NURS FPX 6618 Assessment 2 Mobilizing Care For An Immigrant Population

Name

Capella university

NURS-FPX 6618 Leadership in Care Coordination

Prof. Name

Date

Mobilizing Care for an Immigrant Population 

I am devoted to creating a Care Coordination (CC) program that addresses the challenges undocumented Hispanic immigrants face in accessing healthcare. As the Director of CC at St. Mary’s Hospital (SMH), my goal is to help remove these barriers and improve their healthcare experience. This program aims to break down barriers such as language limitations, financial constraints, and the fear of deportation by fostering culturally competent care. By building trust within the community, we seek to improve health outcomes and ensure that this vulnerable population receives the support they need.

Rationale for Focusing on the Healthcare Needs of a Particular Immigrant Group

In 2016, 57.8 million individuals in the U.S. identified as Latino, representing 19% of the total population (Perreira et al., 2020). Among them, unregistered Hispanic immigrants encounter distinct challenges when it comes to accessing healthcare. The fear of deportation frequently prevents them from seeking necessary medical attention. This situation is worsened by language difficulties, financial hardships, and a lack of insurance, leaving this group particularly vulnerable.

With higher rates of chronic diseases like Diabetes Mellitus (DM) and Hypertension (HTN), as well as Mental Health (MH)  struggles tied to their immigration status, this population requires urgent attention (Wright et al., 2024). By addressing these needs, SHM can work to close health gaps, improve community health, and create a more inclusive environment.  

Caring for unregistered Hispanic immigrants also supports wider public health initiatives. Access to preventive care, Chronic Disease Management (CDM), and MH services can help decrease the frequency of emergency room visits and hospital admissions, which are typically more expensive and less efficient than routine care. Providing care that respects cultural differences fosters trust, making individuals more likely to seek care promptly and follow medical guidance (Wright et al., 2024). Tackling these obstacles will not only improve community health but also lower healthcare costs and position SHM as a model for compassionate, inclusive care. 

Criteria for Selection

The determination to focus on the illegal Hispanic migrant community in this design program is driven by two reasons. This group constitutes a segment of the U.S. community, with Hispanics making up 19%, highlighting the importance of addressing their needs (Perreira et al., 2020). Furthermore, 59% of the illegal immigrant population is of Mexican origin (Passel, 2019). Second, this population experiences notable health disparities, including a higher etiology of continuing diseases such as DM and HTN, along with insufficient access to MH care. These issues are further exacerbated by socio-economic challenges, including low income and a lack of insurance, making this a high-priority group for targeted intervention at SMH.

Evaluating Healthcare Needs

A strategic approach is essential for enhancing healthcare services for Hispanic illicit immigrants. Applying the Six Sigma DMAIC framework provides a structured and efficient method for assessing and meeting the healthcare needs of this population at SHM. 

Define  

In this stage, we articulate the central challenge: Hispanic unregistered immigrants face significant obstacles in getting medical services. These obstacles include concern about exile, language barriers, financial difficulties, and inadequate insurance coverage, which together result in negative health consequences and trust in medical care (Ornelas et al., 2020). This initiative seeks to enhance the approach to the chief and obstructive medical care, better CDM, deliver multiculturally sensible care, bolster MH resources, and foster faith within the neighborhood.

Measure  

This phase shows data collection is crucial for establishing a baseline and evaluating the extent of the problem. We collect demographic information about the Hispanic illegal people in the U.S., examine present care usage trends, and assess the susceptibility of progressive ailments like DM, HTN, and MH metrics and patient atonement stages. To collect this information, we utilize methods like surveys, focus groups, and the examination of Electronic Health Records (EHR) from SHM while also collaborating with local community organizations to enrich our data sources (Funk & Lopez, 2022).

Analyze  

During the analyzing stage, we concentrate on pinpointing causes and identifying fields for enhancement. Major challenges include linguistic communication obstacles, a significant uninsured rate (34%), anxiety about exile, economic difficulties, and ethnic inspiration (Kronenfeld et al., 2021). For example, confined English language proficiency results in misapprehensions and non-abidance with healthcare recommendations, while anxiety about eviction can deter individuals from seeking essential care. Financial issues and the lack of culturally sensitive healthcare only exacerbate these challenges. We use tools such as Pareto Analysis and Fishbone (Ishikawa) Diagrams to identify these underlying causes systematically.

Improve  

In the Improve phase, we devise and implement targeted strategies to tackle the identified barriers. Recommended interventions involve recruiting bilingual healthcare providers, providing interpretation services, establishing safe spaces to foster trust, introducing sliding-scale payment options, offering financial aid, and conducting training for staff on cultural competence (White et al., 2020). Engaging the community through partnerships with local organizations for outreach and educational efforts is crucial. Additionally, pilot initiatives such as patient navigator programs and free health screenings at community centers will be initiated to test and refine these interventions.

Control  

The Control phase is essential for ensuring that advances are affirmed and advance is supervised. Ongoing evaluations of medical usage, patient gratification, and wellness results, along with regular studies and concentrate groupings, will provide necessary supervision. The use of EHR systems to track CDM and carry out care, along with ongoing employee development initiatives and obtaining financial support through grants and collaborations, will support these initiatives (Tsai et al., 2020).

Preliminary findings from pilot programs have shown an increase in primary care service utilization and enhanced client contentment when obstacles are successfully resolved. By employing the DMAIC model, SMH can methodically recognize and address the medical requirements of illegal Hispanic migrants (Funk & Lopez, 2022), resulting in enduring enhancements and improved health outcomes for this vulnerable population.

Recognized Organizations and Stakeholders

Delivering coordinated care to Hispanic undocumented immigrants demands unified efforts from organizations and stakeholders at international, national, state, and local levels. Internationally, non-governmental organizations like Doctors Without Borders and the IOM are pivotal in providing medical assistance and support to migrant and refugee populations (Doctors Without Borders, 2024). On the national front, federal agencies such as the CDC and the HRSA play key roles in setting guidelines, allocating funding, and supporting health initiatives (CDC, 2024). National non-profit organizations like UnidosUS and the National Immigration Law Center also contribute by advocating for immigrant rights and offering resources to these communities.

At the state level, the Florida Department of Health is responsible for managing statewide health programs, allocating funding, and supporting public health initiatives. Key stakeholders in this context include state health officials and public health nurses who play a vital role in these activities. On a local scale, healthcare facilities act as primary providers, delivering services such as primary care, CDM, and MH support.

NURS FPX 6618 Assessment 2 Mobilizing Care For An Immigrant Population

Important stakeholders at this level comprise healthcare professionals, administrative staff, care coordinators, and patient navigators who help patients access these services (Laurisz et al., 2023). Additionally, regional healthcare services and regional charitable institutions, such as the Hispanic Services Council, offer further assistance through legal support, linguistic interpretation, monetary assistance, and a range of community support services (Hispanic Services Council, n.d.).

Collaboration among these diverse entities is essential for creating integrated care teams that provide comprehensive services. Such partnerships facilitate the coordination of services and the sharing of resources within the community. By joining forces, these organizations can more effectively advocate for policies that enhance medical accessibility and secure financing from national health organizations and independent foundations (CDC, 2024).

Defining Characteristics of the Population

The Hispanic illicit non-native demography in Tampa features a varied age demographic, primarily consisting of working-age adults aged 18 to 50, along with children and teenagers. Though the gender distribution is fairly balanced, there is a slight male majority due to labor migration patterns (Ornelas et al., 2020). Most of this population resides in urban and peri-urban areas. Employment opportunities in sectors such as construction, hospitality, and agriculture are abundant, and these areas also provide access to immigrant support services.

Socially, numerous undocumented Hispanic immigrants reside in multigenerational households that provide both emotional and financial assistance, although they frequently face challenges related to overcrowding and scarce resources. Strong familial bonds and community connections are essential, as people frequently rely on relatives and acquaintances for assistance and social engagement. Spanish is the main language addressed, with many adults possessing confined English skills; children commonly serve as interpreters for their households. This community endures elevated degrees of tension, worry, and despair, primarily stemming from the ongoing concern of exile. Economic insecurity intensifies these mental health issues, further complicated by the challenges of adjusting to a new cultural setting and the trauma experienced during migration (Ornelas et al., 2020).

NURS FPX 6618 Assessment 2 Mobilizing Care For An Immigrant Population

Economically, a significant number are employed in low-wage, labor-intensive positions within sectors such as construction, agriculture, hospitality, and domestic services, frequently lacking benefits or job security (Funk & Lopez, 2022). These unstable working conditions make them susceptible to exploitation and wage theft. In comparison to documented residents, undocumented Hispanic immigrants generally earn considerably lower incomes, often living below the poverty threshold and experiencing financial instability. Consequently, many depend on informal economies for their livelihood.

Politically, their undocumented status subjects them to considerable legitimate and societal insecurities, encompassing the constant threat of removal and restricted access to community resources. This uncertain situation impacts various aspects of life, such as employment, housing, healthcare, and education. Although their political representation is minimal, local non-profits and immigrant rights organizations are dedicated to advocating for this population (Hacker et al., 2021).

NURS FPX 6618 Assessment 2 Mobilizing Care For An Immigrant Population

Culturally, these immigrants maintain strong ties to their traditions, customs, and values from their countries of origin. Celebrations of traditional festivals, foods, and religious practices strengthen community cohesion and support individual well-being (Hacker et al., 2021). Roman Catholicism is a prominent religion within the community, providing a sense of belonging and support through churches, which also serve as critical resources for social services and emotional care.

In the realm of education, while many adults in this community have received limited formal schooling, there is considerable emphasis on the significance of youth education as a pathway to prospects. However, obstacles such as language difficulties and illegal positions often restrict the approach to tertiary education and career training (Loganathan et al., 2023). Health inequalities are particularly acute, with an increased prevalence of chronic ailments such as DM, HTN, and obesity. Approach to care is frequently hindered by fears of deportation, lack of insurance, and financial limitations, which compels many to depend on emergency services for their medical needs.

Analyzing Existing Organizational Policies for Healthcare Delivery

SHM implements policies to ensure healthcare access for refugees and immigrants without permanent resident status. These key policies guarantee access to healthcare services regardless of immigration status. They offer monetary support through adjustable pricing and philanthropic initiatives and highlight cultural sensitivity by hiring bilingual personnel and providing interpretation services (White et al., 2020). The hospital emphasizes privacy by safeguarding patient data from being revealed and actively collaborates with community groups to enhance outreach and educational initiatives. These efforts seek to remove barriers to healthcare availability and foster trust within immigrant and refugee communities.

SMH consistently assesses and revises its guidelines to stay in accordance with evolving laws and the requirements of the community. The hospital complies with both national and local laws, including EMTALA, and modifies its policies in reaction to emerging challenges, such as the increased healthcare services implemented during the COVID-19 crisis (Brown, 2020). Furthermore, SMH participates in lobbying and policy formulation to improve healthcare accessibility for at-risk groups while offering continuous employee training to enhance cultural sensitivity and service provision (Brown, 2020). This strategy guarantees that SMH remains in compliance and successfully meets the changing requirements of migrants and exiles.

Assessing Two U.S. Healthcare Policies

Healthcare regulations that greatly impact immigrant and refugee communities include EMTALA and the ACA.EMTALA requires that hospitals offer emergency medical treatment to all individuals, irrespective of their immigration status or financial resources. This legislation ensures ethical treatment during medical emergencies, prohibiting hospitals from refusing treatment based on economic or legal concerns. However, its range is restricted to urgent care services, which means that undocumented immigrants often lack access to ongoing healthcare and preventive services (Brown, 2020).

Conversely, the ACA seeks to increase health insurance coverage and improve accessibility to healthcare for millions, including documented immigrants, through measures such as Medicaid expansion and the Health Insurance Marketplace. Although these initiatives have positively impacted many legal immigrants, undocumented individuals are explicitly barred from obtaining insurance via the Marketplace and accessing Medicaid services (Ye & Rodriguez, 2021). This exclusion poses significant ethical dilemmas regarding fair access to healthcare, leaving a segment of the immigrant population without coverage for essential and non-emergency medical care. Additionally, this lack of coverage can exacerbate health disparities and lead to poorer health outcomes within these communities.

Preconceived Notions and Biases Related

Assumptions and biases play a crucial role in shaping the healthcare experiences of illegal Hispanic migrants. A common misconception is that this group places a strain on the healthcare system by mostly utilizing emergency services. While many do resort to emergency care, this is often a consequence of systemic barriers such as fear of deportation, lack of insurance, and financial difficulties—not because they neglect their health needs (Kronenfeld et al., 2021). Understanding these obstacles is crucial rather than attributing their reliance on emergency services to personal choice.

Another common misconception is the belief that illicit migrants do not value preventive healthcare or fail to comply with medical recommendations. This misconception is largely driven by their limited access to healthcare resources and their hesitancy to engage with the system due to fears surrounding their legal status. Cultural misunderstandings can further contribute to incorrect assumptions, such as the notion that all Hispanic patients prefer traditional medicine, which can lead healthcare providers to adopt dismissive attitudes (Hispanic Services Council, n.d.).

NURS FPX 6618 Assessment 2 Mobilizing Care For An Immigrant Population

Language barriers and cultural differences exacerbate these challenges, frequently leading to miscommunication, incorrect diagnoses, and cut-down standard of care. This emphasizes the necessity for bilingualist staff, and displacement serves to facilitate effective communication. Additionally, cultural values such as “familism” and “respect” play a significant role in healthcare decision-making, making it essential for providers to grasp these subtleties during patient interactions.

Cultural variations also influence health literacy, as numerous Hispanic migrants are unfamiliar with the U.S. healthcare system, making it difficult for them to navigate and access services. To address these challenges, healthcare providers should undergo cultural competency training, work closely with community centers, and advocate for policies that safeguard undocumented immigrants’ rights to healthcare (Wright et al., 2024).

Conclusion

Dealing with the medical necessitates of Hispanic illegal migrants at SHM is vital for breaking down access barriers and enhancing health outcomes. Prioritizing culturally competent care, overcoming language barriers, and offering financial assistance are key steps in reducing disparities and fostering trust within this community. Utilizing frameworks like Six Sigma DMAIC provides a systematic approach to enhancing healthcare delivery. Moreover, as SHM persists in advocating for policy changes and partnering with local organizations, it reinforces its commitment to delivering inclusive, high-quality healthcare that fosters individual well-being and promotes overall public health equity.

References

Brown, H. L. (2020). Emergency Care EMTALA Alterations during the COVID-19 Pandemic in the USA. Journal of Emergency Nursing, 47(2). https://doi.org/10.1016/j.jen.2020.11.009 

CDC. (2024). National health initiatives, strategies & action plans. Public Health Professionals Gateway. https://www.cdc.gov/public-health-gateway/php/communications-resources/national-health-initiatives-strategies-action-plans.html 

Doctors Without Borders. (2024). Doctors without Borders – USA. Doctorswithoutborders.org. https://www.doctorswithoutborders.org/ 

Funk, C., & Lopez, M. H. (2022, June 14). Hispanic Americans’ experiences with health care. Pew Research Center Science & Society. https://www.pewresearch.org/science/2022/06/14/hispanic-americans-experiences-with-health-care/ 

NURS FPX 6618 Assessment 2 Mobilizing Care For An Immigrant Population

Hacker, K., Anies, M. E., Folb, B., & Zallman, L. (2021). Barriers to health care for undocumented immigrants: A literature review. Risk Management and Healthcare Policy, 8(PMC4634824), 175. https://doi.org/10.2147/rmhp.s70173 

Hispanic Services Council. (n.d.). Hispanic services council. Hispanicservicescouncil. https://www.hispanicservicescouncil.org/ 

Kronenfeld, J. P., Graves, K. D., Penedo, F. J., & Yanez, B. (2021). Overcoming disparities in cancer: A need for meaningful reform for Hispanic and Latino cancer survivors. The Oncologist, 26(6), 443–452. https://doi.org/10.1002/onco.13729 

Laurisz, N., Ćwiklicki, M., Żabiński, M., Canestrino, R., & Magliocca, P. (2023). The stakeholders’ involvement in healthcare 4.0 services provision: The perspective of co-creation. International Journal of Environmental Research and Public Health, 20(3), 2416. https://doi.org/10.3390/ijerph20032416 

Loganathan, T., Ong, Z. L., Hassan, F., Chan, Z. X., & Hazreen Abdul Majid. (2023). Barriers and facilitators to education access for marginalised non-citizen children in Malaysia: A qualitative study. Barriers and Facilitators to Education Access for Marginalised Non-Citizen Children in Malaysia: A Qualitative Study, 18(6), e0286793–e0286793. https://doi.org/10.1371/journal.pone.0286793 

NURS FPX 6618 Assessment 2 Mobilizing Care For An Immigrant Population

Ornelas, I. J., Yamanis, T. J., & Ruiz, R. A. (2020). The health of undocumented Latino immigrants: What we know and future directions. Annual Review of Public Health, 41(1), 289–308. https://doi.org/10.1146/annurev-publhealth-040119-094211 

Passel, J. S. (2019). Unauthorized immigrant population: National and state trends, 2010. Pew Research Center. https://www.pewresearch.org/race-and-ethnicity/2011/02/01/unauthorized-immigrant-population-brnational-and-state-trends-2010/ 

Perreira, K. M., Los Angeles Abreu, M., Zhao, B., Youngblood, M. E., Alvarado, C., Cobo, N., Crespo-Figueroa, M., Garcia, M. L., Giachello, A. L., Pattany, M. S., Talavera, A. C., & Talavera, G. A. (2020). Retaining Hispanics: Lessons from the Hispanic Community Health Study / Study of Latinos (HCHS/SOL). American Journal of Epidemiology, 189(6). https://doi.org/10.1093/aje/kwaa003 

Tsai, C. H., Eghdam, A., Davoody, N., Wright, G., Flowerday, S., & Koch, S. (2020). Effects of electronic health record implementation and barriers to adoption and use: A scoping review and qualitative analysis of the content. Life, 10(12), 1–27. https://doi.org/10.3390/life10120327 

NURS FPX 6618 Assessment 2 Mobilizing Care For An Immigrant Population

White, J., Plompen, T., Tao, L., Micallef, E., & Haines, T. (2020). What is needed in culturally competent healthcare systems? A qualitative exploration of culturally diverse patients and professional interpreters in an Australian healthcare setting. BMC Public Health, 19(1). https://doi.org/10.1186/s12889-019-7378-9 

Wright, B., Chen, B. C., Kodish, T., Yazmin Meza Lazaro, & Lau, A. S. (2024). Immigration stress and internalizing symptoms among Latinx and Asian American students: The roles of school climate and community violence. Journal of School Psychology, 104, 101286–101286. https://doi.org/10.1016/j.jsp.2024.101286 

Ye, W., & Rodriguez, J. M. (2021). Highly vulnerable communities and the Affordable Care Act: Health insurance coverage effects, 2010–2018. Social Science & Medicine, 270, 113670. https://doi.org/10.1016/j.socscimed.2021.113670