4 Ways to Improve Cultural Competency in your Organization

Cultural competency is a strategy organizations can use to “to improve health outcomes, increase quality of care, and reduce health disparities especially among minorities.”[1] However, there are many obstacles hospitals face when trying to develop cultural competency programs, which include lack of staff diversity and poor communication, among other issues[2].

In trying to find practical solutions for these challenges, we came across a recent article, A Framework for Cultural Competence in Healthcare Organizations[3], which discusses four main improvement points. We break these down for you below:

1. Make Sure Staff Diversity Reflects Patient Diversity - When providing healthcare to diverse patient populations, it’s a good rule of thumb to have a workforce that’s equally as diverse, since “minority health care professionals are more likely to understand the needs of minority populations.”[4] For instance, if you serve a large Spanish-speaking population, staff should also reflect this racial makeup. This goes for nurses and other staff, as well as executive leadership and members of the board. Since Human Resources is generally responsible for hiring employees, the department should be proactively recruiting and hiring minority staff, as well as language services and diversity staff.

2. Make Sure Vision, Mission and Values are Centered on Cultural Competency - Cultural competency starts with an organization’s vision, mission and values. First, senior management should work with organizational governance to create a vision that is cultural competent and determine how to allocate resources to support that vision. Second, the organization should identify its target patient population, create a culturally competent mission, and develop strategies for carrying out the mission. And thirdly, in its values, the organization should “reflect its attitudes and emphasis on cultural competence and its commitment to providing culturally competent care.”[5]

* For more information on this topic, read “5 Ways to Put Meaning Behind your Hospital’s ‘Mission, Vision and Values,” and see how you can put cultural competency into the mix.

3. Create a Strategic Plan – To promote cultural competency, organizations should “establish a strategic plan that emphasizes the importance of cultural competence training to the overall organization, its employees, patients, and communities served.”[6] The planning process (and, ultimately, the plan itself) should include a discussion of goals and priorities, organizational cultural competency strengths, resources for supporting staff education and in-servicing, and how the plan’s processes can be maintained over the long term.  Once the plan is finalized and put into practice, it’s important to regularly evaluate if objectives are being met and whether or not changes need to be made – to this end, forming task forces and committees with the aim of monitoring progress is helpful.

4. Communicate -  To maximize the effectiveness of the cultural competency program, organization employees, as well as patients and the general community, should be communicated with about the program using a variety of methods. For instance, cultural competency policies and procedures can be published in employee handbooks, regular cross-organizational workgroups can be formed, and in-language support materials can be posted around the hospital for non-English speakers, along with other processes.

By following these steps, health organizations will be moving closer towards equal healthcare access for all people, as outlined in Title VI of the Civil Rights Act of 1964 and The Joint Commission’s standards for Patient-Centered Communication.
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CyraCom’s interpretation and translation solutions are exclusively endorsed by the American Hospital Association. With ISO 9001:2008 certified quality processes, US-based medically-trained interpreters, and a dedicated account management team, we are equipped to meet your patients’ language needs. 

[1] See footnote 3 for reference; p.208: Healthcare organizations are focusing more on cultural competence as a strategy for these key areas

[2] See footnote 3 for reference; P.208: Healthcare organizations face a number of challenges when developing cultural competency programs

[3] Castillo RJ, Guo KL, “A Framework for Cultural Competence in Health Care Organizations,” The Health Care Manager (2011): 205-214

[4] See footnote 3 for reference; P. 208

[5] See footnote 3 for reference; P. 211

[6] See footnote 3 for reference; P.211

What you should Read: Informative Healthcare Language Services Articles of 2011

2011 was a productive year in healthcare language services research, and many pertinent topics were covered. The articles below discuss some of the issues I believe are most central to language services today. I hope the information presented will be of use to language services decision-makers in the healthcare space as they wrestle with these issues daily. Enjoy.

1. Interpreter Perspectives of in-person, telephonic, and videoconferencing medical interpretation in clinical encounters , Patient Education and Counseling. 2011 Sep 17 [Epub ahead of print]

What do professional medical interpreters think about the effectiveness of different interpretation methods (in-person, telephonic, video conferencing)? It’s a good question to ask, seeing as “Interpreters are uniquely positioned to address relative merits of in-person and remote modalities … given their broad interpreting experience.”

That’s what this article seeks to do – explore the effectiveness of different interpretation methods in hospital and ambulatory settings from the interpreter perspective.

After assessing 52 interpreters (a 73% response) concerning a range of medical scenarios, all interpretation modalities were deemed “equally satisfactory for conveying information.” However, in-person interpretation was preferred, over both telephonic and video conferencing interpretation, for situations involving more in-depth conversation and other scenarios.

2. A Framework to Identify the Costs of Providing Language Interpretation Services, Journal of Health Care for the Poor and Underserved. 2011 May 22(2): 523-31

While healthcare organizations are required to provide language assistance, allocating the funding to do so has been less prescribed. This paper is a must read because it “establishes a conceptual framework [for language services] that identifies program costs, can be used across health care entities, and can be understood by administrators, researchers, and policymakers to guide research and analysis and establish a common ground for informed strategic discussion of payment and reimbursement policy.”

3. A Framework for Cultural Competence in Health Care Organizations, The Health Care Manager. 2011 Jul-Sep;30(3):205-14.

Yes, we all know that cultural competency is important in healthcare. However, how does one go about making cultural competency a part of an organization’s fabric?

In this article, authors Richard J. Castillo and Kristina L. Guo take cultural competency from the theoretical to the practical, giving “a framework to guide health care organizations as they focus on establishing culturally competent strategies and implementing best practices aimed to improve quality of care and achieve better outcomes for minority populations.” A great read if you’re looking to improve your cultural competency program.

4. Examining Effectiveness of Medical Interpreters in Emergency Departments for Spanish-Speaking Patients with Limited English Proficiency: Results of a Randomized Controlled Trial, Annals of Emergency Medicine 2011 Mar;57(3):248-256.e1-4.

Does in-person interpretation improve communication satisfaction for patients and health providers? This study takes a fresh look at that question. After assessing numerous patients and health providers over a seven-month period, it was determined that the “… provision of professionally trained, in-person medical interpreters … greatly increased patients’ and providers’ satisfaction [in the ED].”

5. Patterns of Interpreter Use for Hospitalized Patients with Limited English Proficiency, Journal of General Internal Medicine. 2011 Jul;26(7):712-717. Epub 2011 Feb 19

Are interpreters being used appropriately in hospitals? Not quite, as this study indicates. At two urban hospitals that encounter a large percentage of Limited English Proficient (LEP) patients, 234 LEP patients were interviewed concerning interpreter usage. Of the patients interviewed, “57% reported that any kind of interpreter was present with the physician at admission, 60% with physicians during hospitalization, and 37% with nurses since admission.”

What does this show? Essentially, LEP patients are still receiving substandard access to language services, which can pose a variety of problems including misdiagnoses and other errors.

A limitation of the study is that it only examines two hospitals, and its results “may not generalize to other hospitals and settings.” However, the authors point out that “both sites in this study serve large numbers of patients with LEP and are located in a diverse area of the US … [so] It is likely that patients’ experiences may be worse in settings with less linguistic diversity or resources allocated to interpreter services.”

This article demonstrates an important point: while language access has improved for LEP patients, it is still not where it needs to be. The information presented in this study can serve as a wake-up call for organizations to re-evaluate their language access programs and identify areas of improvement.

Jonathan

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CyraCom’s interpretation and translation solutions are exclusively endorsed by the American Hospital Association. With ISO 9001:2008 certified quality processes, US-based medically-trained interpreters, and a dedicated account management team, we are equipped to meet your patients’ language needs.

Why “Bilingual” Doesn’t Translate to “Medical Interpreter.”

Does being bilingual make somebody qualified to provide medical interpretation?

Maybe.

While bilingualism is essential for medical interpretation it is not all – interpreters must also understand various language dialects, have a wide range of medical terminological knowledge in both languages, be aware of possible cultural sensitivities and concerns associated with healthcare, and be capable of interpreting in specific settings such as pediatric or psychiatric units, among other things. A deficiency in any of these areas could lead to miscommunication between patient and provider, resulting in inadequate care or other mishaps.

To avoid these potential issues, bilingual speakers need to pass quality measures in order to ensure that Limited English Proficient individuals receive the treatment they deserve. All patients should be given the best medical care possible, regardless of spoken language, and it shouldn’t be any other way.

Just a little wisdom,

Akmaral

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CyraCom’s interpretation and translation solutions are exclusively endorsed by the American Hospital Association. With ISO 9001:2008 certified quality processes, US-based medically-trained interpreters, and a dedicated account management team, we are equipped to meet your patients’ language needs.


Some Hospitals Lagging in Interpretation Services

Imagine you’re on vacation somewhere, fall ill, and are taken to a local hospital. You only speak English; the hospital staff doesn’t speak any.

According to a recent article, some hospitals are lagging behind in interpretation services, and patients are paying the price; a Spanish-speaking patient was given medical consultation without interpretation services, despite not being able to speak English. The patient ultimately left the examining room with a pile of paperwork and had no idea she needed an MRI.

Examples such as this are illustrative of why some hospitals need a competent language services provider. It’s not only about making patients comfortable – it’s ultimately about patient safety.

Patricia

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CyraCom’s interpretation and translation solutions are exclusively endorsed by the American Hospital Association. With ISO 9001:2008 certified quality processes, US-based medically-trained interpreters, and a dedicated account management team, we are equipped to meet your patients’ language needs.