launching a cultural competency initiative: one school’s experience presented by: melva hardy,...
TRANSCRIPT
Launching a Cultural Competency Initiative:
One School’s Experience
Presented by: Melva Hardy, MHSA
Princeton University
American College Health AssociationMay 29, 2009
Where do I start?
Cultural
Competency
How long will it take?
How do I move from having a
concept to a plan I can make happen?
Where will I find the time?
What do I need to get started?
Cultural
Competenc
y
Cultural Competencypart of the culture of an organization
Change TheoryIn the model as of 1997, change is a "process involving progress through a series
of six stages":
Pre-contemplation - "people are not intending to take action in the foreseeable future, usually measured as the next 6 months"
Contemplation - "people are intending to change in the next 6 months"
Preparation - "people are intending to take action in the immediate future, usually measured as the next month"[nb 1]
Action - "people have made specific overt modifications in their life styles within the past 6 months"
Maintenance - "people are working to prevent relapse," a stage which is estimated to last "from 6 months to about 5 years“
Workshop Goals
Identify what you and your organization need to begin a cultural competency initiative.
Identify the steps of a process to move your organization towards obtaining cultural competence.
Identify strategies to overcome potential challenges or pitfalls.
Developing the Plan
Putting Together What Works For You And Your Institution
University Health
Services
Princeton University
Approximately 7, 000 students
7 MDs
6 NPs
2 PAs
2 MAs
Counselors and Psychiatrists
Services include Counseling, Medical, Athletic Medicine, Inpatient, Sexual Health and Wellness, Employee Health,
Undergraduate Student Population
2008-2009
White 51.1%
Black 8.5%
Hispanic 7.5%
Native American
0.7%
Asian American 15.0%
Multiracial 4.0%
International 10.2%
Unknown 3.0%
Princeton’s History with
Cultural Competency
•Past Staff Retreat / Meetings on the topic
•Work Environment Task Force: Fall 2002
•Cultural Competency Work Group
•Holiday Decorations Policy Development
Princeton’s History with
Cultural Competency
•Disjointed Programs across the Health Service
•Counseling and Psychological Services initiated a reading group
•Brought in a speaker for a 2 hour training of all staff
•Cultural Awareness Boards
•Launched Cultural Competency Work Group: December 2005
Princeton’s Launch of the Cultural Competency Initiative
Determined the team members / staff person accountable for moving the initiative along
Prepare team members / accountable staff person
Literature on cultural competence in healthcare organizations
Resources that will be available to you during the process
Review population data / Set up mechanisms to collect data
Outline goals of the workgroup
Obtain leadership approval
. . .what are some of the questions or concerns that
come to your mind?
When you think about launching a Cultural Competency initiative at your
school . . .
What you need to begin
Resources and Connections
Goals
A plan
A Champion / team of champions
CLAS Standards--- Culturally and Linguistically Appropriates Services in health care
Accreditation Standards on Cultural Competence
State Regulations
Betancourt and Alexander articles
DiversityRx.com (list serve, communities of practice initiative)
Conference on Healthcare for Culturally Diverse Populations
Examples of Resources To Explore
Examples of Resources To Explore
Dennis Andrulis, Drexel University School of Public Health
National Center for Cultural Competence (Georgetown University)
Publication that demonstrates roadblocks Free assessment tools
Thomas LaVeist , PhD (Johns Hopkins University) COA-360
Paul T. Doyle and Associates www.paultdolye.com
What you need to begin
Resources and Connections
Goals
A Champion / team of champions
A plan
Goal SettingGROUP ACTIVITY:
Use the worksheet to come up with goals for a project you will work on today
Princeton’s Work Group Goals
Incorporate cultural competence as a value in professional practice.
Referring to clients and systems
To incorporate cultural awareness in working relationships
To incorporate cultural understanding in thoughts and behaviors.
*Relationships = clients, colleagues, peers, and hierarchical within the organization
Exploration of Internal Reservations and External
Concerns Gain a clear perspective of our current culture and environment
regarding cultural competency in the different departments of the health service
Establish the role of the work group in the implementation process
Desire to avoid repeating past mistakes
Avoid offending people
Expectations about confrontation
Establish common expectations
Avoid one person or small group carrying the burden for success
Maintain a focus on the agenda for cultural competency throughout the process
What you need to begin
Resources and Connections
Goals
A Champion / team of champions
A plan
Workshop Goals
Identify what you and your organization need to begin a cultural competency initiative.
Resources and Connections Goals Champion / team of champions A plan
Identify the steps of a process to move your organization towards obtaining cultural competence.
Identify strategies to overcome potential challenges or pitfalls.
Cultural Competency Launching Process
Develop a project plan
Define Cultural Competency for your organization
Communicate the plan and definition throughout the organization and your campus
Task DevelopmentGROUP ACTIVITY:
Brainstorm tasks for the project your group has chosen to work on today
Task DevelopmentGROUP ACTIVITY:
Categorize tasks that you brainstormed in your group
Princeton’s Plan: Category of Tasks
Process MappingGROUP ACTIVITY:
Place the tasks in order that they would come in the project. The outcome will be the draft of your group’s
project plan.
Task AnalysisGROUP ACTIVITY:
Use the worksheet to determine how long it will take to complete each task and set deadline dates to each
task in your project plan
Strategic Plan•Establish a start date
•Task deadline dates will follow
Workshop Goals
Identify what you and your organization need to begin a cultural competency initiative.
Resources and Connections Goals Champion / team of champions A plan
Identify the steps of a process to move your organization towards obtaining cultural competence.
Identify strategies to overcome potential challenges or pitfalls.
Overcoming Pitfalls and Challenges
Planning Phase
Potential Pitfall Overcoming the Challenges
Goal Setting •Too large of a scope•Program oriented instead of process oriented
•Focus on measureable and time specific goals•Focus on ways to create something sustainable and not program or person dependent
Brainstorming Fighting about the definition of cultural competency and the approach without having data
Review some literature as well as national and professional standards about cultural competency in healthcare organizations
Process Mapping
Ignoring the fears and concerns of workgroup members and your staff
Solicit the information early and review your plan to make sure you are accounting for the information you have about fears and concerns
Task Analysis Skipping this step is easy to do, but will leave your plan vulnerable to “things that come up”
•Take the time to do it and review it as a group•Make sure to account for the “unexpected”
Create Project Plan
•Picking an unrealistic start date•Not including key “leaders” in your process
•Have the buy-in from the executive leadership and make sure that they are aware of your start date.•Be strategic in who helps to develop the plan.
Define Cultural Competency for your organization
•Can bring up tension because of personal differences or perspectives•Involving too many people too early in the discussion
•Read some literature•Obtain information from other college health centers•Refer to national standards
Communication Giving too many details and overwhelming your audience
Know your audience and the best way to communicate information to them without overwhelming them
More Strategies to overcome pitfalls
Conflict Management
Requesting fears and concerns of workgroup members Soliciting information about fears and concerns of the rest
of the staff in the organization Brainstorm ways to address the fears as part of the
project plan. This is different than other projects
Communication
Avoid overuse of terminology / jargon Know your audience as you present your project plan to
build buy-in across the organization Lost 6 months worth of productive project time.
Connections
Develop a list of resources that will be available to staff throughout the development phase of the initiative.
Seek out formal and informal partnerships External partners
Internal partners
More Strategies to overcome pitfalls
Workshop Goals
Identify what you and your organization need to begin a cultural competency initiative.
Resources and Connections Goals Champion / team of champions A plan
Identify the steps of a process to move your organization towards obtaining cultural competence.
Identify strategies to overcome potential challenges or pitfalls.
Princeton’s Strategic Plan
Overview of the Plan
Research
Work group preparation
Assessments
Process planning and program(s) development
Process and program implementations
Re-assessment and plan revisions
RESEARCH
Project Progression and
Visibility to the Organization
Visible
Not Visible
WORK GROUP PREPARATION
RE-ASSESSMENT
PROCESS AND PROGRAM PLANNING
ASSESSMENTS
PROCESS AND PROGRAM
IMPLEMENTATION
PROJECT PROGRESSION
PR
OJE
CT
PR
OG
RES
SIO
N
Overview of the Plan
Research Work group preparation
Assessments
Process planning and program(s) development
Process and program implementations
Re-assessment and plan revisions
Research
Research Cultural Competence Definitions
Culture Cultural Competence Cultural Competence in different healthcare disciplines
Organizations In college health organizations Other health care organizations Our organization and attempts to address the topic
Research Consultants and Trainers Organizational consultants Trainers (for all staff) Counselors to have available for staff during the process
Research8 months
Original Date: January – August 2007
Revised Dates: July 2007 – February 2008
Overview of the Plan
Research
Work group preparation Assessments
Process planning and program(s) development
Process and program implementations
Re-assessment and plan revisions
Work Group Preparation
Education about tools and principles in the field of cultural competence
Avanti retreat / training Work group retreat / training Sensitivity training
Individually process reactions to the trainings
Work Group Preparation (cont’d)
Work Group team building
Share our experiences with each other Share any initial concerns or reservations
about launching the project plan
Establish communication mechanism(s) between Avanti and the Work Group
Work Group Preparation
3 months
Original Dates: April – July 2007
Revised Dates: February - April 2008
Overview of the Plan
Research
Work group preparation
Assessments Process planning and program(s)
development
Process and program implementations
Re-assessment and plan revisions
Assessments Use Assessment Tools
Conduct organizational assessments Offer individual assessments
Focus Groups
Of Clients to learn their experiences Of Staff to learn their experiences
Benchmark our organizational assessment outcomes against similar organizations
Assess organizational readiness for change
Assessments12 months
Original Dates: Summer 2007 – Summer 2008
Revised Dates: May 2008 – May 2009
Overview of the Plan
Research
Work group preparation
Assessments
Process planning and program(s) development
Process and program implementations
Re-assessment and plan revisions
Assessment Outcomes
Inform Planning Communicate results of the organizational
assessments and focus groups with staff
Consider creating a larger working group
Decide on structure of other / larger working group
Determine measurable objectives
Process Planning and Program Development
Solicit input from staff about programming and process improvements
Explore existing campus initiatives
Investigate available training programs and resources
Interview outside speakers and trainers
Process Planning and Program Development (cont’d) Provide action steps for skill building
Brainstorm diverse programs to offer Lectures Workshops Small group sessions Readings Performances
Develop fun activities (lunches, dinners etc.)
Process Planning and Program
Development3 months
Original Dates: December 2008 – February 2009
Revised Dates: Fall 2009
Overview of the Plan
Research
Work group preparation
Assessments
Process planning and program(s) development
Process and program implementations
Re-assessment and plan revisions
Process and Program Implementation
Conduct trainings, seminars, reading groups etc.
Incorporate competency levels into performance appraisals
Develop protocol for supervisors to evaluate cultural competency
Create a grievance process for communicating concern(s)
Process and Program Implementation
1 year
Original Dates: Fall 2008 – Fall 2009
Revised Dates: Winter 2009 – Winter 2010
Overview of the Plan
Research
Work group preparation
Assessments
Process planning and program(s) development
Process and program implementations
Re-assessment and plan revisions
Re-Assessment and Plan Revisions
Conduct a climate check to determine what’s next
Re-evaluate programming, reading groups, activities that will continue our progress
Develop a schedule of regular programming and educational opportunities
Re-assessment and plan revisions
9 months
Original Dates: Fall 2009 – Summer 2010
Revised Dates: Winter 2010 – Fall 2011
3-Year Plan
Research
Work group preparation
Assessments
Process planning and program(s) development
Process and program implementations
Re-assessment and plan revisions
RESEARCH
Project Progression and
Visibility to the Organization
Visible
Not Visible
WORK GROUP PREPARATION
RE-ASSESSMENT
PROCESS AND PROGRAM PLANNING
ASSESSMENTS
PROCESS AND PROGRAM
IMPLEMENTATION
PROJECT PROGRESSION
PR
OJE
CT
PR
OG
RES
SIO
N
Princeton: Where We Are Now
Work Group includes the Executive Team
We have a working definition of cultural competence
List of Resources and Connections
Considering revamping our mission statement
Ready to analyze data and program plan this Fall
Cultural Competence is part of the Performance Appraisal
Member of the University’s Diversity Council
References
Skillspath Professional Development Training Session: Fundamental Elements of Successful Project Management
Change Theory Definition http://en.wikipedia.org/wiki/Transtheoretical_Model#Stages_of_change
