Transcript Making A Title Slide

Nuts and Bolts of Collecting Race, Ethnicity, and
Primary Language Information From Patients
Presented To
Admitting/Registration Staff
INSERT YOUR NAME
INSERT NAME OF YOUR ORGANIZATION
INSERT DATE
© 2007 by the Health Research and Educational Trust
Insert your Logo
Today’s Objectives
• Review the purpose of the data collection
•
Review current patient registration screens
• Review changes that will be made to the registration screens
•
Review Patient Response Matrix
© 2007 by the Health Research and Educational Trust
Purpose of This Initiative
• We are implementing a systematic method of collecting
•
•
data on race, ethnicity, and primary language directly
from patients or their caregivers.
The purpose of collecting this information is to ensure
that all patients receive high-quality care. [Note: If
targeting specific population groups, insert more info
here.]
Our experience will help inform hospitals across the
country on improving quality of care for all populations.
© 2007 by the Health Research and Educational Trust
Admitting/Registration Role
• Admitting/Registration is key to collecting this data:
–
–
–
–
•
Consistently
Accurately
Professionally
Completely
The new system for data collection will be implemented
_____(specify all inpatient, ED admissions, outpatient
clinics, etc…)
© 2007 by the Health Research and Educational Trust
Race Definitions
OMB
•
American Indian or Alaska Native: A person having origins in any of the original peoples of
North and South America (including Central America), and who maintains tribal affiliation or
community attachment.
•
Asian: A person having origins in any of the original peoples of the Far East, Southeast Asia, or
the Indian subcontinent, including, for example, Cambodia, China, India, Japan, Korea, Malaysia,
Pakistan, the Philippine Islands, Thailand, and Vietnam.
•
Black or African American: A person having origins in any of the black racial groups of Africa.
•
Native Hawaiian or Other Pacific Islander: A person having origins in any of the original
peoples of Hawaii, Guam, Samoa, or other Pacific Islands.
*OMB-Mod: This symbol indicates a modification we have made to the OMB recommendations
© 2007 by the Health Research and Educational Trust
Race Definitions
•
White: A person having origins in any of the original peoples of Europe, the Middle East,
or North Africa.
•
Multiracial: A person having more than one or a combination of the above origins. *OMBMod
•
Declined: A person who is unwilling to choose/provide a race category or cannot identify
him/herself with one of the listed races. *OMB-Mod
•
Unavailable: Select this category if the patient is unable to physically respond, there is no
available family member or caregiver to respond for the patient, or if for any reason, the
demographic portion of the medical record cannot be completed. Hospital systems may call
this field “Unknown,” “Unable to complete,” or “Other.” *OMB-Mod
*OMB-Mod: This symbol indicates a modification we have made to the OMB
recommendations.
© 2007 by the Health Research and Educational Trust
Ethnicity Definitions
OMB
•
Hispanic or Latino: A person of Cuban, Mexican, Puerto Rican, South or Central
American, or other Spanish culture or origin, regardless of race.
•
Non-Hispanic or Latino: Patient is not of Hispanic or Latino ethnicity.
•
Declined: A person who is unwilling to provide an answer to the question of Hispanic or
Latino ethnicity. *OMB-Mod
•
Unavailable: Select this category if the patient is unable to physically respond, there is no
available family member or caregiver to respond for the patient, or if for any reason, the
demographic portion of the medical record cannot be completed. Hospital systems may call
this field “Unknown”, “Unable to Complete,” or “Other.” *OMB-Mod
*OMB-Mod: This symbol indicates a modification we have made to the OMB
recommendations.
© 2007 by the Health Research and Educational Trust
Ethnicity Screen
Now I would like you to tell me your race and ethnic background. We use this
information to review the treatment patients receive and make sure everyone
gets the highest quality of care.
First, do you consider yourself Hispanic/Latino?
•Yes
•No
•Declined
•Unavailable
© 2007 by the Health Research and Educational Trust
Race Screen
Which category best describes your race?
•
•
•
•
•
•
•
American Indian/Alaska Native
Asian
Black/African American
Native Hawaiian/Other Pacific Islander
White
Multiracial
Declined (This is a flag indicating that the individual did not want to answer this
question—do not ask again during the same or subsequent visit.)
• Unavailable (This is a flag indicating that the person could not answer the question. May
ask the person again.)
© 2007 by the Health Research and Educational Trust
Using OMB (modified) Categories Without
Splitting Race/Ethnicity
-African American/Black
-Asian
-Caucasian/White
-Hispanic/Latino/White
-Hispanic/Latino/Black
-Hispanic/Latino/Declined
-Native American
-Native Hawaiian/Pacific Islander
-Multiracial
-Declined
-Unavailable/Unknown
Primary Language Screen
• What language do you feel most comfortable speaking with
your doctor or nurse (patient’s primary language)?
•
Provide a list of options. See next slide for examples.
Provide language list from the census (available in the Toolkit
section Collecting the Data—The Nuts and Bolts/Which
Categories to Use/Language Categories) or modify to meet
the needs of the communities you serve.
© 2007 by the Health Research and Educational Trust
New Table : Primary Language
English Proficiency Screen (optional)
How would you rate your ability to speak and understand
English?
•
•
•
•
•
•
•
Excellent
Good
Fair
Poor
Not at all
Declined
Unavailable
The next slide provides a sample screen.
© 2007 by the Health Research and Educational Trust
New Table: English Proficiency
Addressing Concerns from Patients
• General rule of thumb: If a person does not want to answer
these questions, move on. Do not force the issue. Simply
record “Declined.”
•
In some instances, people may have questions or may be
confused. The following slides provide a sample of
questions and responses. These are not meant to be
exhaustive.
•
You are the experts—modify as needed.
© 2007 by the Health Research and Educational Trust
Handling the Responses from Patients:
Basic Guidelines
•
•
Use common sense.
Decide whether you will provide a list of categories (either
Census or OMB) or whether you will let patients selfreport based on their own descriptions.
• Allow patients to respond and use as much of their own
description as possible.
• Respect their descriptions (or choices if providing
categories).
• Avoid words that might be considered confrontational.
© 2007 by the Health Research and Educational Trust
Handling the Responses from Patients:
Matrix
• We realize that patients might be concerned and might feel
•
•
•
•
•
uncomfortable.
They will have questions and comments.
We want you to feel comfortable answering any questions patients
ask.
The Patient Response Matrix is based on actual patient answers to
the race/ethnicity questions.
The matrix is intended to be used as a tool to help you respond in the
best possible manner.
Again, the best course of action is to use common sense, a
nonconfrontational approach, and to take care not to push the issue if
it is clear that the patient does not want to respond to the question.
© 2007 by the Health Research and Educational Trust
Patient Response Matrix - Routine
Patient Response
Suggested Response
“I'm American."
Would you like to use an additional term,
or would you like me to just put
American?
"Can't you tell by looking at me?"
Well, usually I can. But sometimes I'm
wrong, so we think it is better to let
people tell us. I don’t want to put in the
wrong answer. I’m trained not to make
any assumptions.
If using open-ended option:
"I don’t know. What are the
responses?
You can say White, Black or African
American, Latino or Hispanic, Asian,
American Indian or Alaska Native, Pacific
Islander or Native Hawaiian, some other
race, or any combination of these. You
can also use more specific terms like
Irish, Jamaican, Mexican
"I was born in Nigeria, but I've really
lived here all my life. What should I
say?"
That is really up to you. You can use any
term you like. It is fine to say that you are
Nigerian.
Hints
Code
American or
others if
specified
It’s best not to ask
for this information
again.
Patients Returning
Patient Response
Suggested Response
A patient returning for care with
the “DECLINED” code.
DO NOT ASK AGAIN
A patient returning for care with
the “UNKOWN” or "Unable to
provide information" code.
Proceed to ask for the information per
routine.
Hints
Code
Tougher Questions
These generally indicate DECLINED code.
Patient Response
Suggested Response
Hints
Code
"I m Human."
Is that your way of saying that you
don’t want to answer the question?
If so, I can just say that you didn't
want to answer.
DON'T SAY - I'll just code as a
declined.
Declined
"It's none of your
Business."
I'll just put down that you didn't
want to answer, which is fine.
DON'T SAY - I'll just code as a
declined.
Declined
"Why do you care? We're
all human beings."
Well, many studies from around the
country have shown that a patient's
race and ethnicity can influence the
treatment they receive. We want to
make sure this doesn't happen
here, so we use this information to
check and make sure that
everyone gets the best care
possible. If we find a problem, we
fix it.
If patient still refuses,
DON'T SAY - I'll just code as a
declined.
Declined
Tougher Questions (cont’d)
Patient Response
Suggested Response
" Are you saying that this has
happened at _______?”
We don’t know, but we want to make sure
that all our patients get the best care
possible. We are part of a national research
study to help make sure that doesn’t
happen.
"Who looks at this?"
The only people who see this information
are registration staff, administrators for the
hospital, and the people involved in quality
improvement.
"Are you trying to find out if I'm
a US citizen?"
No. Definitely not!! Also, you should know
that the confidentiality of what you say is
protected by law, and we do not share this
information with anyone.
Hints
Code
What if the patient presents a race/ethnicity
that’s not on the table?
• Code as “unknown or unable to answer” or add as a text response so
•
you can track this information.
Staff should flag this (e.g., record this information)—if this happens
frequently, it may indicate a new category needs to be added to the
coding scheme.
Provide contact information of point person for any
questions or concerns that may come up.