equity in care teri g. fontenot president/ceo. canada gulf of mexico pacific ocean atlantic ocean
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Equity in Care
Teri G. FontenotPresident/CEO
Canada
Gulf of Mexico
Pacific Ocean
AtlanticOcean
Essential Statewide Leaderin Obstetrics, Gynecology,
Breast & Neonatal Care
New Orleans 57%37%
3%
1% 2%
Caucasian African American Hispanic
Asian Other
We believe that:
• Patients deserve care, treatment, and services that safeguard their personal dignity and respect their cultural, psychosocial, and spiritual values
• Sensitivity to beliefs is not only the patient’s right but also a key factor in safety and quality patient care
• By understanding and respecting cultural, psychosocial, and spiritual values, providers can better meet the patient’s care needs
Non-English Speaking Patients
2007 2008 2009 2010 2011 2012 Jan - May 2013
0%
1%
2%
3%
4%
5%
6%
2.0%2.5%
3.0% 3.0% 3.4%
4.4%
5.5%
61%
9%4%
7%
18%
Spanish Vietnamese Chinese
Arabic Other
Race, Ethnicity and Language Diversity
Caring for a Culturally Diverse Population
• Language assistance– Key patient information brochures and documents– Medical interpreters – phone and in person– Interpreters for hearing impaired
• Staff training– Patient rights– Annual training for all staff– Hospital employees with diverse backgrounds share personal
stories, beliefs, values– Spanish classes– Reinforcement of importance at departmental/staff meetings,
newsletters
Admission Assessment
• Cultural/spiritual practices that may impact hospital stay
• Special diet
• Primary language
• Special needs/assistance required
• Preferred learning method
• Highest educational level completed
• Barriers to education
• Methods to overcome barriers
Cultural Beliefs in Pregnancy: Hispanic
• Direct eye contact avoided with people in authority
• More traditional nuclear families
• Tend not to complain of pain—suffer through labor
• Many believe that prenatal care is not necessary; pregnancy is a natural condition
• Prefer spontaneous delivery
• Females assist during labor
• Most breastfeed
Cultural Beliefs in Pregnancy: Vietnamese
• Health based on harmony and balance within
• Very modest; avoid eye contact
• Highly family-oriented
• May nod head to acknowledge hearing, but may not understand or agree
• Birth is critical time for hot/cold balance
• Breastfeeding for one year is traditional; adhere to strict diet
Focusing on Population Health Disparities
• HIV– Baton Rouge has highest rate in US in new HIV cases among
females
– African American and Hispanic women are disproportionately affected compared with women of other races/ethnicities
• Mother-to-Child HIV Prevention Program– Nurse case management for HIV/AIDS-infected pregnant women
and their babies
– Funded through community support and individual gifts
– No HIV-positive babies have been born to a mother enrolled in our program
Aug-12 Sep-12 Oct-12 Nov-12 Dec-12 Jan-13 Feb-13 Mar-13 Apr-130%
2%
4%
6%
8%
10%
12%
14%
16%
8.14%
10.71%
5.48% 5.26%
1.64%
10.81%
5.45% 4.55%
15.22%
Focusing on Population Health Disparities• Breastfeeding
– African American women have lower breastfeeding rates than other primary ethnic/race groups (CDC)• Lack of understanding of importance• Lack of support from families and friends
– Targeting specific neighborhoods, Woman’s provides education and support in churches, community centers, etc.
– Goal for exclusive breastfeeding is 42%
Zip codes 70802, 70805, 70807
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