US hospices' approach to racial/ethnic minority inclusion: a qualitative study

BMJ Support Palliat Care. 2021 Feb 11:bmjspcare-2020-002680. doi: 10.1136/bmjspcare-2020-002680. Online ahead of print.

Abstract

Objective: To examine hospices' approaches to improving the current racial/ethnic hospice utilisation disparity.

Methods: During June and July 2020, we conducted in-depth, semistructured interviews with 22 hospice leaders from across the USA. The interviews focused on inclusive strategy approaches. We analysed the data using qualitative methods.

Results: Multiple themes emerged about racial/ethnic minority inclusion strategies: (1) hospices tailor strategies to the local communities they serve; (2) improvement involves addressing social determinants of health that extend beyond end-of-life care; (3) costs of strategies are not a primary concern and the benefits are worth the costs; and (4) hospices want to do more to improve their efforts.

Conclusions: Hospices want to improve racial/ethnic minority inclusion and can take specific action steps to educate community members about hospice and provide an environment within hospice care that is welcoming to all. Hospice-targeted programmes and policies that facilitate language translation, diversity in staffing, enhanced community outreach, and leadership and staff collaboration regarding inclusion may help hospices achieve success in their efforts toward racial/ethnic minority inclusion.

Keywords: cultural issues; hospice care; social care.