CROSS CULTURAL MEDIATION AS CROSS CULTURAL MEDIATION AS ENABLER OF CARE ENABLER OF CARE

THE EXPERIENCE OF TRENTO THE EXPERIENCE OF TRENTO HOSPITALHOSPITAL

Authors:Authors:Chiusole D., Baldantoni E., Mon E., Monterosso M., Passerini A., Chiusole D., Baldantoni E., Mon E., Monterosso M., Passerini A., Favaretti C.Favaretti C.A.P.S.S. TRENTO HOSPITAL - ITALYA.P.S.S. TRENTO HOSPITAL - ITALY

TRENTO HOSPITALTRENTO HOSPITALHEALTH CARE TRUST HEALTH CARE TRUST

AUTONOMOUS PROVINCE OF TRENTO ITALYAUTONOMOUS PROVINCE OF TRENTO ITALY

S. CHIARA HOSPITAL

CROSS CULTURAL MEDIATION (CCM) SERVICE CROSS CULTURAL MEDIATION (CCM) SERVICE

NECESSITY IN THE HOSPITALNECESSITY IN THE HOSPITAL

AWARENESS BY HEALTH CARE WORKERS

STRONGLY LINKED TO COMMUNICATION

OBJECTIVES OF CROSS CULTURAL MEDIATIONOBJECTIVES OF CROSS CULTURAL MEDIATION

IMPROVE LINGUISTIC COMPREHENSION

FACILITATE THE CONNECTION BETWEEN PATIENTS AND

PROFESSIONALS

HELP IN THE COMPREHENSION OF CULTURAL CODES

AND DIFFERENT LIFE STYLES

INFORM PATIENTS ABOUT THE CORRECT USE OF

HEALTH CARE SERVICES

IMPROVE THE COMPLIANCE OF PATIENT IN THE

PROCESS OF CARE

CCM START UPCCM START UP

• THE SERVICE STARTED IN SEPTEMBER 2004THE SERVICE STARTED IN SEPTEMBER 2004

• PARTNERSHIP WITH A NON PROFIT ASSOCIATION - AMICPARTNERSHIP WITH A NON PROFIT ASSOCIATION - AMIC

• FOREIGN LANGUAGES: ALBANIAN, ARABIC, CHINESE, FOREIGN LANGUAGES: ALBANIAN, ARABIC, CHINESE,

MACEDONIAN, POLISH, RUMENIAN, RUSSIAN, SERBIAN-MACEDONIAN, POLISH, RUMENIAN, RUSSIAN, SERBIAN-

CROATIAN-BOSNIAC, SOMALI, TURKISH, URDU CROATIAN-BOSNIAC, SOMALI, TURKISH, URDU

PRELIMINARY PHASEPRELIMINARY PHASE

THEORICAL AND PRACTICAL ORIENTATIONTHEORICAL AND PRACTICAL ORIENTATION

INFORMATION TO THE HOSPITAL WORKERSINFORMATION TO THE HOSPITAL WORKERS

WRITTEN FORMS ABOUT WRITTEN FORMS ABOUT PLEDGE OF SECRECY (CONFIDENTIALITY OF PLEDGE OF SECRECY (CONFIDENTIALITY OF

INFORMATION)INFORMATION) PATIENTS AGREEMENTPATIENTS AGREEMENT GATHERING OF DATA AND EVALUATION GATHERING OF DATA AND EVALUATION

MEDIATIONMEDIATION

ORGANIZATION OF THE ACTIVITYORGANIZATION OF THE ACTIVITY

INTERVENTION MODE (PLANNED OR ON CALL)

CALLS MADE BY PROFESSIONALS OF THE

HOSPITAL WARDS

DATA COLLECTION

EVALUATION AND REPORTING

RESULTS (RELATED TO THE RESULTS (RELATED TO THE FIRST 8 MONTHS OF ACTIVITY)FIRST 8 MONTHS OF ACTIVITY)

57% (20 ON 35) WARDS USED THE SERVICE 70% OF THE INTERVENTION WERE REQUIRED FOR

EMERGENCY ADMISSIONS, 30% FOR PLANNED ADMISSION 65% PLANNED INTERVENTIONS, 35 % IMMEDIATE

INTERVENTION MORE REQUESTED LANGUAGES

- 26 % ARABIC

- 17 % RUMENIAN

- 14 % RUSSIAN

- 12 % CHINESE

INTERVENTION REQUEST IS LINKED TOINTERVENTION REQUEST IS LINKED TO

DISEASES AND TREATMENTSDISEASES AND TREATMENTS

CARE PROCESSESCARE PROCESSES

MAINLY IN CHILDHOOD/MATERNITY WARDS MAINLY IN CHILDHOOD/MATERNITY WARDS

DUE TO INCREASING NUMBER OF PATIENTSDUE TO INCREASING NUMBER OF PATIENTS

EVALUATION OF MEDIATION AS ENABLER OFEVALUATION OF MEDIATION AS ENABLER OF

100% LINGUISTIC COMPREHENSION

87% CONNECTION BETWEEN PATIENT AND

HEALTH CARE WORKERS

40% COMPREHENSION OF PROBLEMS RELATED

TO THE ETHNIC AND CULTURAL BELONGING

MEDIATION MOMENTS (FROM THE POINT OF MEDIATION MOMENTS (FROM THE POINT OF VIEW OF HEALTH CARE WORKERS)VIEW OF HEALTH CARE WORKERS)

COLLECTION OF HYSTORY AND COLLECTION OF HYSTORY AND ASSESSMENT PATIENTSASSESSMENT PATIENTSEXPLANATION OF TREATMENTS AND EXPLANATION OF TREATMENTS AND PROCEDURESPROCEDURESSPECIFIC INFORMATION TO OBTAIN SPECIFIC INFORMATION TO OBTAIN CONSENT TO TREATMENTCONSENT TO TREATMENTHEALTH EDUCATION/PROMOTIONHEALTH EDUCATION/PROMOTIONPATIENT CAREPATIENT CARE

PERCEIVED USEFULNESS BY PATIENTS AND PERCEIVED USEFULNESS BY PATIENTS AND WORKERS BECAUSE IT ENABLESWORKERS BECAUSE IT ENABLES

• BETTER CARE FOR PATIENTS AND BETTER CARE FOR PATIENTS AND IMPROVEMENT OF ENPOWERMENT IN IMPROVEMENT OF ENPOWERMENT IN CARE DECISIONCARE DECISION

• BETTER RELATIONSHIP BETWEEN PATIENT BETTER RELATIONSHIP BETWEEN PATIENT AND MEDIATOR BASED ON TRUSTAND MEDIATOR BASED ON TRUST

• BETTER FOLLOW UP AFTER DISCHARGE BETTER FOLLOW UP AFTER DISCHARGE (AMIC NETWORK)(AMIC NETWORK)

CONCLUSIONSCONCLUSIONS

CCM NUMBER OF CALLS IS A PROXY OF CCM NUMBER OF CALLS IS A PROXY OF PERCEIVED UTILITYPERCEIVED UTILITY

TIME FRAME OF INTERVENTIONS IN THE TIME FRAME OF INTERVENTIONS IN THE

WHOLE PROCESS OF CARE AS A PROXY WHOLE PROCESS OF CARE AS A PROXY

OF CONTINUITYOF CONTINUITY

CROSS CULTURAL MEDIATION AS JCI CROSS CULTURAL MEDIATION AS JCI STANDARD OF CARE FOR PATIENTS AND STANDARD OF CARE FOR PATIENTS AND FAMILY RIGHTS FUNCTION - PFRFAMILY RIGHTS FUNCTION - PFR

The EFQM Excellence Model

Leadership ProcessesCustomer Results

Key Performance

Results

People Results

Society Results

Partnerships & Resources

Policy and Strategy

People

INNOVATION AND LEARNING

ENABLERS RESULTS

THEN WHAT?THEN WHAT?

EXTENSION OF THE CCM TO THE ENTIRE EXTENSION OF THE CCM TO THE ENTIRE HEALTH CARE TRUST OF AUTONOMOUS HEALTH CARE TRUST OF AUTONOMOUS PROVINCE OF TRENTO (6 MORE HOSPITALS PROVINCE OF TRENTO (6 MORE HOSPITALS AND OUTPATIENT SETTINGS)AND OUTPATIENT SETTINGS)CCM AFTER DISCHARGE IN THE PRIMARY CCM AFTER DISCHARGE IN THE PRIMARY CARE SETTING TO IMPROVE CONTINUITY OF CARE SETTING TO IMPROVE CONTINUITY OF CARECARECCM AS A TOOL TO IMPROVE CCM AS A TOOL TO IMPROVE SELFMANAGEMENT AND DIRECT SELFMANAGEMENT AND DIRECT INVOLVEMENT IN THE PROCESS OF CAREINVOLVEMENT IN THE PROCESS OF CARE