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Topics > Reducing Health Disparities Initiative > What We Are Doing > Ambulatory Care Works on Reducing Health Care Disparities

Ambulatory Care Works on Reducing Health Care Disparities

About 140 Ambulatory Care bilingual staff were recently evaluated for language proficiency through a new process initiated by Dianne Dunn-Bowie, Director of Ambulatory Care Services, and Shannan Moulton, Ambulatory Care Administration. "Dianne recognized that language proficiency is a patient safety issue and took steps to correct problems that can lead to disparities in health care," said José Martín, RHD Language Services Manager. Bilingual staff that provide medical interpretation were certified in their language proficiency by Language Testing International, a private agency that provides language proficiency assessments in more than 50 languages. The 30-minute oral exam was conducted over the phone and performance was compared to criteria for 10 proficiency levels. At least 80% who took the exam passed and were issued special badges. Those who did not pass or who have not taken the exam cannot use the language on their own and must use a certified interpreter. "This was very important for us," said Shannan. "We wanted to be sure we met federal mandate as well as our own policy of access to services for patients who are limited English proficient." The new policy has now been implemented at Contra Costa Regional Medical Center, making us the first public hospital in California to evaluate the language proficiency of our bilingual staff. The evaluation process will now be expanded to other Divisions.

Principles of Service Excellence Developed

Service Excellence is identified in CCHS' Five-Year RHD Overview as key to creating an environment where staff and patients feel respected. The Ambulatory Care Unit began in 2005 to describe customer service behaviors that were functional and reflective of our mission, vision and beliefs of how to become the healthcare provider of choice while meeting the health needs of the community. "Service excellence and reducing health disparities are very much interconnected," said Connie James, RHD Manager. "When clients, patients, consumers or customers feel uncomfortable and disrespected, disparities in health care can result." Ambulatory Care management reviewed patient satisfaction data and collected input from staff to define behaviors that evolved into Seven Principles of Service Excellence in Ambulatory Care.

"For us customer service is not just a training, it's a total program, and the key to this program's success lies in the inclusion of staff and patients," said Dianne Dunn-Bowie, Director of Ambulatory Care Services.

The Seven Principles of Service Excellence are: greeting and acknowledgement, telephone skills, continuous patient information, service recovery, accepting responsibility for the system, appreciating diversity and internal customer service. The division is currently in the process of discussing strategies for implementation and rollout of the program.

Clerks Survey to Verify Accuracy of Race/Ethnicity Data

Registration clerks at the Antioch and Brentwood Health Centers conducted a survey recently to verify the accuracy of the race/ethnicity data found in Keane, our billing system. "This is one of many first steps we are taking to be able to move forward with our Health Disparities efforts. We can't identify disparities by race or ethnicity if our data is inaccurate," said Dr. Steve Tremain, Director of System Redesign. Patients identified their appropriate race/ethnicity from a list of the Keane menu choices. The survey, in English and Spanish, was based on national best practices for scripting sensitive material. Registration clerks reported giving the patients a form was more comfortable than asking patients verbally. Feedback showed a 71% rate of accuracy - and patients said they preferred using one group for "Hispanic" instead Hispanic (Black, White, or Other); White Non-Hispanic patients preferred "Caucasian" or "White" to "White Non-Hispanic." The surveys will be expanded to include data from our outpatient and inpatient registration sites.

Content provided by the Reducing Health Disparities Initiative.

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