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Hospitals serving a significant immigrant population find ways to connect with prospective patients across the cultural spectrum.

Whether your hospital serves a rainbow of different cultures or a very specific demographic, your communications plan must include them all.

For New York Downtown Hospital in Lower Manhattan, that meant reaching out to a large Asian population, which makes up more than 80% of its customer base. Cultural sensitivity is part of New York Downtown's mission—but it's also an important part of its market strategy. "We don't want to lose any patients to our competitors," says Jeffrey Menkes, president and CEO of the 180-licensed-bed hospital.

More than 40% of the staff speaks a Chinese dialect. Patient service representatives communicate in callers' language 24/7. The teaching hospital actively recruits interns who speak Chinese. "We want the patient to feel comfortable, to be able to communicate and identify with the physicians," Menkes says.

Other differences are more subtle. For example, says Director of Nursing Kit Yuen, research revealed that Asian patients often do not like cold water or food. The hospital tweaked its menus and installed warm-water stations for patients and their families.

"A little detail like that makes a big difference," she says. "The most important thing is to listen to the patients."

Hospital employees make post-discharge phone calls in Chinese, help patients fill out forms, and give patients a Chinese-language welcome card upon arrival. The hospital is also working with the Centers for Medicare & Medicaid Services to create a Chinese-language version of the Hospital Consumer Assessment of Healthcare Providers and Systems patient survey.

It's a whole-hospital, long-term effort, Menkes says. "One of the things we don't want to do is set up that mentality that everybody wears a yellow button that says, ‘We're being sensitive this month.'"

The fact that everyone in the hospital—from leadership to unions to clinicians—is working together is key, says Harriet Levine, president of Stuart Levine & Associates LLC, the consulting firm that helped New York Downtown develop customer service programs for the Chinese population. "The whole thing is to engage the staff and to basically take their institutional wisdom, what they know to be true, and to have their behaviors linked to that foundation on a day-to-day basis," she says. "Their ownership of the process is what makes it work."

Librarians to the rescue

At 689-licensed-bed University of Nebraska Medical Center in Omaha, a team of five librarians set out to break down barriers to healthcare for immigrants. With just $25,000 in grant money, the group developed a tool that hospital marketers nationwide can use to reach out to their own special populations.

Schools and healthcare organizations across the nation are using UNMC's free video to help them better communicate with diverse populations of patients. The video, narrated in several languages, follows a family through the process of making a doctor's appointment, visiting the doctor, and visiting the library to obtain additional health information.

The video addresses the fact that "folks do things differently," says Teresa Hartman, the head of education at UNMC's McGoogan Library of Medicine. For example, she says, in some cultures the idea of making an appointment to see a physician is strange—dropping in feels much more natural. So the video talks about verifying the time and location of an appointment, the importance of arriving on time, and how to check in upon arrival. It sounds simple, but such cultural differences are real.

The librarians found inspiration for the project in their own backyard. Students in the Omaha public school system speak more than 70 different languages, so the group decided to reach out to families through their children; schools show the video to students, who in turn help spread the word to their parents. Communicating through children in this way allowed them to present basic information without sounding condescending. "We did not want to talk down to anybody," says Hartman.

They promoted the video on their own Web site, library discussion lists, and every free site they hunt down. "We tried to do as much viral marketing as possible," Hartman says. "The outreach has been phenomenal."

—Gienna Shaw

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