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Project ¡ÉXITO!: Success through diversity and universality for outcomes improvement among Hispanic home care patients

      The National Health Disparities Report notes that Hispanics have poorer quality of care in 23 of 38 core measures. The result of this disparity is great personal and health system costs, which could be reduced. Prior studies have focused on access and language. We studied outcomes improvement.
      The purpose of this project was to develop a replicable theory-based outcomes improvement model for delivery of nursing care to Hispanic patients.
      The Leininger Sunrise Enabler approach was used to design a program specific to the cultural needs of a home care population. Outcome and Assessment Information Set (OASIS) data from 125 unduplicated home care patients were tracked. Nursing care delivery was analyzed using ethnographic research techniques.
      Delivery of nursing care using a culturally congruent approach reduced acute hospitalization and emergent care visits. Medication management and customer and nursing satisfaction also improved.
      National standards for culturally and linguistically appropriate services in health care help reduce healthcare disparities, but improving Hispanic outcomes requires moving beyond symptoms and symptom management to transcultural care. The estimated savings to the health care system are significant.
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      References

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      Biography

      Louise Woerner, MBA, FAAN, is Chairman & CEO, Home Care of Rochester (HCR), Rochester, NY.

      Biography

      Javier Espinosa, PhD, is an Associate Professor, Rochester Institute of Technology, Rochester, NY.

      Biography

      Susan Bourne, RN, MSN, is Director of Clinical Specialty Programs, Home Care of Rochester (HCR), Rochester, NY.

      Biography

      Marie O'Toole, EdD, RN, FAAN, is Chair, Department of Nursing, Nazareth College, Rochester, NY.

      Biography

      Gail L. Ingersoll, EdD, RN, FAAN, is a Loretta Ford Professor & Director, Center for Outcomes Measurement & Practice Innovation, University of Rochester School of Nursing, Rochester, NY.