Suggestions for improving the care of international patients
| Consider preappointment orientation to the healthcare system |
| Reconcile medications, assess any unknown medications and other treatments |
| Assess available records, request more as needed prior to first appointment |
| Ascertain provider to assume care upon return to home country, and establish connection |
| Assess patient expectations and requests of care to prepare patient and clinicians for care process |
| Determine how payments will be addressed and set expectations if payment is required before evaluations and treatment; involve the hospital and clinic business offices early as needed |
| Strive for an empathic understanding of the patients’ expectations and cultural and religious norms |
| Ensure staff at all levels have training in cultural competency that is durable and revisited |
| Develop collaborative expectations |
| Set expectations for duration and frequency of appointments |
| Ensure there is a plan for receiving test results, particularly if the patient does not speak English |
| Discuss that the plan of the clinician may not align with prior treatment recommendations from the patient’s home country care providers |
| Understand process of consent for the patient—will the patient or a family member(s) give consent? |
| Consider multidisciplinary, coordinated team visits with a prescheduled interpreter |
| Include both male and female staff and clinicians (physicians and advanced practice practitioners) in the team to allow for flexibility of care |
| Interpreters should be scheduled in advance or telephone/video interpreters set up on arrival to minimize schedule disruption and maximize the interactions of all staff with the patient |
| Start transition of care early |
| From the first visit, establish a receiving home country care provider if possible |
| Some medications and treatments may be unavailable in the home country; this should be determined before initiating therapy that the patient would take after returning home |
| Release of information to home country care provider should be obtained from the patient to allow medical records to be transitioned home as easily as possible |