1. Diversity in Healthcare
Enhancing the Patient Experience in
a Multi-Cultural Society

2. “Serving humanity to honor God”
 To promote and support the health status
of the our community
 To offer and continually improve the
delivery of innovative quality healthcare
services in a cost-effective manner
Methodist Healthcare
Mission

3. Diversity Healthcare Institute
Goals and objectives
 Increase U.S. hospitals’ awareness of the
unique needs of diverse patient populations
 Eliminate language and cultural barriers in
order to enhance patient outcomes
 Promote diversity and cultural sensitivity
 Establish criteria, assess, and measure
 Commitment to continuous improvement

4.  Quirón Consultants
 SOMECASA
Mexican Society for Quality Health
Care Services
 ANECASA
Asociación Neolonesa de Calidad
de Atención a la Salud, A.C.
Diversity Healthcare Institute
Consortium Members
 Health care consulting firm
focused on quality and continuous
improvement initiatives, including
evaluation, implementation
 An organization of health industry
leaders whose focus is promoting
a culture of quality in all aspects
of health care delivery
 State agency responsible for
assessing quality of health care
institutions in the State of
Nuevo León, México

5. Diversity Healthcare Institute
Why Methodist Healthcare in San Antonio, Texas
 Demographics of San Antonio and
South Texas
 DHI aware of International Services
programs created to meet unique needs
of patients from Mexico
 Trends in healthcare

6. Ethnicity of MHS Patients
January-March 2007
American Indian
15
(0.0002%)
N/A
1,708
(3%)
Asian
415
(1%)
Black
3,713
(6%)
Other
3,295
(5%)
White
25,463
(38%)
Hispanic
31,574
(47%)

7. Methodist Healthcare
International Services (Programs and Initiatives)
 Bilingual and culturally sensitive staff
 Concierge Services available 24/7
 One point of contact for access to MHS
health resources and for customer service
 Free physician referral service
International Physicians Panel
 Viva…Intl health and wellness program
 Spanish language health information on-line
www.SAHealth.com and nataldoc.com

8.  Coordinate admitting/financial arrangements
including filing international claims
 Assist physicians, clinical staff and case
managers, with patients related issues
 Availability of translated patient material
 Brochures, patient education guides
 Patient Rights, Conditions of Admission, Consent
Forms, Discharge Instructions, etc.
Methodist International Services
International Services (Programs and Initiatives)

9. Legal/Regulatory Environment
 Title VI of the Civil Rights Act of 1964 establishes
that any entity receiving Federal funds must offer
equal access to everyone regardless of race, color or
national origin.
 Executive Order 13166 which established “national
origin” as applying to Limited English Proficiency
 Culturally and Linguistically Appropriate Services
(CLAS) Standards were established primarily with
health care providers in mind (National Stds by OMH)
 Americans with Disabilities Act (ADA) of 1990
ensures that individuals with disabilities are provided
fair and equal access to health care services

10.  Standard 4. HCO must offer and provide
language assistance services including bilingual
staff and interpreter services at no cost to each
LEP patient at all points of contact, in a timely
manner during all hours of operation.
 Standard 5. HCO’s must provide to patient in
their preferred language both verbal and written
notices informing them of their right to receive
language assistance services
OMH CLAS Standards
Requirements for all recipients of Federal funds

11.  Standard 6. HCOs must assure the competence
of language assistance provided to LEPs by
interpreters and bilingual staff. Family and friends
should not be used to provide interpretation
services (except on request by patient).
 Standard 7. HCOs must make available easily
understood patient related materials and post
signage in the languages of commonly
encountered groups and/or groups represented
in the services area.
OMH CLAS Standards
Requirements for all recipients of Federal funds

12.  Auto-evaluation (January 2007)
 On-site Survey (March 2007)
 Certification (April 2007)
 Work Plan (April 2007 to Present)
 Re-certification (October 2008)
 JC (January 2009)
Diversity Healthcare
Certification Process

13. Auto-Evalution of Methodist Hospitals
Primary Criteria
 HCO philosophy and commitment to Diversity
 Awareness and cultural sensitivity of staff
 Administration to manage program
 Patient access to interpreter/translation services
 Translated documents/forms
 Patient Rights Handbook, Critical Choices, All Consent forms
 Patient education materials (Drug interactions, D/C inst)
 Hospital services, prevention and wellness info/programs
 Economic and financial considerations
 Epidemiological data/studies
 Religious Provisions
 Signage

14. Surveys of Methodist Hospitals
Units and Departments Surveyed
 Emergency Department
 Nursing Units
 Admitting/Financial Office
 Radiology/Imaging
 Laboratory
 Waiting Areas (L&D, O.R.)
 Food & Nutrition/Cafeteria
 Diabetes Education

15.  Methodist Hospitals Level 1 Certified
 Certification valid for 18 months
 Work Plan 2007-08 (Recert October 2008)
Certification and Work plan
April 2007 to present
• Diversity Task Force
• Increase Awareness and
empower employees
• Language and cultural
diversity courses
• Interpreter Competency
• Employee language skill
database
• Signage
• Epidemiological and
demographic research
Area of Focus
• Bio-Ethics, Intl Svcs
• Bio-Ethics, PR, Intl Svcs
• Bio-Ethics/Education
• JC Officer/Bio-Ethics
• HR, CNOs, Int. Svcs.
• Facilities Management
• IS and Strategic Planning
Departmental Contact

16. Diversity Certification
What it has meant for MHS
 Enhanced system-wide awareness and cultural
sensitivity in serving our diverse patient population
 Better prepared to meet the healthcare needs of
the local, regional, international Hispanic population
 On-going effort to eliminate language and cultural
barriers in order to improve outcomes/health status
 Goal is that proactive approach will position us to
better address more stringent JC reqs in 2009+
 Methodist Healthcare is recognized as the first U.S.
hospital system to be accredited by the DHI

17. It is the right thing to do for our
diverse patient population!