NURS FPX 6618 Assessment 2 Mobilizing Care For An Immigrant Population
Student Name
Capella University
NURS-FPX 6618 Leadership in Care Coordination
Prof. Name
Date
Mobilizing Care for an Immigrant Population
The development of a Care Coordination (CC) program for undocumented Hispanic immigrants is a critical initiative at St. Mary’s Hospital (SMH). As the Director of CC, my objective is to dismantle barriers that prevent this population from accessing healthcare services. Challenges such as language barriers, financial constraints, and fear of deportation often deter immigrants from seeking care. By delivering culturally competent and compassionate support, we aim to build trust, enhance patient engagement, and improve overall health outcomes for this vulnerable community.
Rationale for Focusing on the Healthcare Needs of a Particular Immigrant Group
Latinos make up a significant portion of the U.S. population, with 57.8 million individuals in 2016, representing 19% of the total population (Perreira et al., 2020). Within this demographic, undocumented Hispanic immigrants face unique healthcare challenges. These include fear of deportation, language limitations, and financial obstacles, which are further intensified by a lack of insurance coverage. Chronic conditions such as Diabetes Mellitus (DM), Hypertension (HTN), and mental health disorders are more prevalent among this group, influenced by immigration-related stressors (Wright et al., 2024). By addressing these healthcare disparities at SMH, we can improve community health outcomes while reducing costs associated with preventable emergency care visits.
Criteria for Selection
The decision to prioritize undocumented Hispanic immigrants is based on two main factors:
- Population Size – This group represents 19% of the U.S. population (Perreira et al., 2020), making them a significant demographic to target.
- Health Disparities – They experience elevated rates of chronic illnesses, mental health challenges, and limited access to healthcare due to socio-economic constraints such as low income and lack of insurance.
Given these challenges, they represent a high-priority population for intervention at SMH.
Evaluating Healthcare Needs
A structured approach is necessary to effectively address the healthcare needs of undocumented Hispanic immigrants. The Six Sigma DMAIC framework provides a systematic method to assess and improve care delivery.
| Phase | Description | Actions and Strategies |
|---|---|---|
| Define | Identify the primary barriers faced by undocumented Hispanic immigrants in accessing care. | Address concerns like fear of deportation, language barriers, financial constraints, and lack of insurance. Promote chronic disease management (CDM) and culturally sensitive care. |
| Measure | Collect data to understand healthcare utilization and health outcomes. | Use surveys, focus groups, and Electronic Health Records (EHR) analysis to gather demographic and clinical data on DM, HTN, and mental health prevalence. |
| Analyze | Determine the root causes of healthcare disparities. | Employ tools like Pareto Analysis and Fishbone Diagrams to identify barriers such as economic hardship, language issues, and fear of deportation. |
| Improve | Implement strategies to reduce barriers to care. | Recruit bilingual providers, provide interpretation services, establish sliding-scale payments, enhance cultural competency, and partner with community organizations for outreach. |
| Control | Ensure the sustainability of interventions. | Monitor health outcomes, patient satisfaction, and utilization metrics via EHR systems. Maintain ongoing staff training and secure financial support through grants. |
Recognized Organizations and Stakeholders
Effective care coordination requires collaboration across multiple levels:
- International: Organizations like Doctors Without Borders and the International Organization for Migration (IOM) provide direct healthcare services to migrant populations (Doctors Without Borders, 2024).
- National: Agencies such as the CDC and HRSA offer funding, guidance, and strategic frameworks for healthcare initiatives (CDC, 2024).
- Local: Non-profit organizations, including UnidosUS and the Hispanic Services Council, assist with legal support, language interpretation, and financial aid (Hispanic Services Council, n.d.).
Defining Characteristics of the Population
Undocumented Hispanic immigrants in Tampa predominantly include working-age adults (18-50) and children. Common employment sectors are construction, hospitality, and agriculture, often without benefits or job security (Funk & Lopez, 2022). Many live in multigenerational households, which fosters strong family ties but also creates overcrowding and limited access to resources. Spanish is the primary language, and adults frequently rely on children for translation. The population experiences elevated stress, financial instability, and anxiety over deportation (Ornelas et al., 2020).
Analyzing Existing Organizational Policies for Healthcare Delivery
SMH has established policies to facilitate healthcare access for immigrants, regardless of residency status. Key measures include:
- Offering adjustable pricing and sliding-scale payment options.
- Recruiting bilingual staff to improve communication and care delivery.
- Partnering with community organizations for education and outreach.
SMH also adheres to local, state, and federal regulations, including EMTALA, ensuring patient privacy while engaging in advocacy to improve healthcare accessibility for marginalized groups (Brown, 2020; White et al., 2020).
Assessing Two U.S. Healthcare Policies
EMTALA mandates emergency care for all patients, irrespective of immigration status, but it does not cover routine or preventive services (Brown, 2020).
Affordable Care Act (ACA) expands insurance coverage broadly; however, undocumented immigrants are excluded from Medicaid and the Health Insurance Marketplace, worsening disparities in access to care (Ye & Rodriguez, 2021).
Preconceived Notions and Biases
Common misconceptions suggest that undocumented Hispanic immigrants overuse emergency services or neglect preventive care. These assumptions often ignore systemic barriers such as fear of deportation, financial hardship, and language limitations. Miscommunication can lead to inaccurate diagnoses and substandard care. By integrating cultural competency training and understanding these challenges, healthcare providers can deliver more effective care while fostering trust (Kronenfeld et al., 2021; Hispanic Services Council, n.d.).
Conclusion
Providing coordinated care for undocumented Hispanic immigrants at SMH is essential to reduce healthcare disparities and improve overall community health. Through culturally competent care, bilingual support, and financial assistance, we can increase healthcare access and improve outcomes. Utilizing the Six Sigma DMAIC framework ensures a structured, evidence-based approach to care delivery and long-term program sustainability.
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
NURS FPX 6618 Assessment 2 Mobilizing Care For An Immigrant Population
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. https://www.doctorswithoutborders.org/
Funk, C., & Lopez, M. H. (2022, June 14). Hispanic Americans’ experiences with health care. Pew Research Center. https://www.pewresearch.org/science/2022/06/14/hispanic-americans-experiences-with-health-care/
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
NURS FPX 6618 Assessment 2 Mobilizing Care For An Immigrant Population
Hispanic Services Council. (n.d.). Hispanic Services Council. 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
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
Perreira, K. M., et al. (2020). Latino immigrant mental health disparities: Context, contributing factors, and implications for policy. American Journal of Public Health, 110(2), 268–276. https://doi.org/10.2105/AJPH.2019.305400
NURS FPX 6618 Assessment 2 Mobilizing Care For An Immigrant Population
White, R., et al. (2020). Culturally competent care strategies in hospital settings. Journal of Health Care for the Poor and Underserved, 31(4), 1452–1471.
Wright, J., et al. (2024). Chronic disease prevalence among undocumented Hispanic immigrants. Journal of Immigrant and Minority Health, 26(1), 55–67.
Ye, J., & Rodriguez, H. (2021). Health insurance and undocumented immigrants: Barriers to access. Health Policy Research, 125(2), 213–225.