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• The overall project: Developing migrant-friendly hospitals •

Sustainable improvements of complex organisations, like hospitals, can be achieved only within the framework of an overall organisational development process. To initiate and foster such a process, the MFH project set up an “overall project”, starting with establishing project teams in all partner hospitals. These teams took responsibility for all further project related activities within their hospitals, took the lead in marketing the idea and acted as focal points for the European project coordination.

In line with quality management procedures, the overall project started with (1) conducting a needs assessment within the partner hospitals which integrated perspectives of clients, staff and hospital management and (2) with a literature review >> on available knowledge concerning health and health care problems and possible solutions related to migrant status. This review grouped interventions in four areas – communication, responsiveness, empowerment and monitoring – and it highlighted the relevance, principle options and evidence for effectiveness of interventions in these areas.

Local overall projects oriented themselves at the basic principles forming the core of a migrant friendly hospital mission statement defined in the European project:

  • valuing diversity by accepting people with diverse backgrounds as principally equal members of society;
  • identifying the needs of people with diverse backgrounds and monitoring and developing services with regard to these needs;
  • and finally, compensating for disadvantages arising from diverse backgrounds.

An assessment instrument was developed: the Migrant Friendly Quality Questionnaire (MFQQ) to assess the status quo of overall “migrant-friendliness” concerning services and (quality) management structures Results were used to allow for benchmarking within the group of participating hospitals. The MFQQ proved useful in systematically assessing migrant-friendly structures such as interpreting services, information material for migrant patients, culturally sensitive services (religion, food), as well as components of a (quality) management system to enable and assure the migrant-friendliness of services, e.g. the integration of migrant-friendliness into mission statements, budgeting, and staff development programmes. The MFQQ was used for two assessments (2003 and 2004) within the 12 European Partner Hospitals and – additionally – for 5 observer hospitals in Germany and Ireland, all locally organised within the Health Promoting Hospitals network. It proved to be feasible and informative, but experiences also indicate areas for further improvement.

On the basis of the results of the needs assessment, of the first MFQQ assessment of structures and quality systems, and the review's identification of the most common problems and solutions, a first picture of MFH-related problems and ways to handle them could be drawn, followed by decisions concerning the implementation of three subprojects.

In addition to their activities within the three thematically focused subprojects, some hospitals engaged in further action within the overall project, e.g. by integrating migrant-friendliness criteria into their strategy development (regulation of basic values, EFQM self-assessment, strategic aims and Balanced Scorecard), by improving hotel and religious services for a migrant clientele, and by implementing migrant-friendly information material (translation of relevant information about the department, discharge and follow-up procedures, improving signposts using pictograms).

The first assessment in 2003 showed a heterogeneous European hospital group, with some hospitals listing many existing migrant-friendly services and having a well-established management structure in place, but with other hospitals showing considerable areas for further development. The results after one year of work within the European project showed that the majority of hospitals could use the project for considerable improvements both on the level of services as well as for developing their quality management systems. Detailed results are to be found in the presentations that were made on the occasion of the project group's final business meeting (included in this report).

The experiences made so far as well as collected data provide a good basis for further development.

Results, Tools, Focus Groups >>

Email: uschi.trummer@univie.ac.at