Cultural determinants of Health The Quality Improvement Perspective Pr. Marianne Samuelson Kos September 2005

Pr. Marianne Samuelson Cultural determinants of Health and QI 2 Cultural determinants of Health The QI perspective: 2 aspects < 1- Cultural determinants and Quality in the Patient-Physician encounter < 2- Cultural determinants in implementation of Quality improvement methods in the different European countries

September 2005 Pr. Marianne Samuelson Cultural determinants of Health and QI 3 1-Cultural determinants and Quality in the Physician-Patient contact Story The “Tree-man”

September 2005 Pr. Marianne Samuelson Cultural determinants of Health and QI 4 The “Tree-man” After Noelle Lasne

September 2005 Pr. Marianne Samuelson Cultural determinants of Health and QI 5 1-Cultural determinants and Quality in the Physician-Patient contact What is the main idea that you take out for this story? What is the main idea that you take out for this story? One main idea per table, Phrased in one sentence

September 2005 Pr. Marianne Samuelson Cultural determinants of Health and QI 6 Cultural determinants and Quality in the Physician-Patient contact Can Primary Care Physician respond to the needs of cultural diverse populations? < Predominant medical model: pathophysiological basis and patient explanatory model of illness < Self awareness and reflection on one's own values, and beliefs and genuine curiosity and and humility < Cultural practices and norms / towards individual behaviour < Negotiate differences in language, wording and ways of addressing clinical problems < Being knowledgeable, skill full  Lifelong contacts and interactive learning processes  Culture is neither seamless nor static

September 2005 Pr. Marianne Samuelson Cultural determinants of Health and QI 7 2-Cultural determinants of Quality Improvement methods in the different European countries < The approach to reflection and implementation of QI methods in Europe may vary according to the “cultural” background

September 2005 Pr. Marianne Samuelson Cultural determinants of Health and QI 8 1. Transparency Accountability EBM-guidelines Flexibility “colloque singulier” 3 3. Population-oriented systematic prevention From Jan de Maeseneer

September 2005 Pr. Marianne Samuelson Cultural determinants of Health and QI 9 Cultural determinants of Quality Improvement methods in the different European countries Differences in performance? < Approach to change < Implementation of change < Acceptance of measuring < How knowledge is produced and used… < Orientation toward PHC of the Health care system < Culture of the organisation or the system < Type and use of guidelines < …….

September 2005 Pr. Marianne Samuelson Cultural determinants of Health and QI 10 There are differences in the way QI is undertaken in different European countries…… < What might the cultural influences be behind these differences? < Theses are some of my thoughts…..could could think about some others? One idea per table, one sentence.

September 2005 Pr. Marianne Samuelson Cultural determinants of Health and QI 11 What is EQuiP contribution….. < Research or statement papers connected to Cultural determinants and Quality in the Physician-Patient encounter  Europep: on patient satisfaction  Improve: on involvement of aging people in the decision making process  Dealing with Uncertainty….. < Research connected to Cultural determinants to implementation of Quality improvement methods in the different European countries  EPA tools to assess differences in organisational aspects in Europe  Projects: Research on Cultural explanation to variation of performance in the different European countries…….

Merci…