Hawai'i-Pacific Chapter
A quarterly e-newsletter for the Hawai'i Pacific Chapter of ACHE Winter 2018 Vol. 4
In This Issue
Messages from Chapter Leadership
Message from the Regent
Message from the Chapter President
Diversity and Delivery of Healthcare Services: A Journey
Articles of Interest
Sales Representatives in Healthcare: Partnering to fill a need for Healthcare Organizations
The Importance of Laboratory Test Utilization Management
Calendars and Recent Events
2018 Leadership in Action Conference
Calendar of Events
Calendar of Educational Events
News & Committee Updates
News from the Education Committee
News from the Guam Local Program Chapter
Student Corner
Membership Report: New Fellows, Members, and Recertified Fellows
ACHE Resources
ACHE National News
Career Corner
Ensure delivery of Chapter E-newsletter (Disclaimer)
Thank you to all our Sponsors for 2018!
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As a healthcare executive, which sector community leader are you most interested in engaging with and hearing from?
Social Services
Community Housing



Gidget Ruscetta, FACHE

Micah Ewing, MBA, FACHE

Nick Hughey, RN, MBA, FACHE 

Chuck Tanner, FACHE

Suzie So-Miyahira

Emiline LaWall, MA


Josh Carpenter | Education

Sally Belles | Communications

Bobbie Ornellas, FACHE | Diversity

Nick Hughey, FACHE | Sponsorship


Travis Clegg

Andrew Giles

Laura Bonilla

Ryan Sutherland



Denise Della

Diversity and Delivery of Healthcare Services: A Journey
Barbara Ornellas, RN, BSN, MSA, FACHE
Healthcare delivery systems are created and continuously evolve to meet the challenging and changing needs of the patient populations they serve. Inherent in health care delivery systems are healthcare providers and patients. 
Innovative concepts and tools assist health care providers to meet the care needs of a diverse patient population. “Patient-centered medicine” traces its roots to British Psychoanalyst Enid Balint.1 “Patient-centered care” encourages collaboration and shared decision-making between patients, their support systems and healthcare providers.2  AHRQ created the “AHRQ Health Literacy Universal Precautions Toolkit.”3 This tool was designed to “help primary care practices reduce the complexity of healthcare, increase patient understanding of health information, and enhance support for patients of all health literacy levels.”4  In its publication on cultural competence education for Medical Students, the Association of American Medical Colleges identified multiple models on communicating with patients.5 
These concepts and tools complement the skills sets and knowledge base of health care providers and assist in the development of individualized healthcare services with and for each of their patients. There is no “one size fits most” in healthcare. Adding to the complexity of this delivery system is the uniqueness of each patient who brings to the patient - healthcare provider relationship his or her interpersonal communication skills, culture, religious beliefs, socio-economic background, understanding of disease processes, biases, historical knowledge of family or friends who had either poor or great outcomes with healthcare services, fears and expectations of the healthcare provider in his or her care.
Healthcare executives and health care providers collaborate in healthcare organizations. Healthcare executives monitor to ensure their organizations provide a diverse workforce to meet the needs of their patient mix. Patient satisfaction surveys provide trend information and individual comments which help the organization to understand what is being done well and identify areas for improvement. Patients receive their care services from healthcare providers.
In a healthcare system, training of staff on cultural competence is essential. The concepts learned through training should be reflected in the daily interactions between staff within the organization and patients receiving care. Cultural competence is a key indicator of how well an organization is prepared to provide services to a diverse patient population.  
If not already available in an organization, consider creating a pocket-sized culture reference for populations served within the organization. The pocket format which is best when laminated for durability makes information readily available to all healthcare providers and staff as it can fit it in jackets, pockets, uniforms and scrubs. It provides a quick at-a-glance reference. It should include information such as customs (food, dress, beliefs about health and disease, use of eye contact, expectations of men and women in that cultural society, beliefs about healthcare providers, what may or may not be considered unacceptable such as touch which is inherent in healthcare delivery). This baseline information is invaluable to the healthcare provider and the healthcare team. Information obtained from each patient should be made available in the electronic medical record for all team members to review as it enhances continuity of care among providers. The intended message to patients is that everyone in their healthcare team has an understanding of who they are as an individual. It helps to build trust. This information should also be shared during the “warm hand-off” when patients are referred to another provider such as a specialist or discharging from an inpatient to outpatient setting. In the inpatient setting, it would be valuable to include this in the shift-to-shift reporting for continuity of care. Additionally primary language, communication preference, and learning style (verbal, written, combination) should also be readily available in the electronic medical record.  
Each patient is unique. Each healthcare provider is unique. Each patient – healthcare provider relationship is unique. Each patient – healthcare provider encounter is unique. Therefore, the provision of healthcare services in a diverse healthcare delivery system is a journey.
1.  Bardes,C. New England Journal of Medicine 2012; 366:782-783
2.  NEJM Catalyst January 1, 2017
3.  Brega AG, Barnard J, Mabachi NM, Weiss BD, DeWalt DA, Brach C, Cifuentes M, Albright K, West, DR. AHRQ Health Literacy Universal Precautions Topolkit, Second Edition. (Prepared by Colorado Health Outcomes Program, University of Colorado Anschutz Medical Campus under Contract No. HHSA290200710008,TO#10.) AHRQ Publication No. 15-0023-EF. Rockville,MD. Agency for Healthcare Research and Quality. January 2015.
 4.  AHRQ website
 5.  AAMC website

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