1. AHN Immigrant Health Readiness Assessment
Kheir Mugwaneza, Immigrant Health Program Manager, Center for Inclusion Health
Annette Fetchko, Service Line Director, Center for Inclusion Health
2017 TOWN HALL

2. Overview Immigrant Health Program: SWOT Analysis: Next Steps
Background
Description
Goals
SWOT Analysis:
Defining the issue
Analysis Method
Findings & Recommendations
Next Steps

3. Immigrant Health Program
How It All Started:
Listening to the immigrant stakeholders
Taking Action by:
Creating the Immigrant Health Program
Assessing AHN Tools & Resources
Involving Stakeholders in the Process
Doula/CHW Project

4. Immigrant Health Program
Goals:
Establish infrastructure across Allegheny Health Network Service areas to increase access to healthcare and provide better services to immigrants and refugees
Collaborate and engage the immigrant community and organizations that assist immigrants and refugees.
Increase knowledge about different immigrant and refugee populations across the network through improved employee onboarding protocols and continuing education trainings on language access and cultural competency
Collaborate with AHN Human Resources and Highmark D&I to establish an Immigrant/refugee career referral process

5. SWOT Analysis Defining the issue: Method:
-Language/Cultural barriers significantly impact safe and effective health care provision and accessibility
Method:
-Cross-Departmental attendees: Nursing, Training/Education, Social Work, Case Managers, Physicians, Patient Relation, Volunteer Management, Food Services, Emergency Department,…
-Analysis: Open Discussion/Follow-Up questions

6. SWOT Analysis Strengths Weaknesses Opportunities Threats
Stratus Video Interpretation
Back-up services: Phone/translation/In-person Interpreters
Recognition to improve services
Immigrant patients “champions”
Phone/video interpretation does not work well with all patients
Insufficient resources to effectively work with diverse populations
Limited understanding of barriers associated with immigrant population
Limited immigrant related topics in training plans
Opportunities
Threats
Review and use of Social Determinants of Health screening tool
Connecting with experts in cultural diversity training and provide training to staff
Establish Linguistically/Culturally appropriate communication tools for non-English speaker patients
Overall trend of increased Immigrant population in Western PA
Perception/Stigma towards immigrants/refugees
No/limited insurance coverage and limited financial capabilities affect accessibility to care
Limited related training and education
Limited data and knowledge about local immigrant population
Relying exclusively on Video Remote Interpreting system
SWOT Analysis

7. SWOT Analysis Themes: Language Access Language ID Tools
Staff Diversity
Social Services
Cultural Humility
Data Tracking
Systems & Operations

8. Findings & Recommendations
Language Access:
-Relying on Video/Phone Interpretation
-Limited use of professional interpreters
-Use of family/friends as interpreters
Contract more vendors with local interpreters for In-Person interpretation
Ensure interpretation at no cost and in timely manner, at all key points of contact, including scheduling appointments

9. Findings & Recommendations
Language Identification Tools:
Limited use of language identification cards
Limited use of written notices in language of preference
Display of language identification cards in key locations
Provide verbal or written notices informing LEP patients of their right to receive interpretation services at no cost
Provide translated key forms and consents from EPIC

11. Findings & Recommendations
Diverse Staff:
-Recruit staff with diverse background and culture
-Limited resources/programs to educate staff on diversity
Establish strategies to recruit, retain, elevate diverse staff
Work closely with workforce agencies that assist minorities to find jobs

12. Findings & Recommendations
Navigating Patients to Social Services:
Difficulties navigating non-insured and under-insured patients
Difficulties referring patients to appropriate social services
Establish a comprehensive list of service providers in each facility area
Update AHN Charity Care guidelines by removing the citizenship requirement

13. Findings & Recommendations
Cultural Humility Training
Limited regular cultural humility trainings
Limited robust onboarding training for new hires
Require Cultural Humility training for all staff: onboarding and continued education training curriculum
Require other immigrant health related topics as part of continued education training curriculum
Establish periodic “Immigrant Health Education” sessions

14. Findings & Recommendations
Data Tracking
Limited data of interpretation service usage
Limited data of the immigrant population patients
Establish a system at each facility/unit to track the use of interpretation/translation services
Integrate data into network management system and operations

15. Findings & Recommendations
Systems & Operations
Need for coordinated use of resources by facilities/units
Standardize interpretation contracting process(In-Progress)
Establish a centralized contact for all interpretation service related matters
Establish a full-time interpreter/coordinator at each hospital according to each site most requested language
Management accountability/oversight mechanisms to provide culturally and linguistically appropriate services
Communicate progress made to all stakeholders
Establish a Language Access Plan

16. Integrated Advisory Board Develop the Implementation Plan
Next Steps
Integrated Advisory Board
Starting with our November meeting
Develop the Implementation Plan
Cross-Departmental Collaboration
Social Services Stakeholders
Develop a Community Health Worker Model

17. THANK YOU!