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Transcultural Health Care: A Culturally Competent Approach, 4th EditionTranscultural Health Care: A Culturally Competent Approach, 4th EditionTranscultural Health Care: A Culturally Competent Approach, 4th EditionTranscultural Health Care: A Culturally Competent Approach, 4th Edition

Copyright © 2013 F.A. Davis Company

Chapter 4Organizational Cultural Competence

Larry Purnell, PhD, RN, FAAN



Organizational Cultural Competence

Every Department in an organization has responsibilities for assuring cultural competence

Administration has the primary responsibility for the integration of cultural competence



Administration and Governance Diversity is addressed in mission and

philosophy Policies are in place that address the needs of

employees, visitors, and patients Diversity is addressed during orientation –

patients and staff



Administration and Governance

Art work in common areas is reflective of the diversity of the community

Does the organization engage in community diversity fairs, help organize wellness days, health screenings?

Does the organization partner with community ethnic agencies?




Does the organization network with community leaders?

Does a committee for cultural competence exist? Does it include staff, managers, chaplains, administrators, and members representative of the community?




Are fiscal resources allocated to diversity training?

Do policies address bias and prejudice of staff and patients?

Is input on research priorities sought from consumers?




Are researchers reflective of staff, clients, and the community?

Are the organization’s programs advertised in community newspapers and on the radio and television in the languages of the community?




Does Human Resources recruitment and hiring activities reflect the diversity of the community?

Do position descriptions and performance evaluations reflect cultural competence?

Is there active recruitment of bilingual staff – higher pay if certified?




Does data collection include race, ethnicity, culture, and language preferences and abilities of the staff and clients?

Do conflict and grievance procedures reflect the languages of the staff?

Are patients’ rights documents in the major languages if the community?




Is there a holiday calendar that represents the client and staff population base?

Is there a mentoring program to entice recruitment into the health professions?

Do intake forms reflect cultural assessment?




Are culturally appropriate toys available: Hispanic Santas, Black dolls, Jewish and Muslim considerations?

Signage is in the languages of the community Are directions to referral facilities are in the

languages of the populations served?




Ethics Committee has representatives reflective of the diversity of the community

Library has cultural diversity resources – online resources?




Directions to the hospital and clinics in language of the patient

Advertise services where the patient can see them: grocery stores, neighborhood stores, local newspapers, bars, restaurants, bus stops, beauty salons, barber shops, etc.




Knowledgeable about the community Accesses community leaders Hours of operation meet the patient needs Direction to and from organization and to and

from other essential services are in the languages of the patient population




Classes for ESL employees are available Foreign language classes for employees Religious needs of patients and employees are

accommodated – scheduling Complementary and alternative therapies are

incorporated in patient care



Organizational Competence: Orientation

Orientation to the healthcare system Diversity in the health professions addressed Influence of insurance companies on

healthcare decision-making is addressed Concerns related to malpractice are discussed




Nursing care delivery systems are explained Issues related to autonomy are discussed Ongoing in-services at all levels of staff Cultural general programs for professional

staff exist




Cultural specific programs that address the ethnicity of the workforce and patients are conducted at least annually

Cultural celebrations are valued



Organizational Competence Staff

Flexibility in scheduling – religious holidays Food selections are in the ethnicity of the staff

and patients Cultural brokers for staff exist Staff resources are available on the unit and in

the library



Organizational Competence: Staff

Is certification for cultural competence offered at diverse levels?

Are staff surveys in the languages of the staff?



Organizational Competence

Food selections meet the ethnicity of the patient and staff



ClickerCheck

All departments in an organization have a responsibility for organizational cultural competence. The primary responsibility for ensuring integration belongs to

a. The Board of Trusteesb. Nurse managersc. Administrationd. Physicians



Correct Answer

Correct answer: CWhereas all departments and professionals

participate in assuring that and organization is culturally competent, the primary responsibility for ensuring integration is administration



Language

Does the organization engage in activities that address health literacy of the population served?

Do written documents undergo a cultural sensitivity review?

Is the need for an interpreter determined ahead of time?



Language

Does the telephone system have a menu for diverse languages?

Are television channels in the languages of the community?

Are satisfaction surveys in the languages of the community/patients?



Language

Organization actively recruits bilingual staff Guidelines are in place that address the needs

for an interpreter Guidelines exist for using interpreters Directional and informational signs are in the

languages of the catchment area



Language

Discharge instructions are in appropriate languages

Consent forms are translated Community resources are made available Reading material in lobbies, waiting areas, etc. is

available in the languages of the patients/visitors



Language

Patient education materials are in different languages

Videos are in different languages and with the ethnicity of the patients



Language

Pain scales are in the language of patients and faces of the ethnicity served

Prescriptions are in the language of the patient

Dietary instructions are in the language of patient



Translation and Interpretation

Translation: The written word Interpretation: The spoken word Interpretation in Health Care: Know the

language and the culture Interpreters are qualified in both languages



ClickerCheckMrs. Alvarez, age 34 years, speaks very little English. She comes

to the hospital clinic because of vaginal bleeding. She and is accompanied by her 6 year old daughter and 12 year old son who both speak English. The best interpreter would be

a. Her daughterb. Her sonc. A bilingual person from the dietary departmentd. Someone from the language hotline



Correct Answer

Correct answer: DChildren should not be used as interpreters for

their parents except in emergencies or collecting initial admitting information. We do not know if the dietary employee is certified as an interpreter.

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Documents

transcultural health

competent aapppprrooaacchh

governance diversity

health screenings

health professions

tthh eeddiittiioonncopyright

governance directions

davis companycompetence