7 2 Final Project Submission Case Study Analysis and Proposal

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7-2 Final Project Submission: Case Study Analysis and Proposal 7-2 Final Project Submission: Case Study Analysis and Proposal By: Molanda Manassa Southern New Hampshire University IHP- 410: Population Health & Cultural Competence Instructor: Naa-Solo Tettey 2/25/2024

7-2 Final Project Submission: Case Study Analysis and Proposal Founded in 1884 as a hospital for patients with chronic illnesses, Montefiore Medical Center is an academic medical facility in New York City, mostly in the Bronx (Chase, 2010, pp. 1-2). To meet the specific requirements of the low-income and vulnerable communities it serves, this organization has created a patient-centered care system that integrates its access, delivery, and information system (Chase, 2010, pp. 1-2). The community can benefit from the excellent translation and interpretation services offered by Montefiore Medical Center. These services are available to patients who are limited English proficient (LEP), hard of hearing, deafblind, and their family members and companions (Montefiore, n.d., slide 2). The purpose of the organization is to provide patient and family- centered care; to do this, they must provide patients with the appropriate services if they are thought to be deaf or hard of hearing (Montefiore, n.d., slide 4). This is why they established these services. Furthermore, these services guarantee that all patients from this community, regardless of their cultural background, may communicate with their physicians in an effective manner, which may enhance the standard of care and give them with the greatest healthcare services available. The group provides free interpreters in more than 150 languages for use throughout the medical center and its affiliated sites (Montefiore, n.d., slides 7&12). But the offer, the answer, and the assistance and services provided must all be recorded on the chart (Montefiore, n.d. slide 12). Additionally, the organization offers tools such as pocket talkers, communication cards, teletypewriters, closed captioning, and deaf talk to help patients more effectively (Montefiore, n.d., slide 10). In addition, customers and employees can contact customer support at 718-920-TALK, where a multilingual translator is available to help in more than 150 languages (Montefiore, n.d., slide 12). To help patients with their interpreting needs, the

7-2 Final Project Submission: Case Study Analysis and Proposal Nursing Office and Customer Service Department also have dual handset phones and a splitter with two handsets available (Montefiore, n.d., slide 12). To better serve its varied community, Montefiore Medical Center offers a variety of educational resources and materials. About 36% of people in Westchester and Bronx County identify as African Americans, and about 50% of people in both counties identify as Latino or Hispanic (Chase, 2010, p. 2). The organization offers educational and nutritional programs that assist in managing various illnesses and health risks. In the words of Chase (2010), "the outreach workers have designed education materials to communicate with the population's diverse needs based on cultural, language and education-level needs" (p. seven). Furthermore, as patients wait in the waiting area, health educators lead youngsters in a reading program and lead cookery demonstrations to promote healthy eating (Chase, 2010, pp. 6-7). Because a sizable portion of the people that the organization serves identifies as Hispanic or Latino, training resources and information in the case study can be found in Spanish rather than English (Chase,2010, p.2). With multiple locations around the Bronx, the Montefiore Medical Center is a multi-site institution that needs enough people to support and attend to the requirements of its patients. 1,625 doctors, 3,070 nurses, 1,200 medical residents and fellows, and an extra 1,000 volunteers make up the 17,382 employees of Montefiore Medical Center (Chase, 2010, p. 3). With a small workforce and a broad clientele, the healthcare system must provide patient engagement and communication training in order to improve patient care and promote cultural competence. To ensure that patients receive the right care, the organization trains its healthcare professionals to go above and beyond the call of duty. According to the case study, "Clinical skills and the capacity to apply social medicine tools to investigate the impact of social determinants of health are among the criteria used to categorize applicants (Chase, 2010, p. 8)." In relation to the

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7-2 Final Project Submission: Case Study Analysis and Proposal training examined in the study, the Montefiore Medical Center places a strong emphasis on the diversity of their patients as well as the abilities of their personnel, fostering interaction and interaction with the public. Furthermore, by hiring and retaining Hispanic, Cambodian, and Vietnamese staff, Monroe Medical Center addresses cultural competency challenges and patient involvement by hiring staff with networks in the community and the healthcare system (Chase, 2010, pp.6-7). The organization focuses on the community as well as its patients. They establish services like telemedicine, school-based clinics, and homeless shelters to reach out to the community's most vulnerable members (Chase, 2010, p. 16). In terms of patient engagement and communications, Montefiore Medical Center is doing a fantastic job meeting the requirements of their patients. Upon perusing the case study, it became evident to me that the firm places a high priority on treating individuals with care and assistance, as well as providing the resources they require. However, I saw several little weaknesses in the organization's communication and engagement tactics, such as the fact that their patient health library only provides information in languages other than Spanish and English on 6,000 themes. A printout of the material would be preferable to the staff member giving the patient verbal instruction. They already need to successfully cover patients who speak languages other than the ones they already have, so it would be excellent if they added staff members of Vietnamese, Cambodian, and Hispanic heritage. The healthy living initiatives at Montefiore Medical Center are concentrated on teaching kids’ self-control over food and a positive body image. Patients, staff members, and the community at large can all take part in the initiatives that MMC has created to support leading a healthy lifestyle. They are actively involved in a plethora of projects aimed at promoting the best

7-2 Final Project Submission: Case Study Analysis and Proposal health and wellness. To start, MMC partnered with the Lopez Family Foundation, which is comprised of artist Jennifer and her sister Lynda Lopez, to encourage healthy living in the Bronx. Together, they constructed the Center for a Healthy Childhood (established in 2009), whose mission is to support the community in "improving their health regardless of their circumstances" and to provide high-quality care to mothers and children. In areas where mothers are finding it difficult to teach their children to eat healthily, a program that increases the ability to provide those who are less fortunate with high-quality care and health education is essential. The center also offers fresh fruits and vegetables to the community. In addition to offering a wide range of programs, MMC also hosts live presentations where employees and the community can learn how to prepare healthy food. In the fight against diabetes, MMC has partnered with nearby parks and fitness centers to provide free memberships to the local community. The CATCH (Collective Action to Transform Community Health) initiative is a very strategic plan whose primary objective is to enhance community health. They collaborate with numerous businesses and governmental organizations to help identify community needs, offer free health service information to the public, and organize events that directly address community needs (Montefiore.org). It's a terrific marketing strategy, in my opinion, to include the community in helping one another. This will reach those who may not have known about the hospital's offerings beyond the obvious. More communication and word-of-mouth can aid in getting patients back on the path to recovery (Montefiore.org). "The staff at Montefiore Medical Center takes great precautions to ensure neither they nor their patients spread diseases to other patients, visitors, or staff," reads the Montefiore website. In addition, recommendations are given that patients and staff can use when they are not in the hospital. MMC provides a wealth of expertise and well-trained personnel to assist in the

7-2 Final Project Submission: Case Study Analysis and Proposal prevention and treatment of all illnesses. With the use of pathology, radiography, and diagnostic tests, MMC's own Infectious Diseases team helps specialists assess the health state of patients. The institution provides follow-up care for every patient who may be afflicted with any disease through this program. Patients can view their own health information, consult a doctor when necessary, and even renew their own prescriptions thanks to MMC's online community access. In addition to imparting extensive knowledge on appropriate food consumption, the CATCH program delivers additional services that improve the quality of life in the community. On November 24, 2008, MMC created the Patient Safety Transport Initiative. From testing to treatment, the program offers "nurses, transporters, and technicians when they transport their patients during their hospital stay" (Montefiore.org). To provide a qualitative approach to their patient during their stay in the facility, a comprehensive signed and documented form with all the patients' demands and linguistic preferences is included. MMC even considers the "green" component of their services and is mindful of their surroundings while they are not within the building . In order to offer patients transportation while also contributing to the decrease in fuel costs and pollution, MM has made investments in the use of free bikes and hybrid/electric vehicles on the facility's campus. Not only does the Care Giver Center offer all these services to its patients and the community, but it also opened a toddler care center for the staff members' children, ensuring that the facility and the patients have a fully equipped staff without the need for outside help. The center's skilled staff helps people who need assistance navigating daily life activities and offers counseling services so that patients can speak freely about their issues. Though, like with everything, there is always space for improvement, I cannot say that I see the need to continue changing MMC programs to better meet the requirements of their community. There are numerous MMC programs available to meet the demands of the

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7-2 Final Project Submission: Case Study Analysis and Proposal community; adjusting to the residents and employing multilingual staff facilitates trouble-free communication between the staff and the provider. A seamless and enjoyable visit is essential to a place with as much diversity as The Bronx. MMC has accounted for the community's need for important health information by offering free services to those with lower incomes, adjusting their clinical hours to accommodate patients with later schedules, and educating their patients about ways to reduce healthcare costs. I'm not sure what more they could do for their community. Their collaboration with various initiatives and foundations is indicative of their strong desire to provide better assistance to their community. "There is no discrimination against anyone at Montefiore on the grounds of age, physical appearance, gender identity or expression, sex, national origin, race, color, or religion. Because of their race, color, religion, sex, national origin, handicap, sexual orientation, gender identity or expression, physical appearance, or age, no one is excluded from or treated differently at Montefiore hospital Center (Montefiore hospital center, 2022). They offer free services to those with disabilities who require interpreters in sign language as well as to non-English speaking people. They assist patients without health insurance in applying for free hospital programs or health insurance under the Affordable Care Act, including as Medicaid, Child Health Plus, and the NYS Marketplace. To encourage patients and the community to lead healthy lifestyles, they provide a variety of initiatives. The outreach workers who assist the homeless, neighborhood schools, and free public health fairs are the organizations that run these initiatives. According to Chase (2010), "Outreach workers have created educational materials to communicate with the diverse needs of the population based on cultural, linguistic, and educational needs." They have committed their lives to helping people with conditions like obesity, diabetes, and asthma. Through community education, school initiatives, free health

7-2 Final Project Submission: Case Study Analysis and Proposal screenings, and gym memberships based on Montefiore Medical Center's condition criteria, they continue to encourage healthy living. Going above and above for their patients is one way that Montefiore Medical Center is willing to expand its patient-centered approach. They provide on-site medical care in mobile clinics and homeless shelters located around the Bronx. In collaboration with neighborhood- based groups, they started matching these patients who arrived to the ED with a social worker. One of their other strategies for combating obesity is to collaborate with public schools to introduce low-fat milk to classrooms. To assist cut costs, they are only giving their patients the care that is essential. They collaborate with the community to reduce childhood obesity. Their goal is to provide their patients with minimal or no cost assistance in maintaining their health. They have community outreach workers that educate the locals. They go out to neighborhood homeless shelters and mobile clinics to treat patients, rather than waiting for them to get worse before coming to them. following up with patients after they are discharged from the hospital. Each of these tactics aids in reducing expenses and getting rid of pointless processes. Regardless of their background or culture, all patients at Montefiore Medical Center are certain to get top-notch treatment. They continue to provide information and nourishing items to the community in addition to offering free activities. To fulfill the future needs of its community, Montefiore Medical Center must expand its expertise, take on new diseases, prevent diseases, and manage diseases that are already diagnosed in a whole new population living right there in their current population. Continually expanding the scope of ailments will enable Montefiore Medical Center to continue growing its patient base and achieving success.

7-2 Final Project Submission: Case Study Analysis and Proposal When it comes to attaining vital component care and making changes, Montefiore has done rather well. Montefiore should implement the National CLAS Standards, in my opinion. The US Department of Health and Human Services developed 15 criteria to give medical institutions a guide on how to educate themselves about the health status, language, cultural beliefs, and communication needs of their patients. (US Department of Human Resources, n.d.) The level of patient communication and cultural competency will rise at Montefiore if they choose to apply the National CLAS Standards. The National CLAS Standards can be implemented using a checklist developed by the US Department of Health and Human Services. Montefiore might enhance the health of its patients and the Bronx community by emphasizing more access to treatment, cutting costs for services, and offering screening services for free or at a reduced cost to those who require them. "A high level of patient care–team integration and alliances with local public health efforts that, in turn, promote well-being of populations in the surrounding community are required for the growing adoption of population health across multiple healthcare settings" (Chase 2010) Since Montefiore is now laying the foundation for the neighborhood, the objective ought to be attainable. Free health screenings could be a great way for community centers, neighborhood gyms, and pharmacies to promote access to services and raise awareness. At Montefiore, strong patient-community ties are essential to the development and enhancement of patient self- efficiency and behavior-changing self-management of chronic illnesses.

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7-2 Final Project Submission: Case Study Analysis and Proposal References: Chase, D. (2010). Montefiore Medical Center: Integrated Care Delivery for Vulnerable Population. The Commonwealth Fund, pp.1-20. https://learn.snhu.edu/content/enforced/1351814- IHP-410-J6677-OL-TRAD- UG.23EW6/Course%20Documents/IHP %20410_media_files_publications_case_study_2010_oct_1448_chase_montefiore_med_ ctr_case_study_v2.pdf? isCourseFile=true&_&d2lSessionVal=rQzY7X8T27Mv0EfxoP0vD4tB5&ou=1351814 Montefiore. (n.d.). Interpreting Services Program. https://learn.snhu.edu/content/enforced/1351814-IHP-410-J6677-OL-TRAD- UG.23EW6/Course%20Documents/IHP %20410_interpreting_services_program2007.pdf? isCourseFile=true&_&d2lSessionVal=rQzY7X8T27Mv0EfxoP0vD4tB5&ou=1351814 Montefiore 2023; About Us; “History and Milestones” Retrieved from: https://www.montefiore.org/about-history-and-milestones#:~:text=From%20its %20founding%20in%201884,and%20treatments%20that %20save%20lives%2C Montefiore medical center. (2022). Montefiore: non-discrimination notice. Retrieved from: https://www.montefiore.org/discrimination-policy Unknown; Golden “Lopez Family Foundation” Retrieved from: https://golden.com/wiki/Lopez_Family_Foundation-NX5GJY.

7 2 Final Project Submission Case Study Analysis and Proposal

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