Role model

St Vincent's in Sydney believes its diversity model could help other health facilities. By Jeremy Gowing and Tami Ebner

Diversity health is a vital part of holistic patient care and is based on recognising the individual needs and expectations of our patients which may be driven by cultural or other diversity factors.

Working collaboratively, the diversity health team at St Vincent's Private Hospital and St Vincent's Hospital in Sydney has developed an innovative model to facilitate cultural competence among clinicians for the diverse communities we serve. Diversity Health Day plays a big part in this model.

"The purpose of Diversity Health Day is to encourage and support staff in the provision of culturally appropriate care to all. It aims to raise awareness amongst our staff of the need to be more finely attuned to the differences in and between our patients and how we might better work with them to enable safe, effective and culturally sensitive care," said professor Kim Walker from the research office at St Vincent's Private.

Running annually since 2010, Diversity Health Day engages community experts and local universities to create significant learning opportunities for our multidisciplinary staff.

The event also serves to celebrate diversity with a multicultural afternoon tea provided to those who attend.

The team at St Vincent's has an inclusive view of diversity, including ethnicity, culture, language, religion, gender, age, political background, sexuality, geographical location, disability, responsibility as a carer and literacy levels.

Simone Engel, medical records manager at St Vincent's Hospital, highlighted some of the diversity on campus. "Last year we cared for patients from 160 countries of birth, 40 different religions and speaking over 75 languages at home," she said.

The Diversity Health Day model

Community speakers were organised to give presentations to staff in 2010, 2011 and 2012.

Speakers addressed the care needs of patients, including refugees, Jewish and Buddhist patients, traditional Chinese medicine, health literacy and multicultural mental health.

Each year speakers donate their time, representing communities and contributing to staff learning.

We select the topic areas based on an analysis of our patient admission demographics, community trends and from clinician survey results identifying learning needs.

Also requiring early planning is the diversity health poster display.

Each year local universities and students are encouraged to submit posters, and hospitals encourage campus staff to submit work highlighting their diversity health projects.

"The poster display engages staff to focus on diversity issues in their own ward areas and increases awareness of diversity in the community," said Julie Brooks, nursing unit manager, St Vincent's Private. The French project which won the poster prize in the inaugural year came from collaboration between nurses and the hospital's French interpreter, developing educational resources for French-speaking patients.

To engage all staff disciplines in the events, we obtained the support of our CEOs to open each event. Nursing, medical and allied health clinicians were informed of the events at key councils and committees. Key nursing, medical and allied health executives were asked to judge the poster display, further securing "buy-in" from leaders in these professions.

The team worked with internal communications to promote the event on our intranet and via colourful posters.

"An additional strength of the annual event is the venue; our mezzanine lounge is an open area rather than a closed lecture theatre, so it accommodates large numbers of clinicians from both St Vincent's Hospital and St Vincent's Private and community members and patients are also able to attend," said Dr Brett Gardiner, the director of clinical governance at St Vincent's Hospital.

A resource table created each year provides written diversity health resources on a wide range of topics for clinicians.

Outcomes

After each event, we held online surveys to evaluate staff understanding of diversity health generally and for the specific patient groups addressed.

Survey responses indicated that the information presented raised the awareness and intention of clinicians to provide enhanced care. For example:

• About 80 per cent of survey responses (in all years) agreed/strongly agreed that the information presented would enhance their cultural competence when caring for all patients from diverse backgrounds.
• More than 68 per cent agreed/strongly agreed that information presented would improve care to patients who are refugees.
• More than 70 per cent agreed/strongly agreed that information presented would improve care to patients who are Jewish.
• More than 75 per cent agreed/strongly agreed that information presented would improve care to patients who are Buddhist.
• More than 72 per cent agreed/strongly agreed that information presented would improve care to patients who do/could use traditional Chinese medicine.
• More than 74 per cent of clinicians reported that they would improve their practice in relation to health literacy.
• More than 72 per cent would improve their practice in relation to caring for multicultural or diverse mental health patients or their carers.

Other survey questions relating to the structure of the day, poster display, resource table and multicultural afternoon tea were all highly regarded.

Our surveys also indicated that a significant number of staff return each year to attend Diversity Health Day.

Following Diversity Health Day, articles have been included in our campus magazines. This continues the focus "on diversity and cultural competence after the events".

"Diversity Health Day is a major campus educational event that in addition to contributing to improved patient care, also assists our hospitals to meet public and private hospital accreditation requirements and Magnet recognition for St Vincent's Private," said adjunct professor Jose Aguilera, the director of nursing and clinical services at St Vincent's Private.

While many hospitals hold events celebrating staff or patient diversity using art, music or food, our event expands on this in order to create an event that both stimulates and improves diversity practice at our hospitals.

Future directions

The team have already started planning for Diversity Health Day 2013. To sustain and develop the initiative, we will continue to ask innovative guest speakers to give presentations on relevant topics related to the real needs of our patients, community and clinicians.

Continuing to analyse demographics, issues in diversity health and staff surveys, we will focus on additional areas of diversity, such as gender, age, disability and sexuality.

While our surveys currently measure clinician intention and knowledge, measurement of actual improvements in care practices and patient outcomes is our goal.

Last year, diversity health representatives from neighbouring health networks attended our event.

Based on our experience, we would encourage other facilities to introduce similar events to help enhance diversity and cultural competence of their clinicians.

Diversity Health Day has enabled us to put our hospital values into practise, improving culturally competent care for our community.

Jeremy Gowing is the nursing unit manager and project manager for emergency planning, St Vincent's Private Hospital. Tami Ebner is the diversity health coordinator at St Vincent's Hospital.

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