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Transcript of Ch04
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
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
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
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
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
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
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?
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
Administration and Governance
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?
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
Administration and Governance
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?
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
Administration and Governance
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?
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
Administration and Governance
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?
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
Administration and Governance
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?
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
Administration and Governance
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?
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
Administration and Governance
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?
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
Administration and Governance
Ethics Committee has representatives reflective of the diversity of the community
Library has cultural diversity resources – online resources?
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
Administration and Governance
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.
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
Administration and Governance
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
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
Administration and Governance
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
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
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
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
Organizational Competence: Orientation
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
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
Organizational Competence: Orientation
Cultural specific programs that address the ethnicity of the workforce and patients are conducted at least annually
Cultural celebrations are valued
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
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
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
Organizational Competence: Staff
Is certification for cultural competence offered at diverse levels?
Are staff surveys in the languages of the staff?
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
Organizational Competence
Food selections meet the ethnicity of the patient and staff
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
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
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
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
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
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?
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
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?
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
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
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
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
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
Language
Patient education materials are in different languages
Videos are in different languages and with the ethnicity of the patients
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
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
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
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
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
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
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
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.