Objective:
To demonstrate that providing homecare services to bleeding disorder patients with limited English proficiency in a culturally sensitive manner and in their native language can improve quality and outcomes of care.
Methods:
Provider and patient surveys were developed to measure the perceived value of interventions. Respondents were asked to rank dimensions of clarity of translated information, cultural sensitivity, satisfaction, and patient outcomes following homecare interventions on a scale of 1-9. Four patients from different ethnic backgrounds as well as their respective medical providers responded to a survey developed by the authors.
Results:
Our survey and its results, despite small numbers, demonstrate that patients as well as providers see value and improved outcomes when bilingual/bicultural professionals, interpreters and/or qualified translators were provided. Out of a total possible score of 9, an average score of 8.75 to 9 was obtained on the patient surveys. Patient respondents agreed that the information related to their treatment or care was provided in a language that was easy to understand and agreed the homecare service providers accommodated their cultural, religious or spiritual belief practices. Among the surveyed providers, services were ranked at an average of 8.75/9. The providers agreed that the language needs and cultural barriers of their patients were well addressed. It was reported that they “strongly believed” their patients “received accurate instruction on the prescribed treatment plan in a language that was easy for the patient/caregiver to understand” and addressing those needs “exceeded their expectations”.
Conclusion:
According to the Hemophilia Data Set (HDS) there has been a 236% increase in the Hispanic population and a 71% increase for other ethnic populations from 1990 to 2010. Our program has also seen a significant rise in the number of non-English speaking patients on service. This changing demographic landscape necessitates reform in the service delivery in terms of accommodating the needs of cultural diversity and overcoming language barriers. In order to do so, a continuous channel of communication is of high value to monitor and modulate changes in the population. Our survey and its results, demonstrate our success towards those ends, and hopefully will contribute to the continuous quality improvement (CQI) process in the provision of culturally competent care.