For evidence of how understanding diversity and cultural competency can improve patient outcomes, Juana Slade points to the obstetrics unit at AnMed Health Medical Center.
Slade, director of diversity and language services at the 369-bed hospital in Anderson, S.C., said readmission rates among Spanish-speaking women in the obstetrics department have dropped since the hospital hired interpreters to help new mothers and their families understand their detailed discharge plans.
It benefits the hospital if the patient has a good experience and comes back for follow-up care, or more importantly is able to avoid readmission, Slade said. If we are inclusive in our approach, our patients will fare better.
Thats why AnMed was among the early supporters of a first-of-its kind benchmarking study that was launched Oct. 27 by the Institute for Diversity in Health Management. Notices went out to more than 5,000 hospitals last week inviting participants to describe the diversity of their workforces and how their hospitals and systems are delivering culturally appropriate care.
How has the response to the online survey been? We had 11 responses on the first day, said Fred Hobby, chief executive officer of the institute.
The goal is to start developing industry standards that can help hospitals and health systems understand where their own efforts in diversity and cultural literacy rank in the national marketplace. Hospitals have told us they would like to know how theyre doing in comparison to other hospitals. And no one has been able to tell them thus far, Hobby said.
Its not the institutes first study to brandish the word diversity. The institute is one of five sponsors of a separate study on racial and ethnic career attainment in healthcare management, which is slated for release in early 2009. That study will follow in the footsteps of career-attainment surveys in 1992, 1997 and 2002 that reported women and ethnic minorities have found only mixed success in breaking into management at healthcare organizations.
In contrast, Hobby said the institutes new benchmarking study will include one section on executive and boardroom diversity, but will also look at organizations entire staff and operations, and their initiatives to serve patients in culturally and linguistically appropriate ways. The study will also highlight high-performing facilities to be formally recognized as diversity leaders.
Joseph Swedish, president and CEO of Novi, Mich.-based Trinity Health, said interest in the topic of diversity and cultural competence spiked in recent years following publication of two reports.
The first was the 2002 Institute of Medicine study Unequal Treatment: Confronting Racial and Ethnic Disparities in Health Care, which found wide disparities in access to and quality of medical care among ethnic groups. And in 2007, the Agency for Healthcare Research and Quality reported that poor, uninsured and minority patients were less likely to get preventive screenings for colorectal cancer, and faced greater risk of death from a disease that is curable with early detection. Its a topic that over the last few years has become important because of the recognition of the changing landscape of the population we serve, said Swedish, whose health system owns 28 hospitals and manages 14 others under contract.
Though the diversity issue includes linguistic competency, it goes far beyond speaking to patients in their preferred language. For instance some women patients have cultural reasons for needing to see a female physician. Many ethnic groups have specific dietary needs, including Arab and Jewish populations.
Native American cultures hold beliefs that are relevant in end-of-life situations, such as having a way for departing spirits to escape the physical world, like a window. They may want to open up the windows. And thats not a common thing to do in hospitals, said VeLois Bowers, senior vice president of diversity and inclusion at Trinity.
The diversity study is funded through a three-year grant from the Aramark Charitable Fund at the Vanguard Charitable Endowment Program. Hobby said the survey was developed with HR Solutions International through more than a year of consultation with the Institute for Diversity in Health Management, which is an affiliate of the American Hospital Association.
The deadline to respond is Dec. 12, but its not clear when the results of the survey will be released.
Asked whether facilities that might not be so confident in their diversity performance will also take part in the voluntary survey, Hobby said some administrators may be surprised to learn that theyre performing better than they had thought. But ultimately theres no risk of public embarrassment from the study.
Although survey results will be available for hospital officials perusal, all of the responses will be confidential. Individual organizations will be provided with a code that they can use on the institutes Web site to confidentially compare their own responses with the rest of the industry.
The survey poses a series of general and then more-specific drill down questions intended to develop benchmarks and industry standards in four areas of inquiry: How are healthcare organizations engaging diverse communities? How can they ensure that their governing bodies and executive leadership reflect the diverse patient populations they serve? How do they strengthen diversity in their own workforces? And how can they then deliver culturally and lin