-Health Promoting Hospitals- Culturally Competent Hospitals?

Transcription

1 -Health Promoting Hospitals- Culturally Competent Hospitals? -Policy of Culturally Competent Hospitals -a possible structure and overall view to references in the HPH- context- -Working Group 1: Policy and Service Development Coordinators: Prof.Dr. Dr. Werner Schmidt Mag.theol. Elimar Brandt 1

2 WHAT? Topic of our Task Force and definitions of Keywords TOPIC: Improvement of the cultural competence of Heath promoting Hospitals with the goals 1.Equality of opportunity in health, Equity and ethics in health care 2.Improve the quality of health care and the clinical outcome, patient safety, ability to understand treatment options and reduce medical error KEYWORDS (see: Appendix 1: Glossary of Terms Position Paper WG 2) Cultural Competency Migrant-specific and (Trans)cultural Competence Equality ( Equal Access, Treatment, Participation, Outcomes) 2

3 WHAT? KEYWORDS DEFINITION Cultural Competency (CC) CC is the ability to provide effective health care services, taking into consideration the individuals gender, sexuality, disability, age, religious, spiritual and cultural beliefs as well as social situation (status). It requires staff to have a working knowledge of the diverse spiritual and cultural needs of service users, enabling them to provide culturally competent service. A set of congruent behaviours, attitutes an policies that come together in a system, agency, or among professionals that enable that system,agency or those professionals to work effctively in cross-cultural situations (Terry Cross) 3

4 WHAT? KEYWORDS DEFINITION Intercultural competence is an equivalent concept in the field of globalisation and is defined as understandings, competencies, attitudes, language proficiencies, participation and identities necessary for successful cross-cultural engagement. Migrant-specific problems in an ethno-culturally divers are defined and described in the Amsterdam Declaration. In this application we use Cultural Competence as an overarching (predominant) concept. (See Maurice Eisenbruch : Creating a culturally competent university) 4

5 WHAT? KEYWORDS DEFINITION Diversity "in this context describes - impartially - the presence of personal and social differences, e. g. owing to origin, sex, language, abilities, age, way of life and social status als a constituent element of modern societies." (Peter Saladin,2006) 5

6 WHY more attention for cultural competence in HPH network of the? Three simple facts: 1. Cultural competence is an importend part of the HPH Vision, Values, principles and Standards- but the reality is unsatisfactory 2. (Trans)CC is an increase challenge for all hospitalsmore and more patients with divers cultural background- and the same situation at the staff 3. (Trans)CC is a key- factor for improvement of quality in Health care,,treatment, clinical outcom, Patient safety a.s.o. 6

7 WHY? HPH-concept and Cultural Competence 2 dimensions: I. Values and Principles of the and HPH as Health Policy Orientation to CC in hospitals II. HPH- Strategies and Standards as instruments for implementation of CC in hospitals organizational development. 7

8 WHY? HPH-concept and Cultural Competence 1. Values and Principles of the and HPH as Health Policy Orientation to CC in hospitals 7 Guiding priciples for Health Promotion (Rootman et.al. 2001) :. EQUITABLE (guiding by a concern for equity and social justice) 8

9 WHY? Competence HPH-concept and Cultural 7 Principles for Health Promotion: 1.Empowering 2.Participatory 3.Holistic (physical + psychological + social) 4.Intersectoral 5.Equitable 6.Sustainable 7,Multistrategy (Rootman et.al. 2001) 9

10 WHY? HPH-concept and Cultural Competence OTTAWA CHARTA for Health Promotion (1986) Reduce the INEQUITIES IN HEALTH within and between societies The Jakarta Declaration on Leading Health Promotion into the 21st Century (1997) Investments for health should reflect the needs of particular groups such as women, children, older people and indigenous, poor and marginalized populations 10

11 WHY? HPH-concept and Cultural Competence The Vienna Recommendations on Health Promoting Hospitals (1997) Fundamental principles: 1. Promote HUMAN DIGNITY, EQUITY and SOLIDARITY, and professional ETHICS, acknowledging differences in the needs, values and cultures of different population groups 11

12 WHY? HPH-concept and Cultural Competence II. HPH- Strategies and Standards as instruments for implementation of CC in hospitals organizational development 18 Core strategies for HPH This 18 Core strategies are a excellent structure for CC-implementing in the hospitals culture (see Copies) 12

13 Overview: 18 HPH Strategies (Pelikan u.a.)

14 WHY? HPH-concept and Cultural Competence Standards for Health Promotion in Hospitals Implementing health promotion in hospitals: Manual and Self-assessment Forms ( 2006) This self-assessment tool is a practical measuring instrument for assessment and development of the CC- implementation in the hospital structure and culture. CC-Integration in all the 5 Standards is possible and explicit is one Substandard (2.3.) CC- relevant 14

15 Standards for Health Promotion in Hospitals Standard 1: Management Policy Standard 2: Patient Assessment Standard 3: Patient Information and Intervention Standard 4: Promoting a Healthy Workplace Standard 5: Continuity and Cooperation

16 WHY? HPH-concept and Cultural Competence Substandard 2.3. The patient s needs- assessment reflects information provided by others and ensures sensitivity to social and cultural background Information from referring physician or other relevant sources is available in the patients record The patient s record documents social and cultural background as appropriate (Evidence: Religion that requires special diet or other specific attention. Social conditions indicating that the patient is a risk) 16

17 HOW? Quality Management Instruments/Systems in Hospitals: Using for systematic CC-Development in Hospitals 1. Migrant Friendly Quality Questionnaire (SF-MFQQ) 2. Handbook Diversität und Chancengleichheit (Diversita e pari opportunita ) (P.Saladin,2006) Checklists 3.Guide for Using the Cultural an Linguistic Competence Policy Assessment Instrument Checklist for Self-Assessment (2006 NC for CC Georgetown University, USA) 17

18 HOW? Quality Management Instruments/Systems in Hospitals: Using for systematic CC-Development in Hospitals 4. Standards and Guidelines for Culturally Competent Practices (Position paper WG 2, 2006) 7 Standards 5. Excellence Model of the an Foundation for Quality Management (EFQM-Model) 6. Balanced Scorecard (BSC) Management instrument for Strategy-Implementation (see exemple IDG Beate Lieske) 18

19 HOW? 15th International Conference on Health Promoting Hospitals April 11-13, 2007, Vienna Conference theme: Contributions of HPH to quality of care, quality of life and quality of health systems The question for our TFCCH: What are the contributions of a Cultural Competent Health Promoting Hospital -to quality of care? -to quality of liefe (of the patients, relatives, staff and Community)? -to quality of health system? 19

20 Basic References for Policy and Service Development 1. an Pilot Hospital Project Migrant-Friendly Hospitals Final Report, LBISHM Eighteen core strategies for Health Promoting Hospitals (J.M.Pelikan et.al) in: Health Promotion in Hospitals: Evidence and quality management, Barcelona, 2005 LIS number:e Implementing health promotion in hospitals: Manual and self-assessment forms ( 2006, LIS number: E Diversität und Chancengleichheit (Herausgeber P. Saladin) Bern 2006 (german, french, italian) 5. A Guide for Using the Cultural and Linguistic Competence Policy Assessment Instrument,2006 by National Center for Cultural Competence, Georgetown University 6. Recommended Standards for Cultural Competency in Training& Development for Heallth Care Providers (Position Paper WG2, 2006) 20

21 Acknowledgements Special thanks to Maurice Eisenbruch Gill Gurwinder Karl Krajic Robert C. Like Peter Saladin for proposals, questions and references 21