Hospitals in flux: they should be prepared for demographic changes and exhibit cultural sensitivity


Once again, the 39th Hospital Conference resonates with visitors at this year’s MEDICA. Experts discuss various issues centering on the subject of hospitals. Along with the topics of investments for a secure future and patient satisfaction, the current issue as to how much hospitals needs to exhibit cultural sensitivity, and how they should be able to handle demographic changes are also a part of the agenda.

Image: Building with the word "Hospital"; Copyright:

The German Hospital Conference adress to hospital management; ©

Not only are demographic changes affecting our retirement pension, they also impact hospitals. More and more people live past the age of 80. Thanks to medical advances, more causes of death can be eliminated – our society is aging. At the same time, birth rates are declining since about 1970, with occasional minor fluctuations. In the future, approximately six wage earners need to finance one senior citizen. This also has an impact on every hospital. More and more elderly patients need to be treated and cared for; at the same time, there are fewer future nursing talents due to the low birth rate. "Geriatric patients are often not only suffering from multi-morbidity, they also frequently have chronic diseases. In this instance, hospital associates are not just confronted with medical and caregiving tasks, but in many cases also with social issues that require a holistic treatment and caregiving approach," explains Thomas Reumann. President of the German Hospital Federation (DKG- Deutsche Krankenhaus Gesellschaft).

Recruiting employees is not enough of a measure to prevent this problem. That's why the Asklepios group of hospitals in Hamburg, for example, has appointed ten demographics representatives within the scope of a project, who conducted an age structure analysis at the Barmbek Hospital. According to their findings, the average age of patients is 45. First future-oriented improvement measures have already been taken. For example, pairs consisting of older and younger colleagues were formed to talk about their experiences.

Presently, there is no guideline available on how a hospital can prepare or should be prepared for demographic changes – but there are already some approaches. The Asklepios project could be a first step in the right direction. "One of our measures is the development of an information brochure for dementia patients and their family members to provide information about the challenges and options during hospital stays," says Reumann.

Image: Prof. Christian Schmidt (left) and Thomas Reumann (right); Copyright: beta-web/Günther

Prof. Christian Schmidt (left) and Thomas Reumann (right) at Deutscher Krankenhaustag; © beta-web/Günther

Practical guide to sensitize hospitals

In recent decades, the diversity of patients has changed due to the increasing number of foreign nationals. Hospital staff, in particular, has to respond to a variety of people in their work. That’s why there are already several culturally sensitive hospitals in Germany that have taken measures to break down language barriers between non-German speaking patients and the German nursing staff for instance. After all, this is the only way to ensure adequate medical care.

One important support tool is the Praxisratgeber (practical guide in German) by the Federal Government Commission for Migration, Refugees and Integration: it provides approaches hospitals can adopt to become culturally competent and open-minded. "This report is highly recommended for any hospital. It is important to consider whether these changes are relevant to you. This is probably not quite as important in rural areas as it is in the Ruhr region of Germany, for example, where the percentage of foreign nationals is over 15 percent", explains Prof. Christian Schmidt, CEO and Medical Director at the University Hospital Rostock. Today he will give a lecture on this issue at the MEDICA trade fair. Many hospital facilities already offer interpreters and religious events for different cultures. "Cultural sensitivity already starts with food. Muslims don’t eat pork, Jewish people only eat kosher meat. These aspects need to be taken into account in the organization of hospitals". New hospital buildings like the ones in Minden for example, are already required to have a prayer room. "It is simply very important that patients feel safe and accepted. This can only be achieved if you are open-minded towards their culture," says Schmidt.

Treating patients equally, regardless of their nationality

In France and the U.S., this topic is already being covered in the nursing curriculum. "Physicians and staff in Germany still need to be sensitized more; this will become an increasingly important issue in the future". Hospitals in Europe have faced new challenges, especially over the past few months. People who are on the run also bring their culture along with them. Hospital facilities need to be further sensitized to be able to treat these people appropriately. "Having said that, this issue presents challenges, even for already culturally sensitive hospitals like the ones in the Ruhr region. After all, not every hospital facility has a Syrian interpreter for example". Yet Schmidt remains hopeful. "Hospitals in Germany will be able to handle this issue in the long run. After all, the highest priority is to treat people equally – regardless of where they come from or what they look like".

Event tipp:

German Hospital Conference, Krankenhaus-Träger-Forum, "Demography-proof und culture sensible Hospitals", Tuesday, 15 November, 10.30 a.m. -2.30 p.m., CCD-Ost, Room L, with Prof. Christian Schmidt and Dr. Ali Kemal Gün (Language: German)

More about the 39th German Hospital Confernce
Image: Lorraine Dindas; © B. Frommann

© B. Frommann

This article was written by Lorraine Dindas and translated from German by Elena O'Meara.