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改变医疗保健专业人员的行为以消除医疗保健中的差异:我们了解什么?我们该如何推进?

Changing healthcare professionals' behaviors to eliminate disparities in healthcare: What do we know? How might we proceed?

作者信息

Horner Ronnie D, Salazar William, Geiger H Jack, Bullock Kim, Corbie-Smith Giselle, Cornog Martha, Flores Glenn

机构信息

University of Cincinnati Medical Center, Cincinnati, Ohio 45267-0840, USA.

出版信息

Am J Manag Care. 2004 Sep;10 Spec No:SP12-9.

Abstract

The patient-healthcare provider communication process--particularly the provider's cultural competency--is increasingly recognized as a key to reducing racial/ethnic disparities in health and healthcare utilization. A working group was formed by the Office of Minority Health, Department of Health and Human Services to identify strategies for improving healthcare providers' cultural competency. This expert panel, one of several working groups called together to explore methods of reducing healthcare disparities, was comprised of individuals from academic medical centers and health professional organizations who were nationally recognized as having expertise in healthcare communication as it relates to diverse populations. During the 2-day conference, the panel identified, from personal experience and knowledge of the literature, key points of intervention and interventions most likely to improve the cross-cultural competency of healthcare providers. Proposed interventions included introduction of cultural competence education before, during, and after clinical training; implementation of certification and accreditation requirements in cross-cultural competence for practicing healthcare providers; use of culturally diverse governing boards for clinical practices; and active promotion of workforce cross-cultural diversity by healthcare organization administrators. For each intervention, methods for implementation were specified. On-going monitoring and evaluation of processes of care using race/ethnicity data were recommended to ensure the programs were functioning.

摘要

患者与医疗服务提供者的沟通流程——尤其是医疗服务提供者的文化能力——日益被视为减少健康及医疗服务利用方面种族/族裔差异的关键。美国卫生与公众服务部少数族裔健康办公室成立了一个工作组,以确定提高医疗服务提供者文化能力的策略。这个专家小组是为探索减少医疗服务差异方法而召集的几个工作组之一,由来自学术医疗中心和健康专业组织的人员组成,他们在全国范围内被公认为在与不同人群相关的医疗沟通方面具有专业知识。在为期两天的会议期间,该小组根据个人经验和文献知识,确定了最有可能提高医疗服务提供者跨文化能力的干预关键点和干预措施。提议的干预措施包括在临床培训前、培训期间和培训后引入文化能力教育;对执业医疗服务提供者实施跨文化能力认证和认可要求;为临床实践设立具有文化多样性的管理委员会;以及由医疗组织管理人员积极促进员工队伍的跨文化多样性。针对每项干预措施,都明确了实施方法。建议使用种族/族裔数据对护理过程进行持续监测和评估,以确保这些项目正常运行。

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