EVOLUTION TOWARDS A MIGRANT FRIENDLY HOSPITAL

1. EVOLUTION TOWARDS A MIGRANT FRIENDLY HOSPITAL Elvira MÉNDEZ, Fatima CHOYE, Anna SANCHO GOMEZ, Cristina INIESTA. 12th International Conference: Investing in Health for the Future, Moscow 26-28 May 2004

2. OVERVIEW • INTRODUCTION • OBJECTIVES • METHODS • RESULTS • CONCLUSIONS Migrant Friendly Hospital

3. INTRODUCTION This is project has been developed from Juny of last year 2003 to April 2004 with the collaboration of Hospital del Mar of Barcelona (HMB) and Asociación Salud y Familia (ASF). HMB is a 420 bed general university Hospital, located in a district “Ciutat Vella” of Barcelona with a high density of foreign residents, with a large number of regular and irregular migrants using its emergency, inpatient and outpatient services. Migrant Friendly Hospital

4. INTRODUCTION ASF is a non-governamental, non-profit-making organisation that designs and promotes models for improved accessibility and use of health services, targeting vulnerable groups, in socially and culturally disadvantaged positions. Migrant Friendly Hospital

7. OBJECTIVES • Improve general conditions for the provision of healthcare to the migrant population. • Increase the availability of culturally adapted services and health education. • Improve communication by breaking down language and cultural barriers between healthcare staff and immigrants. Migrant Friendly Hospital

8. OBJECTIVES • Reduce unnecessary burdens on workload through reduction of intercultural conflict. • Increase appropriate use of services and level of satisfaction among patients from the immigrant population. Migrant Friendly Hospital

9. METHODS • There is a cross-section of intercultural mediation services available for the Arabic, Pakistani and Rumanian communities, in terms of support for the immigrants themselves and for the healthcare staff. • The intercultural mediation services are dependent on the Helpdesk Unit and they work both at the request of the various hospital services and on their own initiative, in the case of Emergency and Obstetrics services. Migrant Friendly Hospital

10. METHODS • We promote the identification of intercultural adaptation needs on the part of hospital services, products and routines. • Throughout the process, leadership is shared between the HMB and the ASF to stimulate a synergy of knowledge, expertise and innovation in the improvement of quality of help given to new immigrant people. • We encourage the visible presence of the intercultural mediation services inside the hospital and of the HMB/ASF project within the health system and in the city of Barcelona. Migrant Friendly Hospital

11. RESULTS • The Hospital actively uses the services provided by ASF of three intercultural mediators covering the areas of Maghreb, Pakistan and Rumania, giving direct support in 1,359 consultations and serving 739 immigrants during the period under study. INTERCULTURAL MEDIATION USERS AND ACTIVITIES AT THE HOSPITAL DEL MAR (June 2003 – April 2004) Users served: 739 immigrants Consultations made 1,359 Consultations per user: 1.8 Migrant Friendly Hospital Migrant Friendly Hospital

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14. DEPARTMENTS AT THE HOSPITAL DEL MAR REQUESTING INTERCULTURAL MEDIATION SERVICES (June 2003 – April 2004) Admissions Department: 241 32,6% Obstetrics Department: : 150 20,3% Surgery Department: 95 12,9% Accident & Emergency Department: 59 8% Medical Department: 55 7,4% Paediatrics Department: 45 6,1% Help Desk: 36 4,9% Other Departments: 57 7,6% Migrant Friendly Hospital

15. DEPARTMENTS AT THE HOSPITAL DEL MAR IN WHICH INTERCULTURAL MEDIATION SERVICES ARE CARRIED OUT (June 2003 – April 2004) Accident and Emergency Department: 370 50% In-Patient Wards: 223 30,2% Out-Patient Departments: 83 11,2% Central Services: 42 5,7% Day Care Hospitals: 13 1,7% Other Departments: 8 1,1% Migrant Friendly Hospital

16. ACTIVITIES CARRIED OUT BY THE INTERCULTURAL MEDIATION SERVICES AT THE HOSPITAL DEL MAR (June 2003 – April 2004) Intercultural Mediation: 571 41% Healthcare Paperwork: 391 28% Referral to the Health and Family Association: 153 11% Follow-up of cases: 102 7% Support for Undocumented Immigrants: 64 5% Translation: 57 4% Social Work: 52 4% Migrant Friendly Hospital

19. RESULTS • The immigrants attended to are mostly Muslims from the Maghreb and Pakistan, followed by E.U citizens and Latin American immigrants. • The most frequently used languages have been Arabic, Urdu-Punjabi, Spanish and English. • There is a slight majority of immigrant women attended to, and the most represented age group is the 15-44 year old group. Migrant Friendly Hospital

20. RESULTS • The HMB departments that most request the intercultural mediation services are the Admissions Unit, the Obstetrics Department and the Surgery Department. • The areas of the HMB in which most intercultural mediation activities take place are the Emergency Department and the In-Patient Wards. Migrant Friendly Hospital

21. RESULTS • The activities most undertaken by the intercultural mediators are those of direct intercultural mediation, information on obtaining official healthcare documentation and referral to the Health and Family Association for ongoing psychosocial care. Support activities purely for translation are in the minority. • The intercultural mediators have provided services to locate and give advice on home visits to friends and family of patients hospitalised with contagious diseases such as tuberculosis and AIDS. Migrant Friendly Hospital

22. RESULTS • The HMB has initiated a movement in which intercultural conflicts may arise, be discussed and for which appropriate management may be found, fundamentally in the field of maternity/child care. • The HMB has interculturally adapted a significant amount of information in the surgery department and has initiated a project to create intercultural material on health education, fundamentally in the field of maternity/child care. Migrant Friendly Hospital

23. RESULTS • The presence of intercultural mediators in the ongoing training activities of healthcare staff at the HMB is increasing. • The Human Resources Department of the HMB plans to incorporate ethnic minorities in its new plans for staff recruitment. • The experience of the HMB in collaboration with the ASF allows for the process to be assessed in real time and for short and long-term detection and meeting of new needs for intercultural adaptation and project visibility. Migrant Friendly Hospital

24. CONCLUSIONS • Intercultural organisational development has come to stay in the institutional agenda of the HMB. • The experience of the HMB in collaboration with the ASF puts forward a sustainable model of GOOD INTERCULTURAL PRACTICE that can be developed and adapted in other Hospitals. • The experience of the HMB in collaboration with the ASF allows us to bring on intercultural improvements and innovation without generating too much resistance inside and outside the Hospital. Migrant Friendly Hospital

25. Thanks!