Developing an Action Plan for Addressing Change in Immigrant Communities

Problem Overview

Due to a considerable influx of immigrants, the community has to meet a number of challenges in order to satisfy health care needs of the group and ensure their access to all necessary services. For this purpose, an action plan has to be developed. It will allow setting priorities for further work and engaging community members in the implementation process, the outcome of which will determine whether immigrants and refugees will have a chance to settle, find jobs, and belong.

Issues to Be Considered

The following issues need to be considered, changed or planned for the community and the health care facility (García-Pérez, 2016):

• The community must strengthen settlement support for immigrants by reinforcing settlement systems and coordination of services. Effective collaboration between all community sectors is necessary to ensure accommodation.
• The community in general and the health care facility in particular must render health care support for immigrants by increasing access to services and providing insurance benefits.
• It is essential to foster communication by fostering language education. The community should offer linguistic courses to newcomers while the hospital must ensure culture-competent care.
• The lack of navigation among different organizations and services has to be addressed.

Change Model

Before passing to the development of the succession of steps to achieve better health outcomes for the selected group, it is crucial to choose the most effective change model that would make it possible to collect all relevant information, assess the needs of immigrants, and translate theoretical knowledge into practice. This has to be performed for developing a structured approach to change since new data must be integrated into the existing corpus of knowledge, which is practically impossible without systematization.

The ACE Star Model was selected as it provides a comprehensive step-by-step framework for addressing the needs of the population group:

1. At the first stage profound research about immigrants’ major needs and problems has to be conducted by both social and health care workers.
2. The second stage involves summarizing all the data and evidence obtained.
3. At the third stage, the collected knowledge is applied to develop practical guidelines that would allow addressing risk groups, finding ways to ensure access to health care services, developing policies, and ensuring culture-competent care.
4. The fourth stage presupposes implementing the developed guidelines in clinical practice.
5. The fifth, final stage of the change is devoted to evaluation of the achieved outcomes. All the mistakes are to be analyzed and corrected. The major indicators to be measured are the increased access to health services and improved quality of care.

Second Order Change Factors

While first order changes imply dealing with the existing structure of the community and the challenges it presents for immigrant adaptation, second order change presupposes an entirely new way of approaching the problem. It will bring about new vision of the issut. For achieving this, the following factors have to be considered (Hacker, Anies, Folb, & Zallman, 2015):

• the attitude of the community to immigrants and the willingness of its members to assist them in the process of adaptation;
• involvement of hospital administration;
• interest of policy makers;
• active policies and campaigns launched by higher authorities;
• effective coordination between social and medical institutions.

The impact of the change will be better quality of care for newcomers as well as facilitated ways of assessing medical services and getting insurance. Moreover, it will result in the improved population health and public services. However, there are still numerous barriers to be taken into account. They include legal problems with registration, policy limitations for illegal immigrants, lack of funding, social assets, change resistance on behalf of the community, and lack of the government’s attention to the problem (Hacker et al., 2015).

References

García-Pérez, M. (2016). Health Outcomes, immigration, and development converging to American: Healthy immigrant effect in children of immigrants. The American Economic Review, 106(5), 461-466.

Hacker, K., Anies, M., Folb, B. L., & Zallman, L. (2015). Barriers to health care for undocumented immigrants: A literature review. Risk Management and Healthcare Policy, 8(1), 175-189.