Cultural Competency in Health Care
Discussion Topic- Race and nationality
A healthcare facility serving a significant number of patients from Jamaica has an opening to recruit several health professionals. The human resources department decides that because they already recently hired two African American health professionals, one or more Jamaican health professionals are not necessary. What is your view of that decision?
At least 275 words, APA Format
Course Materials: Rose, Patti (2013) Cultural Competency for the Health Professional. Jones and Bartlett.You have access to this ebook in the Content area of the course on Blackboard
Chapter 12: HEALTH PROFESSIONALS AND THE PARADIGM SHIFT
I. Learning Objectives
· Understand the need for a paradigm shift.
· Discuss cultural competence as a market-based issue.
· Understand how the implementation of cultural competence leads to the expansion of minority markets and may enhance the bottom line of organizations.
· Explain the need for a diverse workforce and health services administration.
· Understand aspects of necessary training in cultural competence for health services administrators and public health students.
II. Key Terms
Bottom line
Informed consent
Paradigm shift
Mainstream
Malpractice
Return on investment
Visual affirmation
III. The Need for a Paradigm Shift
Definition of paradigm shift: a revolutionary change from one way of thinking to another, which does not just happen but is driven by agents of change.
Bottom line defined: net income of organization.
What is necessary for the paradigm shift:
1. Commitment from the top down.
2. Identification of barriers to culturally competent goals.
3. Infrastructure change
Visual affirmation defined: a revolutionary change from one way of thinking to another, which does not just happen but is driven by agents of change
4. Policies that reflect cultural competence as well as changes to other organizational directional strategies, including the mission, vision and value statements, the strategic and marketing plans and so on.
III. Expansion of Minority Markets
1. Members of minority communities are aware that services are in place to meet their specific needs.
2. Utilization of visually affirming and developed in terms of their language.
3. Business should be conducted with an understanding that demographic changes are taking place.
IV. Investing in Cultural Competence
1. Definition of Return on Investment (ROI): the monetary benefit derived from having spent money on developing or revising a system.
See IBM example: CEO Lou Gerstner turned the company around with workforce diversity and cultural competency as an area of focus.
V. The Business Aspect of Health Care
1. Health care organizations include a business aspect as it costs money to conduct public health efforts and to provide health care.
2. Organizations must learn about the communities they are serving and diversifyin staff to reflect the community in an effort to ensure that customers feel compatible with those who will serve them.
3. Efforts should be made to meet the language needs of individuals served and training for staff should include universal language techniques.
3. There are a number of reasons to incorporate cultural competence into organizational policy including greater market share, increased profits and decreased malpractice issues.
Check out Figure 12.1, Cultural Competence and Profitability.
VI. Decreasing Malpractice Claims
1. Cultural competence decreases the likelihood of malpractice claims.
Malpractice defined: is improper or negligent treatment of a patient, as by a physician, resulting in injury, damage, or loss.
Informed consent defined: which is consent by a patient to a surgical or medical procedure or participation in a clinical study after achieving an understanding of the relevant medical facts and the risks involved.
VII. Enhanced Customer Service and Quality of Care
1. Knowledge of specific cultures permits those involved in health services administration and public health to understand how to:
a. develop programs
b. treatment protocols
c. interventions that are based on culturally based beliefs and can impact outcomes in a positive direction.
,
Chapter 12
Health Professionals and the Paradigm Shift
1
Learning Objectives
After reading this chapter, you should be able to”
Understand the need for a paradigm shift
Discuss cultural competence as a market based issue.
Understand how the implementation of cultural competence leads to the expansion of minority markets and may enhance the bottom line of organizations.
2
Learning Objectives cont…
Explain the need for a diverse workforce and health services administration.
Understand aspects of necessary training in cultural competence for health services administrators and public health students.
3
Key Terms
Bottom line
Informed consent
Mainstream
Malpractice
Paradigm shift
Return on investment
Visual affirmation
4
Introduction
Cultural competence is a market-based issue.
Hence, the discussion of a need for a paradigm shift for health care organizations is necessary with an emphasis on approaches to expand minority markets and enhancement of the bottom-line of organizations.
5
Introduction cont…
A diverse workforce, can ensure an optimal environment of service and lead to positive outcomes after appropriate cultural competence assessment and training.
Students trained to work in health professions must learn the importance of cultural competence in their respective fields in terms of strategic planning, marketing and enhanced customer service.
6
The Need for a Paradigm Shift
Definition of paradigm shift:
“a revolutionary change from one way of thinking to another, which does not just happen but is driven by agents of change” (Walden, 2004).
7
Bottom-Line
A paradigm shift is necessary in the health care field to expand minority markets and to improve the bottom-line performance of organizations through enhancement of customer service and perhaps increasing the market share of groups from various cultures.
Definition of bottom-line: Net income of an organization.
8
What is Necessary for a Paradigm Shift to Take Place?
Long-term sustained commitment from the top down beginning with the Board of Directors, the Chief Executive Office and other administrators, providers and staff.
9
Necessary Actions
Identification of barriers to culturally competent goals ;
Top-level commitment;
Infrastructure change (including the physical surroundings of healthcare organizations such as artwork and images that reflect the patients/clients/customers served (visual affirmation).
10
Necessary Actions cont…
Policies that reflect cultural competence
Changes to other organization directional strategies (including the mission, vision and value statements, the strategic and marketing plans and beyond).
Allocation of resources to support cultural competence initiative and the identification of benchmarks and rewarding of successes.
11
Necessary Actions cont…(2)
Educational requirements in academic institutions that offer degrees in the area of health ensuring the opportunity to hire staff with adequate cultural competence levels/skills as well as diversification of the health service administration and public health workforce.
12
Expansion of Minority Markets
Begin with efforts to make sure that members of minority communities are aware that services are in place to meet their specific needs.
13
Marketing
Advertisements and communication directed towards minority communities must be visually affirming and developed in terms of their language.
14
Investing in Cultural Competence
Changes toward cultural competence require an expenditure of money or investment on efforts to revise key aspects of the organization such as diversification, training, moving patient/client/customer environments toward culturally visual affirmation, demographic data analysis and so on.
15
Return on Investment (ROI)
Definition of ROI: Monetary benefits derived from having spent money on developing or revising a system, will be worth the effort.
16
IBM as an Example
IBM in 1995
CEO, Lou Gerstner
Initiated effort that considered workforce diversity as an area of strategic focus but not for the sake of diversification only.
Efforts included cultural competence strategies and an understanding that the two terms, diversity and cultural competence are not synonomous.
17
IBM example cont…
The goal of the IBM effort was to minimize differences.
The outcome was and continues to be a great success.
18
Mainstream
Differences are often considered deviation from the mainstream.
Mainstream is a term that is often used to describe the “general market” usually refers to a broad population that is primarily white and middle class” (Smedley, Stith & Nelson, 2003, pg. 524).
This type of thinking is extremely problematic in the health care arena because healthcare services and public health efforts often take place in communities that are very different from the mainstream.
19
The Business Aspect of Health Care
Developing efforts that are reflective of those who are in need of the services makes good business sense.
Health care administrators and public health officials must align their strategic business goals for their organizations with their diversity and cultural competence goals.
20
Understanding Major Markets
It is important for health-care organizations to gain greater insight into their major markets at every level.
This requires learning about the culture of the communities and diversifying staff to reflect the community in an effort to ensure that customers feel compatible with those who will serve them.
It is also important to communicate with individuals in their language to prevent a language barrier and to provide cultural competence training for all staff at every level.
21
Training
Should include universal language techniques (e.g., smiling, hand gesturing, eye contact, understanding the concept of touching which varies between cultures).
Training should ensure that staff, taking culture into consideration will be able to discern particular health needs and concerns and any barriers that may exist in terms of the provision of services.
22
Outcome of Organization Meeting the Needs of the Community
The community wants to maintain a long standing relationship with the healthcare organization.
The outcome is a win-win situation and perhaps a profitable venture.
Reasons for Incorporating cultural competence into organizational policy
According the the National Center for Cultural competence the reasons are:
Greater market share
Increased profits
Decreased malpractice issues
Robert Wood Johnson Foundation (RWJF) Grant Project “Opening Doors”
Four million dollar grant
Supported 23 projects in rural and urban areas
In 11 states
Results
Reduction of unnecessary emergency room visits in a rural immigrant community
Increased patient enrollment in an urban hospital-based health maintenance organization (HMO) where interpreters and outreach workers were available for immigrants
HMO compliance with state standards for access to reproductive health care and cultural competence in managed care
How Results Were Accomplished
Using community outreach workers
Providing interpreter services
Changing policies and practices that created barriers to care
Developing cross-cultural curricula for medical students,
Providing community based training opportunities for residents
Officering cultural competence training for agency staff and board member.
Decreasing Malpractice Claims
Definition of malpractice: improper or negligent treatment of a patient, as by a physician, resulting in injury, damage, or loss.
Failure to obtained informed consent due to failure to translate such a document.
Lack of awareness about differences and failure to provide interpretation and translation services may lead to liability in a number of ways.
Decreasing Malpractice Claims cont…
The ability to communicate effectively has been shown to reduce malpractice claims.
A study in the Journal of the American Medical Association indicates that patients of physicians who were frequently sued had the most complaints about communications.
Physicians can use the findings from this study to reduce malpractice risks and administrators can use this info to ensure that malpractice insures provide this information to guide risk prevention.
Conclusions
Embracing cultural competence by health service administrators and the field of public health requires a paradigm shift.
Cultural competence should be included as part of the strategic plan and business aspect of health care organizations with hopes of a sustained competitive advantage over organizations that do not recognize the need for such efforts.