Hospital officials seek to improve communication with Marshallese

COLDWATER - Mercer County Community Hospital administrators are working to improve how they communicate and work with the local Marshallese population.

CEO Lisa Klenke said during her report to the board of governors that several months ago, physicians had asked what could be done to work and communicate with local Marshallese residents. Martin Shehan, senior director of physician practice management, recently visited northwest Arkansas with other Mercer County representatives to learn more about Marshallese culture and how local health officials communicated with them.

The largest Marshallese population in the United States is believed to be in Arkansas. Of an estimated 75,000 Marshallese worldwide, 15,000 live in northwestern Arkansas. The estimated population in Mercer County is between 1,200 and 1,500, Shehan said.

Those traveling to Arkansas included Shawn Thieman of the Mercer County Board of Developmental Disabilities, Jason Leubke of Celina City Schools and Jennifer Tuttle of the Mercer County Educational Service Center. Shehan said they had met with Marshallese lay people and those considered to be royalty among the community. They also met with a Marshallese pastor and representatives from the University of Arkansas for Medical Sciences.

Though the population in Arkansas is bigger and was settled before the one in Mercer County, a communication barrier still exists.

"The No. 1 biggest issue they had was exactly why I wanted to go. (It) was to figure out how to communicate with them, because we have a translation service that we use called MARTTI. It's a mobile service … you call up a translator, and they translate for us. Well, that doesn't work with the Marshallese," Shehan said. "Although there's only, supposedly, two different dialects with the Marshallese, they use so much slang and so much of their own vocabulary it's hard to get a translator."

In Springdale, Arkansas, hospitals employ Marshallese who can speak English to help them translate between providers and the community. Shehan said another benefit to employing translators was that the Marshallese are more likely to show up for their appointments because someone with whom they feel comfortable is available.

Having a familiar face to encourage patients to visit could help with one of the most common health issues with Marshallese: They wait too long to come in for treatment. Shehan said the community has a strong belief that if it is God's will to make them better, he would take care of them.

A question also was raised of how risk management could be handled in making sure Marshallese patients understood what procedures doctors may ask to do. Cards with pictures and an English word and the Marshallese translation may not always be effective, Shehan said. A written language barrier can be an issue on top of an oral language barrier. Although they use the English alphabet, people within the community can spell things very differently.

The group also met with a Marshallese minister who had family members in Mercer County.

"She said, 'Our people are going to Celina or Mercer County … because of employment opportunities with Cooper and others, but it is such a great, peaceful, kind community,' " Shehan said.

Shehan said he had come up with some ideas to improve the hospital's relationship with the Marshallese community but wanted to discuss them with vice president and chief financial officer George Boyles.

In other business, Boyles updated the board on the recent enactment of the hospital's amnesty program. The hospital identified patients with accounts more than two years old and offered a significant discount if they paid their dues in full. The program is successful in helping to eliminate old debt, Boyles said.

Some accounts that have been paid were originally from 2006, with the oldest account stretching back to 1999. The hospital last implemented the amnesty program in 2011, but because of its success, Boyles said they might look into using it more often than every six years.

Boyles also said the hospital's auditors had visited, and their report should be ready in July.

Also on Wednesday, board members,

• introduced Dr. Thangaraj Amaran as the newly appointed vice president of medical affairs. The role is relatively new in the hospital's administrative team. Amaran will help to communicate between hospital officials and doctors practicing in the field.

• toured the west wing expansion. Weigand Construction superintendent Curtiss Zink updated the board on progress, and said he had no reason to believe crews wouldn't finish the building on time or even ahead of its anticipated fall completion date.