Integration of diversity in quality assurance in Dutch Health Care

1
Integration of diversity in quality assurance in
Dutch Health Care

• Care and Public Health Research Institute
• Maastricht University,
• The Netherlands
• H.Celik I.Klinge

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Contents

• Current state of the art
• The problems
• A proposal for a solution
• Our project
• Methods
• Results
• Conclusions

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Heterogeneous population

• Dutch population is diverse e.g. sex, age, ethnic
  origin, and SES
• Increasingly more diverse
• Globalization (e.g. immigration)
• Demographic changes (e.g. ageing)
• Patients health is related to diversity (RIVM,
  2003)

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Attention to diversity

• Awakening awareness
• Relevant institutional levels
• Health policy
• Quality assurance
• Primary process (Intake, diagnosis, and
  treatment)
• Problems (Ormel et al, 1994)
• Misdiagnosis
• Mistreatment
• Chronic illness
• Higher care consumption

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Mainstreaming gender (Rees, 1998)

• The (re)organisation, improvement, development
  and evaluation of policy processes so that a
  gender equality perspective is incorporated in
  all policies and at all stages by the actors
  normally involved in policy-making

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Objective

• Raise awareness of gender and diversity
• Diversity competence programme
• Target group 8-12 strategic actors
• Health care institutions (experimental gardens)

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Health care institutions

• Main inclusion criteria
• Willingness to address diversity issues
• 8 to 12 actors available
• Selected institutions (anonymous)
• Institute for Mental Health
• Hospital
• Nursing Home

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Diversity competence programme

• Uniqueness
• Sector
• Institution
• Department
• Tailoring of programme to each setting

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Measurements

• Diversity Thermometers I and II
• Institutions
• Management
• Middle management
• Employee
• Participants
• Evaluation of diversity competence programme

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Results institutional level

• Institution for Mental Health
• Diversity factors seen as relevant
• Quality assurance no reference to diversity
• HRM attention could be better
• Financial management partly taken into account
• Primary process diversity factors should be part
  of it

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Results participant level (1)
(Celik et al, 2004)
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Results participant level (2)

• Baseline phase 2 (Do)
• After programme phase 3 (Plan)
• Change is significant (plt0.05) for
• Sex
• Age
• Ethnic origin
• SES

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Evaluation of Programme

• All participants were satisfied
• Knowledge
• Baseline knowledge 6.3
• After Programme 8.1

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Conclusion (Institute for Mental Health)

• Institutional level
• Diversity is not an integral part of quality
  assurance
• Participants
• Raised awareness
• Improved knowledge
• Diversity programme first step

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Acknowledgements

• Participants
• Institutions

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Grant information

• ZonMw
• Project number 3610.0015