee Arrival Data - Burmese

11 Where in the world is BURMA USA Burma is located in South-East ASIA

12 The Burmese Population Kachin Chin Karen Mon Kayah REFUGEES - Different ethnicities: language, culture, experiences

13 Cultural Practices & Behavior Genetics Personal Behaviors & Coping Skills Diet and Nutrition Food Access Income & Financial Status Education Immigration & Acculturation Stress & Mental Health Employment Sense of Belonging Physical Environment Social Support & Network Access to Health Services Health Literacy Health Navigation & Preventive Care Determinants that impact Individual and Community Health

14 The Expressed Need Started with Language Issues Other Related Issues CULTURAL Issues Access to care and Understanding the Western Medicine model and care expectations Medication Adherence Preventive Care processes Accessing a Burmese interpreter Identifying the right dialect Time to explain and seek understanding of the care process

15 Discussion Focus: Texas Health Resources as the system of care Mission, Vision & Values Our Burmese Community in Dallas Organizational Context Project Description Defining Project Objectives and Outcomes Project Process Coordination of Care for Burmese Patients Lessons Learned Next Steps and Advancing the Strategy Resources & Tools Today s Journey 60 minutes

16 LEAN Process Multidisciplinary Team Access to Care Getting Treatment (In Patient) Discharge & Prevention Project Sponsor : Dale Leach, Mina Kini (THR) EE Leader: Nursing: Jazz Patterson, Clint Abernathy Debra DuBois, Erin Smith, Melissa Morton, Shanna Brown Kendra Henderson, Molly Montgomery, Julie Anderson, Patti Marks, Chris Brooks, Krisi Ingram, Jean Tan, Rosa Belgard, Kelli Raibick, Shawna Gonzalez, Myesha Bryant WHC, ED, L&D, OB/GYN, Post Partum, Nursery/NICU, Pedi Clinic, Education Operations: Marjeta Daja (THR), Teresa Cannon (ITS), John Engelhard (Pastoral Care), Nancy Hetherington (Admissions), Ruby Manuel (Patient Services), Sandra Pinkerton (THRE), Elsa Phelan (Community Health) Community Members: Luke Saw, Wilma Montz, Kari Brasselero, Julie

17 Patient Centric Process Design Problem Identification Team & Stakeholder Identification Team Charter & Objectives Definition Key Focus Areas Issues Articulated: Interpretation Needs & Cultural Issues Using Patient/Family Journey Flow: Clinical, Operations & Community Partners Using LEAN & CAP approaches Patient Throughput Analysis Identified by Clinical Area Needs MULTIDISCIPLINARY WORK -TEAM

18 Challenges for Clinicians Basic communication challenges Informed consent (concept unknown) Deliver quality care in an appropriate and safe manner Educate staff about effective care practices Resource Considerations: Time, Budget, etc

19 Patient Calls WHC or Physicians Off. For an Appt. Patient Calls WHC or Physicians Off. For an Appt. Patient Arrives at Emergency Room Patient Arrives at the WHC or Physicians Office Patient Arrives at Emergency Room Patient Arrives at the WHC or Physicians Office Staff Gives Literacy Test Patient Care Given Process Map Staff Informs Depts of Patient Status (L& D, NICU, PP, Gyn, High Risk, Special Care, Newborn) Patient Returns for F/U Patient Care Given Patient Tour Scheduled Patient Returns for F/U and goes on Tour Staff Uses Check Sheet to Document Understanding Patient Presents at L & D Admitting Patient Presents at L & D Admitting Patient Registers and is Directed to Location of Delivery Patient Registers and is Directed to Location of Delivery Patient Fills Out Consent Forms and Gets Initial Teaching Patient Receives Care from L & D Patient Fills Out Consent Forms and Gets Initial Teaching Patient(s) Transported and Admitted to New Area Patient Receives Care from L & D Patient Gets Initial Teaching Patient Receives Care Patient(s) Transported and Admitted to New Area Patient Receives Care Teaching Patient Gets Initial Teaching Patient Receives Discharge Teaching Patient Receives Care Staff Uses Check Sheet to Document Understanding Patient Receives Care Teaching ER Path Only No Planned Change Patient Receives Discharge Teaching Patient Education Graphics/ Interpretation Department Coordinat.

20 Project Core Focus Areas Interpretation Services Care Coordination Team Education Community Outreach Graphical & Instruction Tools

21 Coordinating Care: Process, Tools and Structure

22 Interpretation Services Language Identification tools Minutes SPANISH Top 2 Language Line Groups BURMESE/ KAREN Language Monitoring Language WHC Effective Communication

23 Burmese Staff Interpreter, Mona Mon Mona Mon (pictured in center) Cultural Connection

24 Education: Patient Tours WHC L&D Newborn Nursery Post Partum Pedi Clinic - Pharmacy Care Coordination Tour

25 Patient Tours: Patient Understanding Check Sheets Bilingual Translated Forms

26 Educational Modules Cultural Intelligence - For Healthcare Providers to provide Culturally Competent Care Clinician Education Cultural

27 Patient Education tools/materials Focus on health literacy and Visual teaching aids Graphic Explanation & Accuracy of technical details Exploring various methods of graphical representation Care Tools Focus on

28 Patient Education tools/materials Visual teaching aids Breast feeding Education Self-care videos Care Tools Family & Self-

29 IRC Language Assistance Card

30 Translation & Interpretation Visual display of Burmese Friendly meal options Burmese interpreter direct response for food order

31 WHC or ED Date: June 2010 Care Coordination through EHR - Documentation of Primary Language and need for interpreter is documented in the Patient Learning Assessment in the Patient Education Activity WHC and L&D and can be reviewed by all clinicians in the Patient Learning Assessment report in the Patient Summary Activity. ED and Inpatient documentation of Primary Language and Interpreter needed, can be found in the Professional Exchange Report. Patient Information Tool Patient History for WHC Care Connect Standardization Process, Systems and

32 Community Outreach Partnership for Action Research on Social Organization Partnership with Community Organizations resettling refugees Exploratory Care Models: Care Navigation Community Engagement.

33 Discussion Focus: Texas Health Resources as the system of care Mission, Vision & Values Our Burmese Community in Dallas Organizational Context Project Description Defining Project Objectives and Outcomes Project Process Coordination of Care for Burmese Patients Lessons Learned Next Steps and Advancing the Strategy Resources & Tools Today s Journey 30 minutes

34 Tracking Data Clinical Outcome May : 144 family tours Care bags for infants and mothers Bilirubin testing on Saturdays Interpreting Encounters Staff Interpreter and Over the Phone Interpretation: 2012: 684 patients 2013: 1,163 patients & 18,949 minutes 2014 (Jan-Apr): 330 patients & 6,799 minutes Cultural & Emerging Needs Accessing appropriate medical services Utilizing self-care tools and teaching methods

35 Burmese Staff Interpreter, Mona Mon She stresses the importance of parents taking responsibility for their child s health and well being and learning to navigate the health care system. She holds them accountable to the rules of the clinic and helps us teach when it is appropriate to go the emergency room or how important it is to keep specialty appointments. She is an ally, but not a crutch. She is stern with patients when needed, but very loving and understanding, as well. Ashley Eckstein, APRN, CPNP-PC Pediatric Nurse Practitioner Provider Perspective

36 Improve Health & Wellbeing

37 Q & A

38 Upcoming Webinar: Selling the C-Suite on Your Community Health Impact Thursday, June 12 2:00-3:00 p.m. Eastern Time Featuring: Thornton Kirby, FACHE President & CEO, South Carolina Hospital Association To Register: Learn effective strategies for moving your program to the next level of Attention, Recognition & Funding Thornton Kirby, FACHE President & CEO South Carolina Hospital Association Copyright 2014 Hospital Charitable Services Awards Copyright 2014 Hospital Charitable Services Awards ards.org 38

39 With Hospitals in Pursuit of Excellence s Digital and Mobile editions you can: Navigate easily throughout the issue via embedded search tools located within the top navigation bar Download the guides, read offline and print Share information with others through and social networking sites Keyword search of current and past guides quickly and easily Bookmark pages for future reference Important topics covered in the digital and mobile editions include: Behavioral health Strategies for health care transformation Reducing health care disparities Reducing avoidable readmissions Managing variation in care Implementing electronic health records Improving quality and efficiency Bundled payment and ACOs #hpoe #equityofcare

40 Announcements Community Health Improvement Week continues this week. Find more information on your hospital can get on our website The theme for our March 2015 National Conference in Dallas will be Building the Next Generation of Health Communities. Please check our website, for more information this summer. Follow us on

41