mfh WHO-Collaborating Centre for Health Promotion in Hospitals and Health Care Ludwig Boltzmann-Institute for the Sociology of Health and Medicine Institute for Sociology - University of Vienna, Austria 1 © LBIMGS 2004 Assessing “Migrant Friendliness” of Hospitals – Experiences and Results from a European Project Ursula Karl-Trummer, Karl Krajic, Sonja Novak-Zezula, Jürgen M. Pelikan Ludwig Boltzmann Institute for the Sociology of Health and Medicine, University of Vienna 13 th International Conference Health Promoting Hospitals Dublin, May 2005 Migrant-Friendly Hospitals - A EU Initiative

mfh WHO-Collaborating Centre for Health Promotion in Hospitals and Health Care Ludwig Boltzmann-Institute for the Sociology of Health and Medicine Institute for Sociology - University of Vienna, Austria 2 mfh – 12 European Pilot Hospitals Kaiser-Franz-Josef-Spital, Vienna, Austria Immanuel-Krankenhaus GmbH, Rheumaklinik Berlin-Wannsee, Berlin, Germany Kolding Hospital, Velje-Kolding, Denmark Hospital ”Spiliopoulio Agia Eleni”, Athens, Greece Hospital Punta de Europa, Algeciras-Cádiz, Spain Turku University Hospital, Turku, Finland Hôptial Avicenne, Paris, France James Connolly Memorial Hospital, Dublin, Ireland Presidio Ospedaliero della Provincia di Reggio Emilia, Reggio Emilia, Italy Academic Medical Center, Amsterdam, The Netherlands Uppsala University Hospital, Psychiatric Centre, Uppsala, Sweden Bradford Hospitals NHS Trust, Bradford, U.K. AT DE DK EL ES FI FR IT NL SV UK IR

mfh WHO-Collaborating Centre for Health Promotion in Hospitals and Health Care Ludwig Boltzmann-Institute for the Sociology of Health and Medicine Institute for Sociology - University of Vienna, Austria 3 Moving migration and cultural diversity higher up on the agenda of European hospitals and health policy Identifying problems and solutions  Review, Needs Assessment, MFQQ Assessment Implementing and evaluating model solutions  Interpreting Services, Health Promotion in Mother and Child Care, Staff Training Developing European recommendations  Amsterdam Declaration Disseminating experiences, results, recommendations 

mfh WHO-Collaborating Centre for Health Promotion in Hospitals and Health Care Ludwig Boltzmann-Institute for the Sociology of Health and Medicine Institute for Sociology - University of Vienna, Austria 4 A definition of MFH  A migrant friendly hospital  uses the principles/criteria of „migrant friendly“ or being sensitive to, accepting and compensating for ethnic/cultural diversity in every managerial and clinical decision  for that to happen management has to provide the necessary strategic decisions and support everybody by adequate structures and instruments of quality management

mfh WHO-Collaborating Centre for Health Promotion in Hospitals and Health Care Ludwig Boltzmann-Institute for the Sociology of Health and Medicine Institute for Sociology - University of Vienna, Austria 5 Components of a quality assured (Quality-) Management System for MFH MF QAS - Structures MF QAS- Processes MF QAS- Outcomes  MFQ goals, targets and rules  MFQ plans, programs, projects  MFQ management structure: committee, team, network of contact persons  MFQ Marketing  MFQ Budget Define MFQ Evaluate MFQ Develop MFQ MF Quality Assurance and Development

mfh WHO-Collaborating Centre for Health Promotion in Hospitals and Health Care Ludwig Boltzmann-Institute for the Sociology of Health and Medicine Institute for Sociology - University of Vienna, Austria 6 The MFQQ  an assessment instrument  developed by LBSHM and pilot hospitals  for assessing “Migrant friendliness” of services and settings in hospitals  Part A: MF characteristics of services  Part B: MF support system  Used in 2 surveys (2003/2004)

mfh WHO-Collaborating Centre for Health Promotion in Hospitals and Health Care Ludwig Boltzmann-Institute for the Sociology of Health and Medicine Institute for Sociology - University of Vienna, Austria 7 The overall project: MFQQ 2 nd Assessment Part A – MF Services: Measures to facilitate communication with migrant patients I Range: 1 – 4

mfh WHO-Collaborating Centre for Health Promotion in Hospitals and Health Care Ludwig Boltzmann-Institute for the Sociology of Health and Medicine Institute for Sociology - University of Vienna, Austria 8 The overall project: MFQQ 2 nd Assessment Measures to facilitate communication with migrant patients II

mfh WHO-Collaborating Centre for Health Promotion in Hospitals and Health Care Ludwig Boltzmann-Institute for the Sociology of Health and Medicine Institute for Sociology - University of Vienna, Austria 9 The overall project: MFQQ 2 nd Assessment Part B: Quality system and budget

mfh WHO-Collaborating Centre for Health Promotion in Hospitals and Health Care Ludwig Boltzmann-Institute for the Sociology of Health and Medicine Institute for Sociology - University of Vienna, Austria 10 Experiences and Conclusions  Assessment of MF of services and MF quality/support system  is useful for raising awareness  can monitor changes  can be developed further  selection of main indicators  for regular use  with standardised procedures and responsibilities

mfh WHO-Collaborating Centre for Health Promotion in Hospitals and Health Care Ludwig Boltzmann-Institute for the Sociology of Health and Medicine Institute for Sociology - University of Vienna, Austria 11

mfh WHO-Collaborating Centre for Health Promotion in Hospitals and Health Care Ludwig Boltzmann-Institute for the Sociology of Health and Medicine Institute for Sociology - University of Vienna, Austria 12 MFQQ selected results Part A: Services Communication - Interpreting Services  Improvements in 6 out of 7 indicators  Co-operation with external interpreting service with highest DI-EU (2,6)  No change in availability of service in request of clients Information concerning access to hospital and at hospital  Improvements in 5 out of 6 indicators  more information material translated into community languages (DI-EU 1,3 access and 1,7 at hospital) patient education, health promotion and empowerment  Improvements in 5 out of 5 indicators  with DI-EU of max. 0,9 in 2nd assessment consistent lower level compared to other service areas Rating: quartiles

mfh WHO-Collaborating Centre for Health Promotion in Hospitals and Health Care Ludwig Boltzmann-Institute for the Sociology of Health and Medicine Institute for Sociology - University of Vienna, Austria 13 Selected results Part B: Quality Structures  Increased integration of MF criteria in quality system (6 H/ H/03)  Improvements in written MF-Policies, esp. how to handle discrimination (7 H/ H/03) and action plans (6 H/ H/03)  Increase of activities to make issue visible  list of contact persons available to staff members (9 H/ H/03)  annual MFH presentations (8 H/ H/03)  MFH communication policy (6 H/ H/03)  Press releases (5 H/ H/03) Rating: yes/no

mfh WHO-Collaborating Centre for Health Promotion in Hospitals and Health Care Ludwig Boltzmann-Institute for the Sociology of Health and Medicine Institute for Sociology - University of Vienna, Austria 14 Selected results Part B: Quality Structures  Stable MF management structure conc. involvement of relevant stakeholders, and involvement of migrant representatives in organisational change  Budgets available only in 3 (4) hospitals  Explicit MF budget (3 H/ H/03)  Regular hospital budget (4 H/ H/03)  Monitoring of clinical outcome, health literacy, health behaviour remains low, as well as monitoring of clients and staff satisfaction Rating: yes/no