culture competence in healthcare

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Prepared by Sahar Consutling, LLC. Culture Competence in Healthcare

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www.saharconsulting.com Rapidly changing demographics The population is becoming increasingly diverse -Under-represented groups represent almost 34% of the total population Health care workforce has not kept up with the changing demographics Physicians from underrepresented groups make up only about 7% of the current workforce Nurses only 3% Pharmacists only 3% Why should we care

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Demographics (Based on the 2000 census figures) www.saharconsulting.com

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In 2030 The projected Demographics are: White: 60% Hispanic: 19% Black: 13% Asian/PI: 7% Native Am./Ak N: 1% Source: U.S. Census Bureau, 2000 www.saharconsulting.com

Consequences of lack of cultural competence : 

Consequences of lack of cultural competence In the workplace results in: www.saharconsulting.com Unhappy employees cost an organization more than beyond low productivity, high turnover or absenteeism: discriminatory practices can result in expensive, long and sometimes public ugly court battles.

Consequences of lack of cultural competence : 

The consequences of lack of cultural awareness may be multiple. Patient-provider relationships are affected when the understanding of each other's expectations is missing as the following examples: The provider may not understand why the patient does not follow instructions Or why the family, rather than the patient, makes important decisions about the patient's health care. The patient may reject the provider (and the entire system) even before any one-on-one interaction occurs because of non-verbal cues that do not fit expectations. The patient doesn’t trust the provider or the whole institution Consequences of lack of cultural competence Will result in: www.saharconsulting.com

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Steps for Cultural Competence programs www.saharconsulting.com

What is? : 

www.saharconsulting.com Diversity: Diversity refers to human qualities that are different from our own and those of groups to which we belong; but that are manifested in other individuals and groups. Dimensions of diversity include but are not limited to: age, ethnicity, gender, physical abilities/qualities, race, sexual orientation, educational background, geographic location, income, marital status, military experience, parental status, religious beliefs, work experience, and job classification What is? Diversity, Culture, Culture sensitivity, Culture competence

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What is? www.saharconsulting.com 2

Starting Point : 

www.saharconsulting.com Starting Point Basic things to know about cultural competence Logo Differences exist even within the same group of people Similar appearances don’t necessarily mean sharing the same culture as Asians don’t share cultural similarities as there are differences between: Japanese, Chinese, Koreans, Thai, Cambodians etc… Sharing a language or a nationality doesn’t also mean sharing the same culture: We all speak English in the US but we come from different cultures and backgrounds we have similarities but also differences. Sharing the same religion doesn’t mean similar cultures either as in every religion there is the conservative, the moderate and the liberal or even the non believer.

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Acquiring Cultural Competence In order to be culturally competent clinicians need not possess full knowledge of every cultural practice and belief. Instead they should be sensitive to others' preferences and values, and should not assume that one person's preferences and values apply to everyone in that same group. Starts with Awareness Grows with knowledge Enhanced with specific skills Polished through cross-cultural interactions

Areas of Cultural Sensitivity : 

www.saharconsulting.com Areas of Cultural Sensitivity Family organization: Egalitarian / Hierarchical Language/ Reading proficiency Personal space/ Touching Eye contact/ Gestures Ethnicity/ Country of Origin Beliefs & Customs Spirituality Religion Economic status& Education level

Cultural Diversity Impacts : 

Birth Death Health Illness Health Care Cultural Diversity Impacts Beliefs& Religion/ Spirituality: www.saharconsulting.com

Cultural Diversity Impacts : 

Preventive measures are better in higher socio economic environments. Cancer assessment & treatment are less in underserved minority populations Health Disparities in different socio-economic levels. Greater level pain suffering in lower socio-economic levels. Poor people face substantial obstacles in obtaining and using health insurance and often do not seek care if they cannot pay for it. Cultural Diversity Impacts Socio-Economical factors: www.saharconsulting.com

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Communication and interpersonal relationship styles including word choice, voice tone and volume, eye contact, and proper titles Discipline, correction, and training methods for healthcare professionals Age, respect, and seniority. Individualism and equality. Informal and social interactions Gender issues and consideration of appropriate male/female interaction Clothing, hair styles, and body adornment Language/ spoken and English fluency. Use of interpreters or family members www.saharconsulting.com Factors that can further impact the relationship between patients and health providers Other issues of Cultural Sensitivity

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www.saharconsulting.com By applying Cultural Competence Goals to achieve 2

Objectives : 

www.saharconsulting.com Objectives Of Cultural Competence 1. Cultural diversity/ sensitivity relate to the competencies of “Patient Care,” "Interpersonal and Communication Skills" and "Professionalism." 2. Raising the awareness that nods and polite smiles don’t necessarily accomplish effective communication 3. Cultural issues involve age, gender, education, and socioeconomic status as well as ethnic, racial, and religious differences. 4. Reminding healthcare professionals, that medicine is a "language" that may require translation even for native‐English speakers due to the medical terminology

Objectives (Cont.) : 

www.saharconsulting.com Objectives (Cont.) Of Cultural Competence 5. Teaching that medical decision‐making may involve a family or community& not only the individual patient. 6. Teaching about the value of involving the hospital chaplain/ local religious leader or the patient’s own religious leader; when belief systems may affect health‐care decisions 7. Teaching that respect is a core value in all cultures therefore, respect must be shown to the patient and family members at all times. 8. Use lectures, presentations, films, and literature, helping the healthcare professionals understand that many cultural and faith issues are involved in patient‐centered health care.

Lack of awareness of Cultural Competence : 

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www.saharconsulting.com Should include the following concepts: Training for Cultural Competence To provide information that will assist health care professionals to maximize the quality of patient care in a diverse society Awareness

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www.saharconsulting.com To increase cultural competencies between Healthcare professionals Celebrate differences & have zero tolerance for discrimination

Workforce Diversity : 

www.saharconsulting.com Workforce Diversity As Our population is becoming increasingly diverse. Our workforce must strive to mirror these demographic changes.

Workforce Cultural Competency : 

www.saharconsulting.com Workforce Cultural Competency As “In the end the ultimate goal is a health care system and workforce that can deliver the highest quality of care to every patient, regardless of race, ethnicity, cultural background, or English proficiency.” Betancourt, J. 2002. Cultural competence in Health Care: Emerging Frameworks and Practical Approaches. Field report.

Cultural Competency : 

www.saharconsulting.com Cultural Competency Logo 1- Begins with respect. 2- Apply the Golden rule:“Do Not Do to Others What You Do Not Want Done to Yourself” – Confucius. 3- Recognize your own bias and prejudice. 4- Avoid stereotyping and discrimination by asking the proper questions respectfully. 5- Practice effective communications and monitor the patients comprehension either through interpreters, colleagues or the patient’s family along with the verbal and non verbal signs of the patient. 6- Don’t be ethnocentric where you think that your culture is the best or try to impose it. For Healthcare professionals

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THANK YOU! For more information about Cultural Competence training Please contact: Sahar Consulting, LLC www.saharconsulting.com sahar@saharconsulting.com