October 2003 Newsletter ********************************************** ---------------------------------------------------------- IN THIS ISSUE: Diving Into Diversity Test Your Knowledge Fast Facts: The Aging Boom Common Characteristics of Success Guidelines for Cultural Competence ---------------------------------------------------------- Diving Into Diversity How to Meet the Needs of Diverse Patients Diversity is an issue that all businesses must face, but for healthcare organizations maintaining a diverse workforce is paramount. Today's multi-ethnic, multi-cultural society equates to a plethora of patients that vary in economic status, gender, race, and creed. Without a representative workforce, items such as language and cultural customs could stand in the way of effectively com- municating and treating patients. Recognizing the Problem The consequences of a healthcare staff not equipped to meet the needs of diverse patients are immense. For example, if a patient has a difficult time expressing what's wrong due to language barriers, the probability of misdiagnosis and treatment greatly increase. In fact, a report released in 2002 by the Institute of Medicine found that communication obstacles between patients and healthcare workers contributed to dis- parities in the quality of healthcare received by minorities. Unfortunately, the dilemma does not stop with language and communication barriers alone. A study published in the journal, Health Affairs found that a persistent feeling remains among minorities that the care they receive is not equal to that of whites. Finding the Solution Plain and simple, we can all relate to some- one who looks like us and sounds like us. Patients who see a healthcare organization that values people like them on their staff are more likely to feel comfortable and confident as they are being treated. Unfortunately, the ability to staff a fully diverse workforce is not an easy task. In fact, many minorities continue to be under- represented at every level of medicine. In 1997, black Americans, Hispanics, and American Indians/Alaska Natives represented approximately 23.6 percent of the population, while only 12.2 percent of all enrollees in medical schools were underrepresented minorities. So what are healthcare organizations to do? While the nation as a whole is working toward a representative healthcare system, individual healthcare companies can do a number of things right now to address this issue. Achieving Cultural Competence Cultural competence refers to the ability of healthcare professionals to act appropriately and effectively when dealing with diversity. The list below is a set of key guidelines and tips to keep in mind. § Be aware. Be cognizant of personal attitudes, beliefs, biases, and behaviors that may influence (consciously or un- consciously) your care of patients as well as your interactions with professional colleagues and staff from diverse racial, and ethnic backgrounds. § Remain open-minded. Remember, there is no "one" way to treat any racial and ethnic group. Interventions and care should be individualized and applied in a patient and family-centered manner. § Stick to the rules. Experts point out that clinical and preventive care needs to be evidence-based, flexible, authentic, and ethical. § Reinforce education. Hold weekly or monthly cultural learning sessions. Focus on a specific, diverse group. Recruit experts and speakers to educate your staff. Post websites in break rooms, the intranet, etc. where staff can find more information about diversity (some helpful sites are listed at the end of this article). Lastly, it's important for healthcare companies to remember that diversity isn't just about race" it includes socioeconomic status, gender, disability" not just race and ethnicity. While continually striving for a culturally competent staff, attracting a more diverse workforce in your organization will push for better care for all under-served groups. For More Information For more information and resources concerning diversity in the healthcare profession, click on the links below. Diversity Rx: http://www.diversityrx.org/HTML/DIVRX.htm The Institute for Diversity in Health Management: http://www.diversityconnection.org/ National Center on Minority Health and Health Disparities: http://ncmhd.nih.gov/ "Eighty-one percent of white male, female, and minority healthcare workers surveyed by Witt/Kieffer agree that having women and minorities on their senior management team is important to their organization's goals and objectives." " Perspectives, published by Witt/Kieffer, Ford, Hadelman & Lloyd ---------------------------------------------------------- Test Your Knowledge! The Management Sciences for Health (MSH) has created a site to assist healthcare organizations throughout the U.S. provide high quality, culturally competent services to multi-ethnic populations. By clicking on the link below you can examine your own cultural competence. The quiz is confidential and your answers will not be shared with anyone. Please also note that the results of this quiz do not necessarily "certify" you as a culturally competent provider. The intent of this quiz is to help create awareness as well as stimulate your thinking about cultural issues in healthcare. http://erc.msh.org/quiz.cfm?action=question&qt=all&module=provider "To remain competitive, the healthcare in- dustry must look beyond traditional labor sources and focus recruitment efforts on qualified, yet underrepresented workers, especially people with disabilities." " Business Leadership Network ---------------------------------------------------------- Fast Facts The Aging Boom By 2012, it's estimated that the U.S. will have nearly 10,000 people a day turning age 65. Undoubtedly, this upcoming aging boom is bound to affect the manner in which healthcare professionals are trained and perform their daily job. Consider these facts: " Older Americans will more than double in number from 35 million today to 70 million by the year 2030. " The average 75-year-old person ex- periences three chronic conditions at any- time. Some report as many as 10. " Less than one percent of nurses in the U.S. are certified in geriatrics and only three percent of advance practice nurses specialize in the care of older people. " Geriatricians comprise approximately 0.5 percent of all medical educators in the U.S., representing the largest educational training gap in any field. " A survey conducted for the Alliance for Aging Research by Opinion Research Corporation in February 2002 found that 74 percent of all Americans feel it is "very important" that their health- care providers have some aging-specific training. Source: The Alliance for Aging Research "The pessimist sees the difficulty in every opportunity. The optimist, the opportunity in every difficulty." " L. P. Jacks ---------------------------------------------------------- Great Minds Think Alike! The Common Characteristics of Success The saying, "great minds think alike" may be more than just a catchy cliché. In fact, a number of studies have found that this phrase actually holds water. In a 1982, study researchers determined that successful corporations and leaders possess many of the same characteristics. And in 2000, the Shortel et al study found the same to be true in the field of healthcare. According to Shortel et al high-performing organizations and leaders in healthcare share several common traits. The study found that successful healthcare professionals and organizations: § Go the extra mile. High-performing health- care organizations are never happy with the status quo. They are always striving for improvement. § Never stop learning. Shortel found that top organizations learn quickly and continually search their environment for new opportunities as well as threats. § Seek challenges. Successful organizations and professionals classify problems as challenges. They're able to look beyond the obstacles and find the opportunities that from a "bump in the road." § Are mission-driven. Successful leaders continually keep the values of the organization in the forefront to develop a strong organizational culture" they live and breathe the company's vision or mission statement. § Are action oriented. These leaders do not bring up problems unless they have a possible solution. Rather than complaining, they believe they can influence their environment in a positive fashion. § Embrace change. High-performing health- care organizations do not crumble in the wake of change. In fact, they are the change makers. They create problems for others. Others do not create problems for them, only opportunities. § Find balance. Shortel's findings support the idea that some operational looseness among staff is useful. When employees are given the opportunity in the decision making process they are more apt to buy into the overall goals and values of the organization. § Are spiritual. Highly functional organizations seem to recognize spirituality and are able to capitalize on it. Keep in mind that spirituality does not refer to religious affiliation or sponsorship, but rather the capability to give meaning and purpose to people's lives. ---------------------------------------------------------- Blueprints Guidelines For Building Cultural Competence In late December 2000, the Office of Minority Health (OMH) and the U.S. Department of Health and Human Services, published the final recommendations on national standards for culturally and linguistically appropriate services (CLAS) in health care. The revised CLAS Standards From the Office of Minority Health are as follows: 1. Health care organizations should ensure that patients/consumers receive from all staff members effective, understandable, and re- spectful care that is provided in a manner compatible with their cultural health beliefs and practices and preferred language. 2. Health care organizations should implement strategies to recruit, retain, and promote at all levels of the organization a diverse staff and leader- ship that are representative of the demographic characteristics of the service area. 3. Health care organizations should ensure that staff at all levels and across all disciplines receive ongoing education and training in culturally and linguistically appropriate service delivery. 4. Health care organizations must offer and provide language assistance services, including bilingual staff and interpreter services, at no cost to each patient/consumer with limited English proficiency at all points of contact, in a timely manner during all hours of operation. 5. Health care organizations must provide to patients/consumers in their preferred language both verbal offers and written notices informing them of their right to receive language assistance services. 6. Health care organizations must assure the competence of language assistance provided to limited English proficient patients/consumers by interpreters and bilingual staff. Family and friends should not be used to provide interpretation services (except on request by the patient/ consumer) 7. Health care organizations must make available easily understood patient- related materials and post signage in the languages of the commonly encountered groups and/or groups represented in the service area. 8. Health care organizations should develop, implement, and promote a written strategic plan that outlines clear goals, policies, operational plans, and management accountability/oversight mechanisms to provide culturally and linguistically appropriate services. 9. Health care organizations should conduct initial and ongoing organizational self-assessments of CLAS-related activities and are encouraged to integrate cultural and linguistic competence-related measures into their internal audits, performance improvement programs, patient satisfaction assessments, and outcomes-based evaluations. 10. Health care organizations should ensure that data on the individual patient's/consumer's race, ethnicity, and spoken and written language are collected in health records, integrated into the organization's management information systems, and periodically updated. 11. Health care organizations should maintain a current demographic, cultural, and epidemiological profile of the community as well as a needs assessment to accurately plan for and implement services that respond to the cultural and linguistic characteristics of the service area. 12. Health care organizations should develop participatory, collaborative partnerships with communities and utilize a variety of formal and informal mechanisms to facilitate community and patient/ consumer involvement in designing and implementing CLAS--related activities. 13. Health care organizations should ensure that conflict and grievance resolution processes are culturally and linguistically sensitive and capable of identifying, preventing, and resolving cross-cultural conflicts or complaints by patients/consumers. 14. Health care organizations are encouraged to regularly make available to the public information about their progress and successful innovations in implementing the CLAS standards and to provide public notice in their communities about the availability of this information. For more information on these standards, please visit The Office of Minority Health's website at: http://www.omhrc.gov/. |