1 cultural competence in healthcare an important refresher for physicians
TRANSCRIPT
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Cultural Competence in Healthcare
An Important Refresher for Physicians
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Session Objectives
Define Cultural Competence
Describe why delivering Culturally Competent Care is important
Understand being Culturally Competent is a continual process
Use Culturally Competent Practicesin the provision of care
After this session physicians will be able to:
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Why do we focus on Cultural Competence at Wheaton Franciscan Healthcare?
It is our Mission • “Providing exceptional and compassionate health care
service that promotes the dignity and well being of the people we serve.”
Clinical Excellence• Ensure equal and individualized care is delivered to all patients
Our Patient and Family Experience• Nothing is more important than our patient’s health and well being
Culturally competent care meets the needs of our culturally diverse patient population!
Important reminder!
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The next few slides are common words and information to help you learn more about what cultural competence is and why it matters in
healthcare and the workplace
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What is Culture?It is the learned and shared values of a particular group that:
-Guides thinking
-Actions
-Behaviors
-Emotional reactions to daily living
It is the sum of beliefs, practices, habits, likes and dislikes. It is norms and customs that are learned.
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Culture is central to the Delivery of Healthcare
• It influences patients’ healthcare beliefs, practices attitudes toward care, and trust in the system and in the individual providers
• Cultural differences affect how health information and healthcare services are received, understood and acted upon.
*US Department of Health & Human Services/ Office of Minority Health
Our Patients Represent Many Cultures
Group
YEAR
WFH–North Market (WI)
St. Joseph, Elmbrook & Wisconsin Heart Hospital
WFH-Central Market (WI)
St. Francis & Franklin & MOSH
WFH-South* Market (WI)
All Saints
WFH-Iowa*Sartori, Mercy & Covenant
Marianjoy (IL)
Native Hawaiian & American
Indian
FY04 FY11
.1% .2%
.5% .3%
.4% .003%
.5% .1%
.2% .03%
Asian
FY04 FY11
1.5% 1%
1% 1%
.7% .5%
.8% .3%
1% 1%
Latino/ Hispanic
FY04 FY11
2.7% 2%
12% 11%25% SFH
8% 10%
1.6% .6%
2.6% 3%
African American/
Black
FY04 FY11
27% 24%62% SJH
7% 5%
11% 16%
4% 3%
1.4% 3.3%
White/ Caucasian
FY04 FY11
67% 71%21% SJH
75% 79%61% SFH
79% 71%
93% 94%
89% 84%
Our Patients Represent Many Religions and Languages
Religions
Apostolic Church of God Greek Orthodox Methodist
Baptist Congregational Hindu, Hmong Mormon
Buddhist Eastern Orthodox
Jehovah’s Witness
Muslim/Islam
Catholic Episcopal Jewish, Pentecostal
Christian Science Evangelical Lutheran Presbyterian
Languages
Arabic Farsi Japanese Serbian
Bosnian French Laotian Sign language
Chinese Greek Polish Spanish
Danish Hebrew Punjabi Somali Bantu
English Italian Russian VietnameseIOWA Patient data is in bold
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What is Cultural Competence?Cultural competence is the ongoing capacity of
healthcare systems, organizations and professionals to provide for diverse patient* populations high
quality care that is safe, patient- and family- centered, evidence-based, and equitable
The National Quality Forum
* The term “patient” refers to the individual recipient of care – i.e. patient, client, legal surrogate or person.
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Cultural Competence in Health Care
1. Eliminate misunderstandings in
diagnosis or in treatment planning that my arise from differences in language or culture
2. Improve patient adherences with treatments
3. Eliminate health care disparities
Primary concerns:
Associations We Make
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• Alzheimer’s patient• Black male• Asian man• Welfare recipient• Teenager
What type of person do you think of when you hear the following descriptions?
Associations We Make
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Dr. Ben Carson
The people shown below fit into the descriptions reviewed on the previous slide
Alzheimer’s victim
Black male
Asian man
Welfare recipient
Teenager
Jackie Chan
President Ronald Reagan
JK Rowling
Justin Beiber
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Associations We Make
• When we initially hear the profile of a patient, we all make associations and assumptions based on our past experience. We have a perception of the person before we ever meet them.
• Our patients make the same associations when they meet us.
• This can be described as a component of transference and counter-transference.
Transference
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• Transference occurs when the physicians or patients transfer past emotions, beliefs or experiences to the present situation.
• The feelings can be positive or negative Counter-transference, but are ALWAYS a distortion of realty.
• Transference is an unconscious process. When transference occurs around cultural issues, it becomes a serious barrier that keeps the patient from being receptive to medical advice and treatment.
It is up to us as Culturally Competent Providers to maintain and convey unconditional positive regard for our patients
The American Journal of Psychiatry, VOL. 157, No. 9
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• Gaining cultural competence is an ongoing PROCESS. It is developed as cultural knowledge increases
• In order to achieve higher levels of competence, it is helpful to engage in self assessment
• Self assessment provides direction for improvement
The Center for Public Health Education
Cultural Competence is a Continuum
KNOWLEDGE
ATTITUDES
SKILLS
Journal of the Nation Medical Association, Nov. 200816
ATTITUDES SKILLS
Cultural Competence is a Continuum
Moving From Basic Knowledge to Clinical Practice
Understanding the meaning of culture and its importance to
healthcare
Having respect for
variations in cultural norms
Eliciting patients’
explanatory models of
illness
KNOWLEDGE
Physicians must continue skill development to learn each culture
Eliciting Patient’s Explanatory Model of Illness
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Role of the Physician . .
1.Asking questions to elicit the patient’s understanding of their illness
2.Having strategies for identifying and bridging the different communication styles
3.Having skills for assessing decision-making preferences and the role of family
Journal of the Nation Medical Association, Nov. 2008
Eliciting Patient’s Explanatory Model of Illness
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4. Utilizing techniques for ascertaining the patient’s perception of using biomedicine and his or her use of complementary and alternative medicine
5. Having tools for recognizing sexuality and gender issues
6. Having communication strategies for negotiating
7. Methods for bringing to bear an awareness of issues of mistrust and prejudices and of the impact of race and ethnicity on clinical decision-making
Journal of the Nation Medical Association, Nov. 2008
The Culturally Competent Physician• Knows competency involves a deeper
commitment to the people for whom we provide services
• Recognizes and learns to work within the context of different languages, customs, worldviews, religions, spiritual views, health beliefs, gender roles, sexuality and family relationships when interacting with clients/patients
• Develops specific practice skills
The Center for Public Health Education
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• Practice Skills- Has an awareness and acceptance of
difference whereby diversity is valued
- Understands how his own culture influences how he thinks, acts and delivers services
- Understands the dynamics of difference and is conscious of those dynamics inherent when cultures interact
The Culturally Competent Physician
The Center for Public Health Education
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• Becomes familiar with the different aspects of various cultures in target areas where service is provided
• Has the ability to adapt practice skills that fit the cultural context of the patient/client
The Culturally Competent Physician
The Center for Public Health Education
Physicians must continue skill development to learn each culture
At Wheaton Franciscan Healthcare, we recognize our patients as individuals with unique physical,
emotional, spiritual, and cultural needs.
As a compassionate, faith-based health care provider, we believe developing a positive
relationship with our patients and families is essential to the healing process and key to
carrying out our Mission of providing exceptional and compassionate health care service.
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Why is this important for Physicians?
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The Goal of Each PhysicianTo always provide culturally competent health care services that are respectful of
and responsive to the health beliefs, practices, cultural and linguistic needs
of our diverse patients
Additional Resources
Please click on the picture for a quick reference on delivery culturally competent care.
There are also CME credits:
“A Physician's Practical Guideto Culturally Competent Care” at https://cccm.thinkculturalhealth.hhs.gov .
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Diversity & Inclusion ContactsTheresa Jones
Vice President of Diversity and Inclusion Strategies
414-465-3433
Leslie Galloway Sherard
Director, Diversity and Inclusion Programs
414-465-3504
Sandy Jones
Manager, Cultural Diversity
414-465-3005