1. Diversity Outreach Initiative Making a Difference in Hospice Care for the Minority Community 2011 GCHC/ASQ Innovative Solutions Award

2. 2 Diversity Outreach Initiative How was this Project Selected? A clear, well-documented problem of under- utilization of hospice care for minority patient populations nationally and locally –Hospice of Cincinnati (HOC) seeks to better understand the extent, dynamics and scope of the problem in the Greater Cincinnati service area HOC works through TriHealth to partner with Accel Advisors to develop methods and tools to inform the selection and project confirmation process –Eight methods and tools were identified (i.e. focus groups, management interviews, MD interviews, survey, etc.) NHPCO Patient Population NHPCO—National Hospice and Palliative Care Organization

3. 3 Diversity Outreach Initiative What is the Project’s Situation Analysis? HOC’s resources for identifying potential root causes: 1) Literature, articles and published research 2) Primary qualitative research conducted by Hospice of Cincinnati and/or Accel Advisors 3) Opinion and subjective theories from Care Team 4) HOC’s frontline Caregivers and Admissions Nurses Using these four resources, HOC identified 12 potential root causes Each root cause was assumed to be valid for our project if it was confirmed or consistent across three of the four resources Internal and external stakeholders played key roles in identifying root causes HOC Patient Population

4. 4 Diversity Outreach Initiative What was the Project’s Solution? In order to achieve objectives, HOC aimed to be successful in at least three key areas: 1) Access, 2) Messaging and 3) Cultural Proficiency Strategies in each of these three areas were evaluated on four criteria: feasibility, cost-effectiveness, appropriateness and synergy with HOC processes already in place Final Solutions: –Access ► Touchpoints are “grassroots-oriented” and personalized. Mass media also utilized to complement this approach. –Messaging ► Relevant and targeted/AA value proposition –Cultural Proficiency ► In-person diversity awareness training for all 500+ HOC employees

5. 5 Diversity Outreach Initiative What were the Project’s Results? More African-Americans are receiving hospice care than ever before –HOC AA patient days ↑ by 43% Hospice care information is much more accessible to African- Americans and other minority groups –HOC has taken information directly to the communities –Average of 18 events annually attended in targeted areas –HOC recognized by Muslim community with I-CAIR Award in 2010 –HOC accredited by National Institute of Jewish Hospices (NIJH) Hospice of Cincinnati’s caregivers and staff are more culturally-proficient –92% of entire staff of 500+ employees attended diversity awareness training Hospitals in greater Cincinnati have benefited from HOC’s Diversity Initiative efforts –HOC has provided in-person diversity education and CEU’s to every hospital system in Greater Cincinnati