Subcommittees

Access and Patient Experience of Care

Members

Charge: Assess the experience of care at the MGH for patients of color, develop and implement action plan to address disparities.

Projects and accomplishments:

Patient Survey
The Patient Experience and Access to Care Subcommittee became interested in better understanding minority patients' experiences of care at MGH. Whereas patient satisfaction data could be stratified by race/ethnicity and provides some general information on patient experience, racial/ethnic minorities are often under-represented in patient satisfaction surveys, and it was felt that a more detailed exploration of issues of race and racial disparities was helpful and necessary. As a result a survey tool was developed to identify these key issues. The instrument was comprised of satisfaction, patient experience and societal perspective measures primarily drawn from other surveys of patients and the general public, including the Kaiser Family Foundation Survey on Race, Health, and Medical Care.

The survey focused particularly on personal, institutional and societal observations about race, respect and unfair treatment. The survey sought patients’ perceptions of the MGH, including the quality of care they received, as well as how they thought other patients were treated. The sample was selected from a random cross section of outpatients seen in primary care clinics (both on the main campus and in two large affiliated community health centers) over a period of six months prior to survey administration, purposely over sampling for racial/ethnic minorities. The survey was conducted by telephone in English and Spanish, fielded by ICR/International Communications Research, a national survey firm. The survey was administered between June and July 2004 with more than 400 patients responding to the survey.

The survey revealed that while the perception of quality of care for minorities is better at the MGH than in society in general, there is still a significant gap, and four to nine percent of minorities could cite a specific example of unfair treatment at the MGH that they believed was based on race or ethnicity. In addition, two key themes were found: 1) The treatment, satisfaction and training of front line staff has a large impact on patients perceptions and experiences of care and 2)  It is not just language that is important, but also the overall sensitivity and compassion demonstrated to patients matters as well.
The survey was developed and analyzed by Karen Donelan, Sc.D., and Nakela Cook, M.D., M.P.H. Results are currently being analyzed.

Multicultural Advisory Committee
The Patient Experience and Access to Care Subcommittee also felt that the MGH should develop a mechanism to routinely bring the community perspective into the disparities agenda. In 2004, it was decided that a Multicultural Advisory Committee (MAC) should be formed to achieve this purpose. The goal of the MAC is to advise the MGH on minority patients' experiences of care and the perception of the hospital in various minority communities, as well as provide guidance and feedback on the MGH’s disparities efforts and initiatives. It is comprised of leaders, patients and their families from various minority communities and is chaired by MGH President Peter Slavin and Senior Vice President for Patient Care Services and Chief Nurse Jeanette Ives Erickson, RN, MS.

The MAC, which meets quarterly, began its work by learning the results of a survey of MGH minority patients about their experiences and perceptions of issues of diversity, disparities and race and prioritizing issues that emerged from that survey for action.  The committee first focused on the importance of a welcoming environment, particularly from front line staff, in forming their impressions of the institution.  As a result of MAC recommendations, the MGH recently began a Service Improvement lecture series targeted at improving the service of front-line staff. The MAC has also focused on the MGH response on racial/ethnic disparities in care, language as a barrier to care, the effect of payor status on experiences of care, the role and perception of the MGH in the community and other topics. The MAC is uniquely structured to allow its members to give high-level input on important organizational and programmatic hospital efforts with the goal of continual improvement of the MGH as a citizen of Boston and a servant of its diverse community. This committee is run by Joan Quinlan, MPA, and Nakela Cook, MD, MPH.

The charge to the Multicultural Community Advisory Committee is:

• To advise the MGH on various minority patients’ experiences of care at the hospital;
• To advise the MGH on various minority communities’ perceptions of the hospital, as a provider and as a community member;
• To review new and existing programs or initiatives aimed at addressing minority patient or community issues at the MGH.

Committee Composition

President, Senior Vice-President of Patient Care Services and Chief Nurse Officer, and the Co-chairs of the MGH Disparities Committee.
In addition 15-18 members reflecting:

• Patients
• Family members
• Religious leaders
• Community leaders
• Business leaders

The committee will meet three to four times per year. This year, the committee has met on three occasions and the major themes of the meetings centered around the following presentations and discussions.

• The committee heard and discussed a brief overview on Diversity, Cultural Competence, and Disparities Programs at the MGH presented by Peter Slavin.
• The committee heard and discussed findings from the MGH Disparities Committee Patient Experience of Care Survey (a 400-person telephone survey of patients, over sampling for minorities).
• The committee began an in-depth discussion of four major themes that have arisen from presentations as priority areas to address.
  • Staff Attitudes
• Language
• Insurance
• Patient Experience and Perception

The focus of the upcoming meeting is to delve into staff attitudes and how the MGH can approach the multicultural experience of care through “front-line staff.”
Members:

Resources for developing a Multicultural Advisory Committee:

Multicultural Advisory Committee Selection Process

Other Resources at MGH:

MGH Interpreter Services: http://www.massgeneral.org/interpreters/

Patient Care Services: http://www.massgeneral.org/pcs/index.asp

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