Transcript Background - AUSL.RE.IT

Cultural Competence Training:
a Sub Project of the
Migrant Friendly Hospitals Initiative
at
University College Hospital, Galway
Presented by Fiona Falvey & Catherine Sherlock
Migrant Friendly Hospital
Initiative
The increasing diversity of patient populations poses new
challenges to hospitals, which are frequently the first point of
access for migrants and ethnic minorities. This European-wide
pilot initiative aimed to implement model interventions, enabling
hospitals to respond effectively to the diverse needs of our
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migrant population
12 countries in Europe participated in this project:
Austria, Denmark, Germany, France, Finland, Ireland, Italy,
Netherlands, Sweden, UK, Greece and Spain.
Migrant Friendly Hospital Initiative
Migrant Friendly Hospital Project Aims
To identify, develop and evaluate models of good practice for
promoting the health & health related knowledge and
competence of migrants and ethnic minorities
Improving hospital services for these patients groups
These models of good practice served as a basis for the
Amsterdam Declarion of European recommendations which was
launched in December 2004
Benefits of MFH Project
For Patients:
Migrant friendly health care settings through increased
availability of culturally adequate services
Improved communication
Enhanced quality of life during hospital treatment
Empowerment through improved health literacy
Increased patient satisfaction
Benefits of MFH Project:
For Hospitals:
Quality improvement in aspects of patient orientation and
patient-orientated services with special focus for a migrant
population
Reduction of conflicts in the provision of care for migrants and
ethnic minorities
Benefits of MFH Project:
For Staff:
Reduced workload through reduction of conflicts though
increased patient satisfaction and adequate help-seeking
Reduction of barriers to effective service delivery
Improved compliance of migrant patients through better health
literacy
Improved communication with migrant patients
Galway Regional Hospitals
Steering committee formed including representatives from:
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Senior Management
Social Work
Health Promotion
Psychiatry
Galway Refugee Support Group
Irish Refugee Council
Accreditation Dept
Obstetrics-Gynaecology Division
Accident & Emergency Dept
Medical Records Dept
Human Resources
The Health Promotion Officer and Social Worker chaired the meetings
Galway Regional Hospitals
The Steering Committee picked 2 Areas of intervention:
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Improving interpreting (services) for clinical communication.
Improving the cultural sensitivity and cultural competence of hospital staff
through training and personnel development
and 3 pilots areas of the hospital:
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Maternity Outpatients’ Dept
Ward Clerks
Accident & Emergency Dept
Cultural Competence Training
Aim
To increase staffs’ understanding of the impact
culture can have on patients’ access and experience
of health care.
Objectives
To improve participants’ knowledge in relation to the
health/social/economic status of migrants
Participants to identify the ways in which fear and
prejudice can affect the way services are delivered
Participants to identify the main barriers to accessing
the health services experienced by migrants
Methodology
A subcommittee was formed to develop a training pack. We were
provided with best practice guidelines from the European MFHI
project. We also used a Traveller Friendly Training Pack which
had previously been developed, and successfully evaluated, by
the Western Health Board Health Promotion Team. Other
resources came from the Social Work Dept, UCHG. The training
was edited by the Galway Refugee Support Group
The training was 10 hours in length and was delivered over 3 days
(approximately 3.5 hours each day) to staff in 2 pilots areas of
the hospital:
 Maternity Outpatients’ Dept
 Ward Clerks
Contents of Training
The training pack included modules on:
 Relevant reading material
 What is Culture?
 Myths and Beliefs about migrants
 Health service providers’ experiences of working with
migrants
 Barriers to accessing our services
 A reflection on privilege
 Culturally sensitive work
 Audit of good practice
Results
 2 10-hour training programmes were delivered to
ward clerks and staff in Maternity Outpatients’ Dept.
 13 participants began the first training session, and 7
participants completed the full 10 hours.
 9 participants began the second training session, and
all 9 participants completed the full 10 hours.
 Of the 22 participants, 4 were midwives in the
Maternity Outpatients’ Dept, the remaining 18 being
ward clerks throughout the hospital (including A&E
and Maternity Outpatients’).
Evaluation
Overall, evaluations have found the training programme to be informative
and useful.
The following points give a flavour of the evaluations, both positive and
negative:
What participants found most helpful in the training programme:
The information about other cultures provided, entitlements, etc.
 The discussions generated among the groups
 More understanding of migrants
 Made participants think more about culture
 Not being judged by facilitators
 Clarified a lot of myths
 Realising the challenges that face migrants
Evaluation
What participants found least helpful in the training programme:
 Not enough time to discuss all topics raised
 Facilitators making excuses for migrants
 Not getting some answers
 Would like more handouts
 Expected more feedback from facilitators
Conclusions
There were a number of issues which we felt could be changed
1. Definition of a migrant was not available from the European
Initiative and this may have been helpful for the purposes of
discussion.
2. Training might be more accessible over two days instead of
three days. The current training has been incorporated into the
overall Human Resources Training Plan, and is now being run
successfully over 2 afternoons.
3. Having a facilitator who is a migrant would have possibly been
quite beneficial
4. Some further preparation work by management with each Dept
may have been useful so that participants felt that they
attended the training voluntarily
Culturally Diverse Health Care
Information & Resources
Arising out of the pilot Migrant Friendly
Hospital Initiative, a pack was developed to
assist staff with the many issues which may
arise when working with people from other
cultures, including language barriers, racism,
misunderstandings, and contact details for
useful organisations.
Culturally Diverse Health Care
Information & Resources
The guide was developed by the MFHI steering committee and
includes information on:
 Culture and cultural identity
 Culturally competent care and its relevance
 How to access and work with interpreters
 How to work without an interpreter
 Rights and entitlements of migrants, including asylum seekers
and refugees
 Contact details for government and NGO support agencies and
churches
 Notes on racism, inter-culturalism and equality
Conclusion
Promoting a migrant friendly culture is an ongoing
process. Both areas of this pilot initiative have
evaluated positively, and we have continued beyond
the pilot phase and expanded the project to the rest
of the hospital.
Contact Details
Fiona Falvey, Health Promotion Services, UCHG
091 542103 [email protected]
Catherine Sherlock, Social Work Dept, UCHG
091 544089, [email protected]