Patients who come to Holy Name under one of the programs can access services with the help of a bilingual care coordinator. During hospital stays, patients are served food from their native culture and have access to television and newspapers in their native language.
Part of those efforts require educating clinicians and other healthcare staffers on some of the subtleties of Asian culture. Some of those cultural norms can include offering warm water instead of cold, providing a bowl of rice and soup as opposed to a sandwich, and referring to a patient by their surname instead of by their first.
A serious faux pas in the healthcare setting is writing a patient's name in red ink, the color traditionally used in some parts of Asia to signify a person is dead. "Can you imagine if you came to the hospital and the nurse picks out red ink and begins to write your name?" Choi asked. "That is not a good thought."
Providing culturally tailored amenities is just one part of what the program offers patients. Maron said the program has been effective because of the systemwide commitment toward culturally sensitive care from Asian and non-Asian clinicians alike. "What we learned is that there is an incredible amount of science and an incredible amount of enhanced, high-quality, cost-efficient care that can be delivered when you tune in to ethnic segmentation of the population," Maron said. (See sidebar, p. 23.)
Dr. Hee Yang said when he began participating in Asian Health Services 10 years ago, the goal was to provide culturally sensitive care to a population whose health needs were often ignored. But he discovered that providing care with such an approach let clinicians practice some of the truest forms of population health management.
"We basically started a program to see if we could help people," said Yang, chief medical officer for the Asian Health Services program at Holy Name. "But an interesting thing happens along the way when you do something like this, when you start centralizing a minority group in a region, you begin to see subtle differences in medical issues."
Choi said Holy Name has reaped the benefits since becoming known as the area's go-to health site for Asian-Americans. The hospital as well as its three satellite sites attract 50,000 patient visits a year through Asian Health Services. Over the past several years, the program has helped more than 7,000 patients obtain coverage through the Affordable Care Act's health insurance marketplace.
Maron agreed the program has been financially positive for the hospital, but acknowledged problems existed before the ACA due to bad debt the system had to carry to treat first-generation immigrants, many of whom were uninsured. The situation improved somewhat when New Jersey opted to expand Medicaid to all low-income adults.
Over the years, Maron said, the program has helped the hospital recruit ever-more talented Asian clinicians, making it an attractive healthcare destination for all members of the community. "For many of them, their reputations have grown so their practices now are probably half Korean and half the rest of the population," Maron said. "That for us is just another great growth story—when you put the people first, the dollars end up following."
Maron said the Asian Health Services program has already influenced how the hospital delivers care to other ethnic groups. Recently, the hospital formed a Patient-Centered Cultural IQ Committee to develop a pilot program that packages the methodology of Asian Health Services in order to share the model with other providers.
In recent years, representatives of three area hospitals have visited Holy Name as they study adopting a similar model to serve their Asian-American populations, and Illinois and California providers have called seeking information.
Choi said she never aspired for Asian Health Services to go beyond its initial goal of helping her community, but feels its success has shown a potential path other healthcare providers can take to better manage the health of their minority patient populations.
"We want to become the national leader in culturally sensitive care," she said.
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