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