One Size Does Not Fit All: Diverse Populations Pose Special Health Needs

Main Category: Public Health
Article Date: 21 Apr 2008 - 16:00 PDT

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As the face of America continues to change, a research report released today by The Joint Commission, entitled "One Size Does Not Fit All: Meeting the Health Care Needs of Diverse Populations," urges health care organizations to assess their capacity to meet patients' unique cultural and language needs. In its 2001 report "Crossing the Quality Chasm," the Institute of Medicine identified patient-centered and equitable care as important elements of quality.

The report is based on successful practices now being used in hospitals, and underscores the need to move away from a "one size fits all" approach that negatively affects the quality and safety of care for diverse patients. The report includes a self-assessment tool that can help health care organizations tailor their initiatives to meet the needs of diverse populations. The tool addresses the main issues found in the report and provides a framework for discussing needs, resources and goals for providing the highest quality care to every patient served.

The report is the result of a multi-year research study, Hospitals, Language, and Culture: A Snapshot of the Nation supported by funding from The California Endowment. This study provided the first comprehensive examination of how hospitals in the United States respond to the diverse cultural and language needs of their patients. The study explored how 60 hospitals across the country provide care to culturally and linguistically diverse patient populations. This experience helped in developing the framework.

"Before meeting the treatment needs of patients, effective communication with them is needed in order to understand what the health problem is and how they wish to go about addressing that health problem," says Mark R. Chassin, M.D., M.P.P., M.P.H., president, The Joint Commission. "By using this framework, hospitals can assess their current practices and take action to treat each patient as a unique individual."

"This report provides many useful examples of how hospitals are effectively addressing the cultural and language needs of their increasingly diverse patients," says Robert Ross, M.D., president and CEO, The California Endowment. "We hope that hospitals across the nation will adopt some of these practices and use the report's self-assessment tool to improve the quality of care that their patients receive."

The report urges hospitals to systemically engage in a range of practices across four areas:

- Build a foundation. Leadership must drive efforts to establish specific policies and procedures for better meeting the diverse needs of patients. For example, cultural and language considerations should be included in the organization's mission, vision and value statements. The foundation should also include devoting resources for organizational planning and organization-wide policies that integrate cultural competence and support improved patient care for diverse populations.

- Collect and use data to improve services. Before determining which cultural and language services are most appropriate to implement, it is important to collect and review demographic data to assess both community and patient needs. To better evaluate an organization's current cultural and language services, it is critical to track how often these services are used. Some of the services that may be monitored include language services, religious and spiritual care services, and special dietary requests that are cultural in nature.

- Accommodate the needs of specific populations. A continuous process is necessary to target culturally competent initiatives to specific populations. This includes staff training and education, as well as patient education and other strategies that help patients better manage their care.
v - Establish internal and external collaborations. Organizations must work together with the community in order to share information and resources that meet the needs of diverse patients. Involving the community and making use of available external resources can help keeps costs down, while taking steps to develop a more diverse workforce, bridge cultural barriers and become a more active part of the community.
v To access the complete text of "One Size Does Not Fit All: Meeting the Health Care Needs of Diverse Populations," visit The Joint Commission website at http://www.jointcommission.org.

http://www.jointcommission.org