Cultural competence in healthcare is something I often think about. I think this is because I work in the field of healthcare and I see where sometimes people lose focus of trying to understand other cultures and their reasons for doing some of the things that they do. I work at a Nursing home/rehab and we dont seem to get too many residents that ask to practice different ways of doing things because of their culture. There were a couple different people that I remember that did. We had a monk staying with us that passed away and the family wanted the body to be prepared in a specific way. The problem was that in their culture, the body could not be touched for a certian amount of days. In a Nursing home, this was difficult because there are room mates and policies that we have to abide by. One problem I have seen where cultural differences have caused conflict was where we had an Asian man staying with us. His wife wanted to do certian things to take care of her husband (clean him, feed him,etc) and this would often cause the CNA's frustration. These CNA's lacked understanding of different cultures and instead of embracing it, they let it upset them. Also, the company lacked training for these CNA's that could have better prepared them to deal with this situation. I did learn a lot from this report; that some of the barries to cultural competence begin with a lack of diversity in leadership and systems that are put in place that are geared for one specific culture. I did not know that many companies do different kinds of cultural competency trainings with their staff. If this is so, why are so many healthcare facilities still lagging in this area? I know that many hospitals have interpreters, but I learned that many places and hospitals lack appropraite health education materials. Page 13 of the report states that "98% of senior leaders in healthcare management are white". I have been working at the same facility for 13 years and for 13 years all senior management have been white. I did not notice this unitil one of our social workers was promoted. This social worker is Africian American and the only person of a different "color" on our management team. I think this is a problem, because like the report states, there is a lack of diversity coming from the top, which affects the entire building, from staff to resident care. One quote that I really liked was that "if we dont have diverse physicians and people that we serve, policy making will be exclusionary as well". This is very important, and I think should be taken into account with all healthcare establishments. A lot of the information in this report was new to me, from how trainings were done, or even that trainings were done in the first place. I also found out that there were actual cultural frameworks. I would like to learn more about this so that I can hopefully take this information back to my facility.
Hey Danielle, thank you for sharing your own situation of how you had to practice cultural competence. I also agree with you that a lot of this information in the article was new. I, as well, didn't know about the cultural competence trainings and I feel that more facilities should implement them within their practices to help reduce individuals' feelings of being underserved within the healthcare community.
I really enjoyed reading your post this week. I have zero experience in the healthcare field so reading your post has really helped me understand cultural experience from a first hand experience. I'm happy that reading this report was a positive learning experience for you and also is something that you can use to help bring cultural competence to your job.
I really enjoyed reading this post as well because it was so interesting to hear from your perspective. From the point of view as an employee in the healthcare field. I agree that these cultural competence trainings should be facilitated everywhere.
In reading the cultural competence article, I feel that we need to constantly address this issue is every way that we can. During the 1990’s while at STCC, we formed a multicultural group on campus, not a Hispanic group, or a Caribbean Group, or a Black Group....but a true multicultural group whose members where white, black, yellow, LGBT, Muslim, Christian, Atheist, Jewish, Asian, and of varying socio-economical statuses. We shared in foods, stories, games, and outings, such as camping. We spoke of dilemmas in academics and healthcare. With that, the most important part of this article and its research is that we need to keep researching the possibilities for varying implementations of clinical cultural competence through the entire systems of healthcare – keeping in mind this Field Report is from 12 years ago. Page 15 discusses standardized and evidence-based monitoring. I am not sure I agree with that, as people are not standardized However, I realize it is a tool which allows us to measure. I do not like standardizations of anything, including testing in school systems. I feel that cultural competence is about opening the heart and learning in order to give each client, patient, or person what they need to get appropriate and good care. On that same page 15, it is noted that “many experts noted that patient empowerment is an important facet of cultural competence.” I very much agree and advocate for patient empowerment. Both knowledge of the healthcare system and trust in those providing the health care are empowering to the patient. I do agree with cross-cultural training as a part of health care professionals at all levels. There was a lot of information in this article, and there were proposals given to assist in how to “gain” cultural competence. However, the public needs to be made aware of what options they might have when going to the hospital or medical center. Advocates should be available, and information should be viable for people to obtain. If mailings are sent out, follow-up should be done by phone or in person to see if a person or a group of people understand what they are being told about their rights to health care. I hope that the growing Community Health Centers, will gain strength in cultural competence and become trainers in their communities. I do not have the knowledge to speak on global changes, but I do believe that local changes can spread city by city and state by state.
Hi Christine, I think you're right, changes done city by city seems to be a great place to start. I can't imagine how difficult a task it would be to try to accomodate every diffiferent culture or at least try to educate staff about the differences and importances. Maybe even this way, cities can learn from each other. I'm not sure how different hospitals and healthcare facilities do it now, do they educate their staff on whichever cultures/races are most prevalent to that vacinity? Another idea would be to educate the interpreters to be culturally compotent. That way you are not trying to educate everyone on a wide variety of topics, and then some other maybe smaller trainings for the rest of the staff. I think this report did make some very good points though. Starting with management in healthcare and the majority being white. How is anyone going to care enough to fight for change if it is not their culture that is being affected, they may even be blind to it. I know it is very important for many different reasons, to be culturally competent in healthcare, but I also think people in general should have some of this same training or knowlege.
Hi Danielle: I am not positive about community health centers, but I believe that are established in communities and often help to assist those in struggling socio-economical situations. I also believe that it is classes like this that are taken when, let's say a nurse, wants to go into community health, as opposed to working in a larger hospital. I know a few people from my old "gym" were going back to school for that. So my thought, which you agree with, is the city to city exchange of cultural change and competence and I think that some of that is done through the develop of establishments like community health centers. Certainly interpreters should be the ones who understand the culture they are speaking, yet at the same time understands the culture or even lack of culture in the hospital or medical setting. I believe interpreters should certainly be an advocate as well, in the sense of understanding the culture of the language they are interpreting. If I were fluent in Spanish, and did not know the variety of cultures that speak Spanish, I could do a service that is helpful, but may not be sufficient enough in some cases. Many years ago I was going to get some specialty tests done, and the doctor was from India. I was, at the time, very sensitive and high strung, if you will....the response which the doctor said to me, I took extremely offensively and left his office. My brother, who was and is a nurse, told me that it was because of his culture that he said that, and that I did not understand what he was trying to say. Isn't that interesting?
The article explores the issues of cultural competence in healthcare .It discusses the issues facing healthcare in respect to race,ethnicity and cultural differences.It further discusses the effect of socioeconomic statuses and the quality of care given depending on the economic stature of an individual.It basically explains why socio cultural affect peoples access to the healthcare a person will receive.Sadly it nothing new to me .I almost expect these things to happen only because of the society we live in .The system is tailored to serve people according to the social class.Every part of our society thrives on disparities of inequality .So having a healthy care system that is flawed is not a surprise. Some of the reasons ,that are listed as a reason for these disparities are Lack of diversity in the healthcare leadership and Workforce,lack of minority representation in healthcare field.This is very true ,they is not a lot of diversity for those in leadership roles who can better provide and understand the people they are treating.Another factor that was very poignant to me was poor cross cultural representation between doctors and patients.Though there are allot of initiatives that have been placed to help with the gap of cultural competence .I do not feel there is much been done.If i had access to resources in my community that fostered a pipeline to provide the resources to be a medical professional ,i think i would have chosen that path in my academic career.But that always seemed to be so far of a reach.
One issue that I felt with the article was the the recommendations at the end of the article were non-specific and not practical. Opening up opportunities for those in a lower socio-economic statuses would help to bring more diversity into healthcare. Recruiting and offering college scholarships for those in under-served school or perhaps offering some kind of tuition reimbursement if graduates work for a certain number of years in an urban hospital (similar to the tuition program Massachusetts offers for teachers). If we are going to provide more culturally competent care, we have to be practical in the approach.
I think you make a good point about not being surprised because our society tends to serve people based on socioeconomic status. I also agree that there is not a lot of diversity in leadership roles.
According to this reading, “cultural competence in the health care field describes the ability of systems to provide care to patients with diverse values, beliefs and behaviors”. I learnt this for the first time and I had no idea what cultural competence even was. I learnt this is very important because as United States is becoming more and more culturally diverse we need to start learning about different cultural views and perspective. As a future health care professional, I was able to learn from this reading that understanding other patients from various backgrounds is key to having a successful treatment. There are certain cultural differences that as a health care professional I would be faced with, some patient would not be open to certain kind of treatments and I would need to work around it as well as understand it. I was able to determine that if I don’t have this sort of mutual understanding then it could potentially lead to a failed health treatment which is the last thing I would want for my patient. I learnt from this that USA is actually having many difficulties with cultural competence hence there should be changes. Some examples from this readings was the fact that there was a lack of diversity in health care’s leadership and workforce, system is not designed in perspective to diverse patient populations and there is a poor communication barrier. I was able to learn of actual health care facilities around the USA that are beginning to change and become more multicultural. This was through different ways such as; hiring translators with no additional cost, creating health centers with emphasis on immigrants and minority and educating the staff through different programs. This is a good idea because we want everyone to feel comfortable when going to see a health care professional and a strong bonding between the health care provider and patient will result in a better treatment and visit. It is estimated that by 2030 there will be an increase in minority by 10%, from 30% to 40%. This article was very interesting and I learnt a lot that never occurred to me. I hope in the future we put more emphasis into this that way everyone has a high quality visit to their health provider.
I feel that I think about cultural competence a lot within the healthcare system because my close friend. My friend's mother has MS and only speaks in Spanish. This in many different cases, caused great hardships within my friend's family because she often had to act as a medical interpreter at a very young age because she was the only one in her family that could speak English. I was amazed by the responsibility she took without question, and the countless amounts of time she would miss school to help her mother at her medical appointments. I would ask her why her mother would not just request an interpreter, and she would simply answer that it was too difficult to do so because of the size of the hospital and the overload of need for interpreters within the community. Reading this article only confirmed the growing need for cultural competent health care facilities within this country. I learned a lot about the hardships of being a part of a different culture and seeking healthcare from this article. It illustrated how “the ultimate goal is a healthcare system and workforce that can deliver the highest quality of care to every patient, regardless of race, ethnicity, cultural background, or English proficiency” (2). Yet, many diversities often feel discouraged by the healthcare system because they feel their needs are unmet. The article also brought up that “achieving cultural competence in health care would help remove these (cultural) barriers, supplanting the current one-size-fits-all approach with a system more responsive to the needs of an increasingly diverse population” (3). This was new information that I valued as important because I often feel that many healthcare providers do try to implement the “one-size-fits-all” approach because it is easier. But, the problem is that it isn't beneficial to our growing diverse cultural nation. We need to find and practice new ways of implementing cultural competence within healthcare. All the healthcare facilities that were mentioned in the article that provided great cultural competence to patients as well as workers emphasized the need and “understanding of the communities being served as well as the sociocultural influences on individual patients’ health beliefs and behaviors” (14). By providing cultural competence education, the healthcare system could be greatly improved.
Angela , My daughter worked in the MRI clinic at a local hospital they had very good access to interpreters via phone and in-person for scheduling ,questions and appointments . Although they had a large pool of interpreters available a number of patients did not request one for various reasons including embarrassment . Many times the appointments were scheduled by an English proficient member of the patients' family and as such were not identified by staff as needing additional language services. Families were encouraged to accompany relatives for appointments despite the presence of a scheduled interpreter as some cultures were less forthright with providing information to strangers. Families ( even children ) were often knowledgeable of pertinent medical history and at times even the facility interpreters faced barriers due to dialect differences.
Angela, I agree with you that health care has become a "one size fits all" as far as treatment. When I go to the doctor's office, I feel that I am rushed and not fully listened to because of the increased work load the staff has. The same goes for some hospitals as well. I work in a long term care facility and I try to provide my residents with the care that they deserve. This includes their cultural aspects, religion, etc. I treat my residents as a whole individual and not just a clump of illnesses and diseases. For me, I try to learn about their culture and integrate their wants and desires into their treatment plan so that they know and feel that they are getting the best care possible from myself. This also holds true for the other staff at my facility as well. Where I attended nursing school, we were taught to include patients' cultures and beliefs into their treatment plans. This way the patient feels more involved in their care, but also that we are treating them wholly. This may or may not be the standard with other schools, but it should be. As a nurse too, we have to continue our education throughout our career in order to keep our license. Maybe by offering more classes about cultural adversity we could close that gap. Nena T.
I really enjoyed hearing about your friend's mother with MS. I think that was a great example of how hard it is in healthcare for people who don't want to request an interpreter. I also agree with you that this article confirmed the need for cultural competent healthcare facilities in the U.S.
I also had friend's who were the first in their family to speak English, and they had to take care of their parents when it came to making appointments to visit with the doctor and act like a middleman in sharing information between the doctor and the parent that you may not want to hear. It's a lot to ask for especially in your friend's case. Having to talk to a doctor for a parent may be tough on a person, and even harder when the disease is something so serious. It shouldn't have been your friends mom's responsibility to find an interpreter. The hospital should have people working or at least on call for certain situations like this one.
As the report mentioned if you look at the upper echelons of power in healthcare systems it does seem to remain overwhelmingly white and I would like to add male ( my own observation) as well.Having worked in the field of healthcare for 25 years (long-term care, short -term rehab , and hospice) I have seen a quite a bit of positive change in diversity of healthcare workers at the "hands on" or line staff level in most of the facilities I have worked. In Worcester I have seen direct caregivers, nurses, social workers,managers and supervisors of varying backgrounds in many of these positions , while having staff of different backgrounds is good in any workplace it does not ensure a company is making a good faith attempt to embrace awareness and acceptance of cultural differences . I have worked for both large corporations and smaller nonprofit healthcare facilities and participated as required in some of these diversity training's . Usually" training" consists of watching a series of short videos which are pretty blatant examples of mistreatment of others based on racial, sexual, or other differences . At the end you are required to acknowledge the training in some way either by signing you have received training on the subject and/or by completing a short quiz. I do not recall anything learned in these training's that improved my ability as a worker to interact with others, whether patients or coworkers . In practical terms the training shows regulatory bodies that a company has met certain benchmarks in this area, but realistically it lacks the authenticity necessary to promote cultural intelligence.
H. Grant: you make a good point about watching videos for training. I do not have 25 years in healthcare, but I have 25+ years working for large and small,international, public and private, non-profit companies.
I can only totally agree with you that the benchmark checklist "we've given everyone our training" is mostly worthless, if employees even stay awake through them. Training should be done by professionals, as if going through a seminar, interactive, break through training.
Christine , Good point regarding the quality of the type of training offered. You are right in that the presentation of the material should be stimulating to the trainees . I once held a position with some HR responsibilities in a local nursing home that had me providing orientation to new hires . We had mandatory videos called the Code of Conduct and depending on the employees position in the company these could take from 3 hours to the better part of 2 days to view . As you mentioned we did literally have people fall asleep during these videos .Due to corporate restrictions our hands were tied as far as adjusting delivery or content of the material.
After reading this article, I learned that more and more health care systems are becoming aware and recognizing the importance of being culturally diverse. Treating people who need medical attention, either a visit to the doctor’s office to emergency care, need to feel comfortable that all their needs will be met and not just their medical needs. Health care systems need to take into account language, religion, racial and ethnic differences, and culture in order to treat a patient as a whole individual and not a bunch of signs and symptoms of an illness or disease. By failing to take into account one of these aspects of the individual, we may not be able to care for them fully. During LPN school, one of the focuses was how to care culturally diverse patients. By understanding what a patient’s needs are culturally, we can provide a treatment plan that is accepted both by the patient and medical staff. If we fail to do this, then the patient may not follow the treatment plan and their condition could get worse. This article reiterated a lot of what I was taught in school. The article also spoke about how the majority of those who sit on the health care boards are white and that more minorities should be represented on these boards so that more cultures are represented. I believe that if we want a more culturally rounded health care system then this should happen. This even trickles down to the doctors, nurses, and other staff that care for patients. We are considered the “melting pot” of the world and by being known as such, why isn’t one of the most important aspects of our nation not more culturally diverse? I was happy to see that from small community based clinics to large nationally recognized health care systems, like Kaiser Permanente, are becoming more aware to their community’s needs and are addressing them. Understanding what a community needs and making these changes to benefit their health and well-being only makes a community stronger. Overall, this article had a lot of interesting information and facts throughout. I hope that more health care systems are aware of cultural diversity and making the changes that are needed to better treat their community.
After reading this article titled, “Cultural Competence in Health Care: Emerging Frameworks and Practical Approaches”, by Joseph R Betancourt, I first learned what cultural competence is. Cultural competence in health care is described as the ability of systems to provide care to patients with diverse values, beliefs and behaviors, including tailoring delivery to meet patients’ social, cultural, and linguistic needs. I also learned about the benefits of cultural competence. Betancourt discusses a few studies that make the link between cultural competence and the benefits it has with eliminating racial and ethnic disparities in health care. In my medical sociology class, we have been discussing the issues of racial disparities in depth. I recently just wrote a paper on the transmission of HIV/AIDs, and one of the social health disparities were with Haitian Americans. Haitians were the second population group to transmit the disease after of course, the homosexual males. This group of new contractors, the Haitians, were getting negatively targeted, and most lost a majority of their friends and family. I also learned that the ultimate goal for cultural competence is for a healthcare system and workface that delivers the highest care to every patient, regardless of race, ethnicity, cultural background, or English proficiency. Socioeconomic differences, a topic that I am already well educated about, comes in with the relationship between providers and patients. When health care providers fail to understand these socioeconomic differences that they may have between themselves and their patients, the communication and trust may suffer in this relationship. When providers fail to understand a patient may have sociocultural and socioeconomically factors, they will resort to stereotyping. Overall, I think that this report was extremely well-written, very organized, and had a good amount of useful and interesting information to learn from!
Hannah, I see your point on how stereotypes can be made when a provider fails to understand a patient but how can they fully understand a patient if there is no system set up to teach them about cultural difference. For language barriers, its unrealistic to have every nurse speak all the languages and with so many languages, hospitals cannot even keep up with interpreters. In this instance, a provider fails and then results to "we are in America, so speak English" or turns to stereotype but in my opinion, more should be done to make sure health care systems don't get to that point. Its a vicious circle if you ask me.
Cultural competence in healthcare is not something I previously thought about before. I am not in the healthcare/medical field so this is not a topic that I would normally think of. However, after reading “Cultural Competence in Health Care: Emerging Frameworks and Practical Approaches” I understand how important cultural competence in healthcare is. From the beginning of the report it states “failure to understand and manage social and cultural differences may have significant health consequences for minority groups in particular.” (5) This statement was really eye opening. It let me understand how big of an impact cultural competence can have in health care. Cultural competence according to this article is “cultural competence in health care describes the ability of systems to provide care to patients with diverse values, beliefs and behaviors, including tailoring delivery to meet patients’ social, cultural, and linguistic needs.” (5) I like how this report right in the beginning tells you what cultural competence in the health care is. I really got an understanding of what cultural competence in healthcare is from this definition. Reading this article reminded me of the time I had to go to various doctor’s appointments before having my daughter. Each time I went in and had to fill out paperwork there was a question that asked if I had any cultural practices that would get in the way or prevent me from having the hospital treat me. Back then I didn’t think anything of this question, just wanting to get in and out of my appointment as quickly as possible. But now that I read this article I understand why the question was always asked. Another time I have experienced hospitals trying to be culturally competent is when they ask you if you need an interpreter and if you say yes then they will provide one for you. I think this is very important because people who do not speak the same language could be understood and that will help them get better healthcare. Overall, I found this report to very informative especially for someone like me who has zero experience in the healthcare field. I liked how the report gave in depth but understandable reasons for why we need cultural competence in healthcare and the barriers that there are to cultural competence in healthcare. From this report it seems like healthcare is trying very hard to be aware of cultural, ethnic, and racial differences it faces. And an overall trying hard to provide a good healthcare experience for everyone.
People come to the United States in order to find a better and sometimes safer life for their families. Just because people come to America does not mean they have to give up their values and traditions. Upon doing that each individual should be allowed to have the same healthcare opportunities as everyone else. Figure 1 on diversity clearly shows how diverse the U.S. is projected to be in 2030. In about 15 years the racial/ethnic composition of whites is supposed to drop by 10% while every other ethnicity is on the rise. Since there are statistics to back this up, there should be more sources for the rising number of “minorities”. “The ultimate goal is a health care system and workforce that can deliver the highest quality of care to every patient, regardless of race, ethnicity, cultural background, or English proficiency.” It shouldn’t matter what a person looks or talks like, the main point is to take care of every individual who needs help. After reading the article I also think that people would feel more comfortable talking with a physician of the same race or ethnic background because they would feel like they could be understood better by someone who is similar to them. Poor communication can lead to a catastrophic ending and that’s usually what it takes before change occurs. Minorities are underrepresented in the high scale jobs such as doctors and/or politicians; this did not come as a surprise to me. There population is growing but their voice in major issues is still barely recognizable. Although I am not in the medical field I recently interned at the courthouse in Worcester, and they always had 7 or 8 different language speaking interpreters on hand each day. It was vital to have an interpreter in the courtroom when needed so the defendant could fully understand what was being asked of him by the judge during a trial. If there wasn’t an interpreter there and the defendant ended up violating what the judge said, then the defendant would be further punished. The same goes for the medical field but instead of getting in trouble, a life may be lost by simple miscommunication. I also believe stereotypes play a huge role in this issue. When people see someone of a different race they assume that the person doesn’t speak English. People are always in a rush and talk so fast and when asked to repeat something certain workers in a healthcare facility may get annoyed, especially with someone of a different race. This may become uncomfortable for the people who do not understand and they would be the ones to suffer.
Reading this article has broaden my understanding of Cultural Competence in HealthCare. I like the statement of their ultimate goal, which is to "deliver the highest quality of care to every patient, regardless of race, ethnicity, cultural background, or English proficiency". I understand that cultural competence expanded in the late 1980s through the 1990s, first to the population to whom cultural care was applied expanded from primarily immigrants to essentially all minority groups, particularly those most affected by racial disparities in the quality of healthcare. I have been in the healthcare for thirteen years now and as I read this article, the question I asked myself was why are we not applying cultural competence in the hospitals, nursing homes, rehabilitations, group homes e.t.c. Even though it is said we seen it to the minimum. A few people understand the meaning of Cultural Competence in the HealthCare and Culture itself, so as individuals, we should be teachers and educators to help other people to understand what it is in our homes and workplaces. This article also tells us that, they are using a lot and several different models to help everyone understand the meaning of culture and its importance to healthcare delivery. I have learned that we are all leaders, and as leaders and mentors we should recognize common barriers to cultural understanding among providers, staff, patients and residents.
I think theoretically its a great idea ,and would be a good thing to have these ideas be applied in our healthcare system ..but practically it would be very difficult and mere impossible to establish it in general.The healthcare arena is so huge and results I believe will limited.Each community has its own diversity ,group of people that it caters to .It will be ideal to make it more accessible to everyone,Quality care despite the cultural makeup of a community.
I agree with Laurencia, I think it would be extremely difficult to make that a reality. As I said in my post, with just the hospital my mom works at, they have about 180 known languages between patients and still have patients with languages that are unknown with no interpreters to help. Diversity is unimaginably huge and its impossible to teach everyone in health care every detail about the different cultures. But still, more can be done to the processes easier and I think that's what the articles is getting at. But it would nice!
After reading the article Cultural Competence in Health Care I can say that I did not truly learn anything that I didn’t already know. My mother has been a nurse at UMass Memorial Health Care for the past 28yrs and cultural competence in her field is something she quite often talks about. One of the biggest frustrations she encounters on a daily basis is language barriers between staff and patients. At this moment in the hospital, they have about 180 languages known that call for phone interpreters. Because there are so many languages, it is impossible to be staffed with this many interpreters and have them get around to the entire hospital; over the phone is the only way to communicate efficiently. Sadly, my mother is frequently finding herself unable to communicate with a patient because none of the interpreters know their language. Left with no way of communicating, is almost impossible for health care to be provided because it would become a guessing game of languages and charades. The article states “As we become a more ethnically and racially diverse nation, health care systems and providers need to reflect on and respond to patients’ varied perspectives, values, beliefs, and behaviors about health and well-being. Failure to understand and manage sociocultural differences may have significant health consequences for minority groups in particular”. This is something that is one hundred percent true however it is not being put into motion to make an impact. On the other hand, there are many things that are being done that do make a difference and cater to cultural difference in health care. For example, my mother discussed how each year all the nurses take a mandatory competency test to make them more aware of different cultures and how to make working with different them efficient. Something the article talked about that I did not agree with is that there are not enough leaders in health care that are from different ethnicities. I have seen more than my fair share of doctors, managers, nurses, and leaders at hospitals that are all from different backgrounds. I think it used to be the case that is was primarily “white” but times are definitely changing. However, this article did prove that many of the struggles my mother encounters are real and happening all over the world. More needs to be done to provide to different cultures to make sure health care systems run smoothly and effectively.
Seeing as I am not in the health care field it was nice to be able to read your response to the report as it related to your mother. It helps to put things in perspective when you hear a real life account of the struggles faced be patients who cannot communicate their needs. Your mother is lucky to work for a hospital where cultural competence is clearly a concern for the well being of patients, and requires cultural education. I gives a sense of hope that healthcare is moving in the right direction.
After reading the article, I found myself in total relation. I believe it is necessary for healthcare facilities to acquire towards the needs of every patient, or potential patient. The United States in not based on one sole ethnicity or language, and although the majority may speak english, it is essential that those who do not are cared for adequately. I have found that hospitals and health care facilities are very culturally competent and diverse presently, especially compared to the past. In my experience I have witnessed hospitals cater to those needs with interpreters. Besides language barriers, many hospitals have taken religious and personal beliefs in relations towards care practices. I think this report was spot on, and provides necessary information on the cultural diversity presently in healthcare's facilities.
Reading this report really opened my eyes to the importance of cultural competence in the field of health care. As I am not in the health care field myself, and because I have never been personally affected by it, I guess I hadn’t ever really thought about the issue of health care disparities faced by many minorities. As I read through the report I stopped often to think about my own experiences with my healthcare providers and how it compared to what people of diverse ethnicities and languages must go through to receive quality services. For example, if I need to see a new doctor/specialist for some reason and I call to make an appointment, there have been instances where the receptionist belittles me and makes me feel like a complete idiot for not knowing the offices hours of operation or knowing if I need a referral. I can’t even imagine what it must be like for a non-English speaking individual to try to make an appointment with a doctor, much less be able to convey their health concerns and be assure appropriate treatment when staffing cannot accommodate their cultural needs. I don’t even want to get into communicating between doctor’s offices, hospitals, and insurance companies. I am twenty eight years old and whenever I get a medical bill or summary in the mail I immediately bring it to my mother to translate into non-medical terms, but to think how helpless a person must feel when they can’t even have medical documents translated must be so frustrating. As the report mentioned America has changed drastically over the years in terms of its diversity and thus healthcare needs to change as well to provide quality care for every person no matter their culture, ethnicity, or language. I liked the way in which the report was broken down throughout into the four programs which are models of cultural competence in each healthcare component, that were involved in the interviews, and shared what each one was doing to improve cultural competence in the healthcare field, while also providing key concepts that can be taken from these programs to help spread cultural competence within the field. Before reading this report I had no idea any of these healthcare programs existed, but was fascinated to learn that most of them started in response to culturally diverse changes seen in communities, which required a change in healthcare programs. I also appreciated that although this report had plenty of information in regards to what can be done to improve cultural competence within healthcare, it was also very realistic about the goal and the obstacles which stand in the way.
Its easy to understand what the concept of this report was going for. How come our nation doesn't provide a free-care that is accepted everywhere? Healthcare providers are supposed to provide for patients, why does insurance matter so much?There was alot of talk about the language barrier. I honestly think that if you are someone who is from another country and is seeking help, you should have to provide your own interpretation. Chances are they didn't migrate alone. I feel like there wouldn't be so many issues if people just used their own FREE resources, such as family foreign language to English. I experience cultural competence firsthand everyday. I work at a local rehabilitation facility and mostly what i do is speak to patients and verify insurance. There are certain insurances that we do not accept, why? Because they don't give the hospital enough money. If we're so worried ab ut a low census and how we cant meet goal for the week, let alone the month, why cant we just take anybody, freecare or not?! Cultural competence is about diversity and alot of the diverse people cant afford expensive insurances that is accepted every where like Blue Cross or Delta Dental, so how are they supposed to get help? Most diverse people aren't accepted by healthcare jobs because of their "background" or even their name! I honestly just don't understand and I'm outraged. People are culturally competent for the image and not for the people themselves.
Cultural competence in healthcare is something I often think about. I think this is because I work in the field of healthcare and I see where sometimes people lose focus of trying to understand other cultures and their reasons for doing some of the things that they do. I work at a Nursing home/rehab and we dont seem to get too many residents that ask to practice different ways of doing things because of their culture. There were a couple different people that I remember that did. We had a monk staying with us that passed away and the family wanted the body to be prepared in a specific way. The problem was that in their culture, the body could not be touched for a certian amount of days. In a Nursing home, this was difficult because there are room mates and policies that we have to abide by. One problem I have seen where cultural differences have caused conflict was where we had an Asian man staying with us. His wife wanted to do certian things to take care of her husband (clean him, feed him,etc) and this would often cause the CNA's frustration. These CNA's lacked understanding of different cultures and instead of embracing it, they let it upset them. Also, the company lacked training for these CNA's that could have better prepared them to deal with this situation.
ReplyDeleteI did learn a lot from this report; that some of the barries to cultural competence begin with a lack of diversity in leadership and systems that are put in place that are geared for one specific culture. I did not know that many companies do different kinds of cultural competency trainings with their staff. If this is so, why are so many healthcare facilities still lagging in this area? I know that many hospitals have interpreters, but I learned that many places and hospitals lack appropraite health education materials.
Page 13 of the report states that "98% of senior leaders in healthcare management are white". I have been working at the same facility for 13 years and for 13 years all senior management have been white. I did not notice this unitil one of our social workers was promoted. This social worker is Africian American and the only person of a different "color" on our management team. I think this is a problem, because like the report states, there is a lack of diversity coming from the top, which affects the entire building, from staff to resident care. One quote that I really liked was that "if we dont have diverse physicians and people that we serve, policy making will be exclusionary as well". This is very important, and I think should be taken into account with all healthcare establishments.
A lot of the information in this report was new to me, from how trainings were done, or even that trainings were done in the first place. I also found out that there were actual cultural frameworks. I would like to learn more about this so that I can hopefully take this information back to my facility.
Hey Danielle, thank you for sharing your own situation of how you had to practice cultural competence. I also agree with you that a lot of this information in the article was new. I, as well, didn't know about the cultural competence trainings and I feel that more facilities should implement them within their practices to help reduce individuals' feelings of being underserved within the healthcare community.
DeleteHi Danielle,
DeleteI really enjoyed reading your post this week. I have zero experience in the healthcare field so reading your post has really helped me understand cultural experience from a first hand experience. I'm happy that reading this report was a positive learning experience for you and also is something that you can use to help bring cultural competence to your job.
I really enjoyed reading this post as well because it was so interesting to hear from your perspective. From the point of view as an employee in the healthcare field. I agree that these cultural competence trainings should be facilitated everywhere.
DeleteIn reading the cultural competence article, I feel that we need to constantly address this issue is every way that we can. During the 1990’s while at STCC, we formed a multicultural group on campus, not a Hispanic group, or a Caribbean Group, or a Black Group....but a true multicultural group whose members where white, black, yellow, LGBT, Muslim, Christian, Atheist, Jewish, Asian, and of varying socio-economical statuses. We shared in foods, stories, games, and outings, such as camping. We spoke of dilemmas in academics and healthcare. With that, the most important part of this article and its research is that we need to keep researching the possibilities for varying implementations of clinical cultural competence through the entire systems of healthcare – keeping in mind this Field Report is from 12 years ago.
ReplyDeletePage 15 discusses standardized and evidence-based monitoring. I am not sure I agree with that, as people are not standardized However, I realize it is a tool which allows us to measure. I do not like standardizations of anything, including testing in school systems. I feel that cultural competence is about opening the heart and learning in order to give each client, patient, or person what they need to get appropriate and good care. On that same page 15, it is noted that “many experts noted that patient empowerment is an important facet of cultural competence.” I very much agree and advocate for patient empowerment. Both knowledge of the healthcare system and trust in those providing the health care are empowering to the patient.
I do agree with cross-cultural training as a part of health care professionals at all levels. There was a lot of information in this article, and there were proposals given to assist in how to “gain” cultural competence. However, the public needs to be made aware of what options they might have when going to the hospital or medical center. Advocates should be available, and information should be viable for people to obtain. If mailings are sent out, follow-up should be done by phone or in person to see if a person or a group of people understand what they are being told about their rights to health care.
I hope that the growing Community Health Centers, will gain strength in cultural competence and become trainers in their communities. I do not have the knowledge to speak on global changes, but I do believe that local changes can spread city by city and state by state.
Hi Christine,
ReplyDeleteI think you're right, changes done city by city seems to be a great place to start. I can't imagine how difficult a task it would be to try to accomodate every diffiferent culture or at least try to educate staff about the differences and importances. Maybe even this way, cities can learn from each other. I'm not sure how different hospitals and healthcare facilities do it now, do they educate their staff on whichever cultures/races are most prevalent to that vacinity? Another idea would be to educate the interpreters to be culturally compotent. That way you are not trying to educate everyone on a wide variety of topics, and then some other maybe smaller trainings for the rest of the staff.
I think this report did make some very good points though. Starting with management in healthcare and the majority being white. How is anyone going to care enough to fight for change if it is not their culture that is being affected, they may even be blind to it. I know it is very important for many different reasons, to be culturally competent in healthcare, but I also think people in general should have some of this same training or knowlege.
Hi Danielle:
DeleteI am not positive about community health centers, but I believe that are established in communities and often help to assist those in struggling socio-economical situations. I also believe that it is classes like this that are taken when, let's say a nurse, wants to go into community health, as opposed to working in a larger hospital. I know a few people from my old "gym" were going back to school for that.
So my thought, which you agree with, is the city to city exchange of cultural change and competence and I think that some of that is done through the develop of establishments like community health centers.
Certainly interpreters should be the ones who understand the culture they are speaking, yet at the same time understands the culture or even lack of culture in the hospital or medical setting. I believe interpreters should certainly be an advocate as well, in the sense of understanding the culture of the language they are interpreting. If I were fluent in Spanish, and did not know the variety of cultures that speak Spanish, I could do a service that is helpful, but may not be sufficient enough in some cases.
Many years ago I was going to get some specialty tests done, and the doctor was from India. I was, at the time, very sensitive and high strung, if you will....the response which the doctor said to me, I took extremely offensively and left his office. My brother, who was and is a nurse, told me that it was because of his culture that he said that, and that I did not understand what he was trying to say. Isn't that interesting?
The article explores the issues of cultural competence in healthcare .It discusses the issues facing healthcare in respect to race,ethnicity and cultural differences.It further discusses the effect of socioeconomic statuses and the quality of care given depending on the economic stature of an individual.It basically explains why socio cultural affect peoples access to the healthcare a person will receive.Sadly it nothing new to me .I almost expect these things to happen only because of the society we live in .The system is tailored to serve people according to the social class.Every part of our society thrives on disparities of inequality .So having a healthy care system that is flawed is not a surprise.
ReplyDeleteSome of the reasons ,that are listed as a reason for these disparities are Lack of diversity in the healthcare leadership and Workforce,lack of minority representation in healthcare field.This is very true ,they is not a lot of diversity for those in leadership roles who can better provide and understand the people they are treating.Another factor that was very poignant to me was poor cross cultural representation between doctors and patients.Though there are allot of initiatives that have been placed to help with the gap of cultural competence .I do not feel there is much been done.If i had access to resources in my community that fostered a pipeline to provide the resources to be a medical professional ,i think i would have chosen that path in my academic career.But that always seemed to be so far of a reach.
Hi Laurencia,
DeleteOne issue that I felt with the article was the the recommendations at the end of the article were non-specific and not practical. Opening up opportunities for those in a lower socio-economic statuses would help to bring more diversity into healthcare. Recruiting and offering college scholarships for those in under-served school or perhaps offering some kind of tuition reimbursement if graduates work for a certain number of years in an urban hospital (similar to the tuition program Massachusetts offers for teachers). If we are going to provide more culturally competent care, we have to be practical in the approach.
I think you make a good point about not being surprised because our society tends to serve people based on socioeconomic status. I also agree that there is not a lot of diversity in leadership roles.
DeleteAccording to this reading, “cultural competence in the health care field describes the ability of systems to provide care to patients with diverse values, beliefs and behaviors”. I learnt this for the first time and I had no idea what cultural competence even was. I learnt this is very important because as United States is becoming more and more culturally diverse we need to start learning about different cultural views and perspective. As a future health care professional, I was able to learn from this reading that understanding other patients from various backgrounds is key to having a successful treatment. There are certain cultural differences that as a health care professional I would be faced with, some patient would not be open to certain kind of treatments and I would need to work around it as well as understand it. I was able to determine that if I don’t have this sort of mutual understanding then it could potentially lead to a failed health treatment which is the last thing I would want for my patient. I learnt from this that USA is actually having many difficulties with cultural competence hence there should be changes. Some examples from this readings was the fact that there was a lack of diversity in health care’s leadership and workforce, system is not designed in perspective to diverse patient populations and there is a poor communication barrier. I was able to learn of actual health care facilities around the USA that are beginning to change and become more multicultural. This was through different ways such as; hiring translators with no additional cost, creating health centers with emphasis on immigrants and minority and educating the staff through different programs. This is a good idea because we want everyone to feel comfortable when going to see a health care professional and a strong bonding between the health care provider and patient will result in a better treatment and visit. It is estimated that by 2030 there will be an increase in minority by 10%, from 30% to 40%. This article was very interesting and I learnt a lot that never occurred to me. I hope in the future we put more emphasis into this that way everyone has a high quality visit to their health provider.
ReplyDeleteI feel that I think about cultural competence a lot within the healthcare system because my close friend. My friend's mother has MS and only speaks in Spanish. This in many different cases, caused great hardships within my friend's family because she often had to act as a medical interpreter at a very young age because she was the only one in her family that could speak English. I was amazed by the responsibility she took without question, and the countless amounts of time she would miss school to help her mother at her medical appointments. I would ask her why her mother would not just request an interpreter, and she would simply answer that it was too difficult to do so because of the size of the hospital and the overload of need for interpreters within the community. Reading this article only confirmed the growing need for cultural competent health care facilities within this country.
ReplyDeleteI learned a lot about the hardships of being a part of a different culture and seeking healthcare from this article. It illustrated how “the ultimate goal is a healthcare system and workforce that can deliver the highest quality of care to every patient, regardless of race, ethnicity, cultural background, or English proficiency” (2). Yet, many diversities often feel discouraged by the healthcare system because they feel their needs are unmet.
The article also brought up that “achieving cultural competence in health care would help remove these (cultural) barriers, supplanting the current one-size-fits-all approach with a system more responsive to the needs of an increasingly diverse population” (3). This was new information that I valued as important because I often feel that many healthcare providers do try to implement the “one-size-fits-all” approach because it is easier. But, the problem is that it isn't beneficial to our growing diverse cultural nation. We need to find and practice new ways of implementing cultural competence within healthcare. All the healthcare facilities that were mentioned in the article that provided great cultural competence to patients as well as workers emphasized the need and “understanding of the communities being served as well as the sociocultural influences on individual patients’ health beliefs and behaviors” (14). By providing cultural competence education, the healthcare system could be greatly improved.
Angela ,
DeleteMy daughter worked in the MRI clinic at a local hospital they had very good access to interpreters via phone and in-person for scheduling ,questions and appointments . Although they had a large pool of interpreters available a number of patients did not request one for various reasons including embarrassment . Many times the appointments were scheduled by an English proficient member of the patients' family and as such were not identified by staff as needing additional language services. Families were encouraged to accompany relatives for appointments despite the presence of a scheduled interpreter as some cultures were less forthright with providing information to strangers. Families ( even children ) were often knowledgeable of pertinent medical history and at times even the facility interpreters faced barriers due to dialect differences.
Angela,
DeleteI agree with you that health care has become a "one size fits all" as far as treatment. When I go to the doctor's office, I feel that I am rushed and not fully listened to because of the increased work load the staff has. The same goes for some hospitals as well. I work in a long term care facility and I try to provide my residents with the care that they deserve. This includes their cultural aspects, religion, etc. I treat my residents as a whole individual and not just a clump of illnesses and diseases. For me, I try to learn about their culture and integrate their wants and desires into their treatment plan so that they know and feel that they are getting the best care possible from myself. This also holds true for the other staff at my facility as well.
Where I attended nursing school, we were taught to include patients' cultures and beliefs into their treatment plans. This way the patient feels more involved in their care, but also that we are treating them wholly. This may or may not be the standard with other schools, but it should be. As a nurse too, we have to continue our education throughout our career in order to keep our license. Maybe by offering more classes about cultural adversity we could close that gap.
Nena T.
I really enjoyed hearing about your friend's mother with MS. I think that was a great example of how hard it is in healthcare for people who don't want to request an interpreter. I also agree with you that this article confirmed the need for cultural competent healthcare facilities in the U.S.
DeleteI also had friend's who were the first in their family to speak English, and they had to take care of their parents when it came to making appointments to visit with the doctor and act like a middleman in sharing information between the doctor and the parent that you may not want to hear. It's a lot to ask for especially in your friend's case. Having to talk to a doctor for a parent may be tough on a person, and even harder when the disease is something so serious. It shouldn't have been your friends mom's responsibility to find an interpreter. The hospital should have people working or at least on call for certain situations like this one.
DeleteAs the report mentioned if you look at the upper echelons of power in healthcare systems it does seem to remain overwhelmingly white and I would like to add male ( my own observation) as well.Having worked in the field of healthcare for 25 years (long-term care, short -term rehab , and hospice) I have seen a quite a bit of positive change in diversity of healthcare workers at the "hands on" or line staff level in most of the facilities I have worked. In Worcester I have seen direct caregivers, nurses, social workers,managers and supervisors of varying backgrounds in many of these positions , while having staff of different backgrounds is good in any workplace it does not ensure a company is making a good faith attempt to embrace awareness and acceptance of cultural differences . I have worked for both large corporations and smaller nonprofit healthcare facilities and participated as required in some of these diversity training's . Usually" training" consists of watching a series of short videos which are pretty blatant examples of mistreatment of others based on racial, sexual, or other differences . At the end you are required to acknowledge the training in some way either by signing you have received training on the subject and/or by completing a short quiz. I do not recall anything learned in these training's that improved my ability as a worker to interact with others, whether patients or coworkers . In practical terms the training shows regulatory bodies that a company has met certain benchmarks in this area, but realistically it lacks the authenticity necessary to promote cultural intelligence.
ReplyDeleteH. Grant: you make a good point about watching videos for training. I do not have 25 years in healthcare, but I have 25+ years working for large and small,international, public and private, non-profit companies.
DeleteI can only totally agree with you that the benchmark checklist "we've given everyone our training" is mostly worthless, if employees even stay awake through them. Training should be done by professionals, as if going through a seminar, interactive, break through training.
Christine ,
DeleteGood point regarding the quality of the type of training offered. You are right in that the presentation of the material should be stimulating to the trainees . I once held a position with some HR responsibilities in a local nursing home that had me providing orientation to new hires . We had mandatory videos called the Code of Conduct and depending on the employees position in the company these could take from 3 hours to the better part of 2 days to view . As you mentioned we did literally have people fall asleep during these videos .Due to corporate restrictions our hands were tied as far as adjusting delivery or content of the material.
After reading this article, I learned that more and more health care systems are becoming aware and recognizing the importance of being culturally diverse. Treating people who need medical attention, either a visit to the doctor’s office to emergency care, need to feel comfortable that all their needs will be met and not just their medical needs. Health care systems need to take into account language, religion, racial and ethnic differences, and culture in order to treat a patient as a whole individual and not a bunch of signs and symptoms of an illness or disease. By failing to take into account one of these aspects of the individual, we may not be able to care for them fully.
ReplyDeleteDuring LPN school, one of the focuses was how to care culturally diverse patients. By understanding what a patient’s needs are culturally, we can provide a treatment plan that is accepted both by the patient and medical staff. If we fail to do this, then the patient may not follow the treatment plan and their condition could get worse. This article reiterated a lot of what I was taught in school.
The article also spoke about how the majority of those who sit on the health care boards are white and that more minorities should be represented on these boards so that more cultures are represented. I believe that if we want a more culturally rounded health care system then this should happen. This even trickles down to the doctors, nurses, and other staff that care for patients. We are considered the “melting pot” of the world and by being known as such, why isn’t one of the most important aspects of our nation not more culturally diverse?
I was happy to see that from small community based clinics to large nationally recognized health care systems, like Kaiser Permanente, are becoming more aware to their community’s needs and are addressing them. Understanding what a community needs and making these changes to benefit their health and well-being only makes a community stronger.
Overall, this article had a lot of interesting information and facts throughout. I hope that more health care systems are aware of cultural diversity and making the changes that are needed to better treat their community.
After reading this article titled, “Cultural Competence in Health Care: Emerging Frameworks and Practical Approaches”, by Joseph R Betancourt, I first learned what cultural competence is. Cultural competence in health care is described as the ability of systems to provide care to patients with diverse values, beliefs and behaviors, including tailoring delivery to meet patients’ social, cultural, and linguistic needs. I also learned about the benefits of cultural competence. Betancourt discusses a few studies that make the link between cultural competence and the benefits it has with eliminating racial and ethnic disparities in health care. In my medical sociology class, we have been discussing the issues of racial disparities in depth. I recently just wrote a paper on the transmission of HIV/AIDs, and one of the social health disparities were with Haitian Americans. Haitians were the second population group to transmit the disease after of course, the homosexual males. This group of new contractors, the Haitians, were getting negatively targeted, and most lost a majority of their friends and family.
ReplyDeleteI also learned that the ultimate goal for cultural competence is for a healthcare system and workface that delivers the highest care to every patient, regardless of race, ethnicity, cultural background, or English proficiency. Socioeconomic differences, a topic that I am already well educated about, comes in with the relationship between providers and patients. When health care providers fail to understand these socioeconomic differences that they may have between themselves and their patients, the communication and trust may suffer in this relationship. When providers fail to understand a patient may have sociocultural and socioeconomically factors, they will resort to stereotyping. Overall, I think that this report was extremely well-written, very organized, and had a good amount of useful and interesting information to learn from!
Well said Hannah, I think health care providers should asses and respond to socioeconomic differences in values, beliefs and health behaviors.
DeleteHannah, I see your point on how stereotypes can be made when a provider fails to understand a patient but how can they fully understand a patient if there is no system set up to teach them about cultural difference. For language barriers, its unrealistic to have every nurse speak all the languages and with so many languages, hospitals cannot even keep up with interpreters. In this instance, a provider fails and then results to "we are in America, so speak English" or turns to stereotype but in my opinion, more should be done to make sure health care systems don't get to that point. Its a vicious circle if you ask me.
DeleteCultural competence in healthcare is not something I previously thought about before. I am not in the healthcare/medical field so this is not a topic that I would normally think of. However, after reading “Cultural Competence in Health Care: Emerging Frameworks and Practical Approaches” I understand how important cultural competence in healthcare is. From the beginning of the report it states “failure to understand and manage social and cultural differences may have significant health consequences for minority groups in particular.” (5) This statement was really eye opening. It let me understand how big of an impact cultural competence can have in health care.
ReplyDeleteCultural competence according to this article is “cultural competence in health care describes the ability of systems to provide care to patients with diverse values, beliefs and behaviors, including tailoring delivery to meet patients’ social, cultural, and linguistic needs.” (5) I like how this report right in the beginning tells you what cultural competence in the health care is. I really got an understanding of what cultural competence in healthcare is from this definition.
Reading this article reminded me of the time I had to go to various doctor’s appointments before having my daughter. Each time I went in and had to fill out paperwork there was a question that asked if I had any cultural practices that would get in the way or prevent me from having the hospital treat me. Back then I didn’t think anything of this question, just wanting to get in and out of my appointment as quickly as possible. But now that I read this article I understand why the question was always asked.
Another time I have experienced hospitals trying to be culturally competent is when they ask you if you need an interpreter and if you say yes then they will provide one for you. I think this is very important because people who do not speak the same language could be understood and that will help them get better healthcare.
Overall, I found this report to very informative especially for someone like me who has zero experience in the healthcare field. I liked how the report gave in depth but understandable reasons for why we need cultural competence in healthcare and the barriers that there are to cultural competence in healthcare. From this report it seems like healthcare is trying very hard to be aware of cultural, ethnic, and racial differences it faces. And an overall trying hard to provide a good healthcare experience for everyone.
People come to the United States in order to find a better and sometimes safer life for their families. Just because people come to America does not mean they have to give up their values and traditions. Upon doing that each individual should be allowed to have the same healthcare opportunities as everyone else. Figure 1 on diversity clearly shows how diverse the U.S. is projected to be in 2030. In about 15 years the racial/ethnic composition of whites is supposed to drop by 10% while every other ethnicity is on the rise. Since there are statistics to back this up, there should be more sources for the rising number of “minorities”. “The ultimate goal is a health care system and workforce that can deliver the highest quality of care to every patient, regardless of race, ethnicity, cultural background, or English proficiency.” It shouldn’t matter what a person looks or talks like, the main point is to take care of every individual who needs help. After reading the article I also think that people would feel more comfortable talking with a physician of the same race or ethnic background because they would feel like they could be understood better by someone who is similar to them. Poor communication can lead to a catastrophic ending and that’s usually what it takes before change occurs. Minorities are underrepresented in the high scale jobs such as doctors and/or politicians; this did not come as a surprise to me. There population is growing but their voice in major issues is still barely recognizable. Although I am not in the medical field I recently interned at the courthouse in Worcester, and they always had 7 or 8 different language speaking interpreters on hand each day. It was vital to have an interpreter in the courtroom when needed so the defendant could fully understand what was being asked of him by the judge during a trial. If there wasn’t an interpreter there and the defendant ended up violating what the judge said, then the defendant would be further punished. The same goes for the medical field but instead of getting in trouble, a life may be lost by simple miscommunication.
ReplyDeleteI also believe stereotypes play a huge role in this issue. When people see someone of a different race they assume that the person doesn’t speak English. People are always in a rush and talk so fast and when asked to repeat something certain workers in a healthcare facility may get annoyed, especially with someone of a different race. This may become uncomfortable for the people who do not understand and they would be the ones to suffer.
Reading this article has broaden my understanding of Cultural Competence in HealthCare. I like the statement of their ultimate goal, which is to "deliver the highest quality of care to every patient, regardless of race, ethnicity, cultural background, or English proficiency". I understand that cultural competence expanded in the late 1980s through the 1990s, first to the population to whom cultural care was applied expanded from primarily immigrants to essentially all minority groups, particularly those most affected by racial disparities in the quality of healthcare. I have been in the healthcare for thirteen years now and as I read this article, the question I asked myself was why are we not applying cultural competence in the hospitals, nursing homes, rehabilitations, group homes e.t.c. Even though it is said we seen it to the minimum. A few people understand the meaning of Cultural Competence in the HealthCare and Culture itself, so as individuals, we should be teachers and educators to help other people to understand what it is in our homes and workplaces. This article also tells us that, they are using a lot and several different models to help everyone understand the meaning of culture and its importance to healthcare delivery. I have learned that we are all leaders, and as leaders and mentors we should recognize common barriers to cultural understanding among providers, staff, patients and residents.
ReplyDeleteI think theoretically its a great idea ,and would be a good thing to have these ideas be applied in our healthcare system ..but practically it would be very difficult and mere impossible to establish it in general.The healthcare arena is so huge and results I believe will limited.Each community has its own diversity ,group of people that it caters to .It will be ideal to make it more accessible to everyone,Quality care despite the cultural makeup of a community.
DeleteI agree with Laurencia, I think it would be extremely difficult to make that a reality. As I said in my post, with just the hospital my mom works at, they have about 180 known languages between patients and still have patients with languages that are unknown with no interpreters to help. Diversity is unimaginably huge and its impossible to teach everyone in health care every detail about the different cultures. But still, more can be done to the processes easier and I think that's what the articles is getting at. But it would nice!
Delete-Andrea D
After reading the article Cultural Competence in Health Care I can say that I did not truly learn anything that I didn’t already know. My mother has been a nurse at UMass Memorial Health Care for the past 28yrs and cultural competence in her field is something she quite often talks about. One of the biggest frustrations she encounters on a daily basis is language barriers between staff and patients. At this moment in the hospital, they have about 180 languages known that call for phone interpreters. Because there are so many languages, it is impossible to be staffed with this many interpreters and have them get around to the entire hospital; over the phone is the only way to communicate efficiently. Sadly, my mother is frequently finding herself unable to communicate with a patient because none of the interpreters know their language. Left with no way of communicating, is almost impossible for health care to be provided because it would become a guessing game of languages and charades. The article states “As we become a more ethnically and racially diverse nation, health care systems and providers need to reflect on and respond to patients’ varied perspectives, values, beliefs, and behaviors about health and well-being. Failure to understand and manage sociocultural differences may have significant health consequences for minority groups in particular”. This is something that is one hundred percent true however it is not being put into motion to make an impact. On the other hand, there are many things that are being done that do make a difference and cater to cultural difference in health care. For example, my mother discussed how each year all the nurses take a mandatory competency test to make them more aware of different cultures and how to make working with different them efficient. Something the article talked about that I did not agree with is that there are not enough leaders in health care that are from different ethnicities. I have seen more than my fair share of doctors, managers, nurses, and leaders at hospitals that are all from different backgrounds. I think it used to be the case that is was primarily “white” but times are definitely changing. However, this article did prove that many of the struggles my mother encounters are real and happening all over the world. More needs to be done to provide to different cultures to make sure health care systems run smoothly and effectively.
ReplyDelete-Andrea D
Seeing as I am not in the health care field it was nice to be able to read your response to the report as it related to your mother. It helps to put things in perspective when you hear a real life account of the struggles faced be patients who cannot communicate their needs. Your mother is lucky to work for a hospital where cultural competence is clearly a concern for the well being of patients, and requires cultural education. I gives a sense of hope that healthcare is moving in the right direction.
DeleteAfter reading the article, I found myself in total relation. I believe it is necessary for healthcare facilities to acquire towards the needs of every patient, or potential patient. The United States in not based on one sole ethnicity or language, and although the majority may speak english, it is essential that those who do not are cared for adequately. I have found that hospitals and health care facilities are very culturally competent and diverse presently, especially compared to the past. In my experience I have witnessed hospitals cater to those needs with interpreters. Besides language barriers, many hospitals have taken religious and personal beliefs in relations towards care practices. I think this report was spot on, and provides necessary information on the cultural diversity presently in healthcare's facilities.
ReplyDeleteReading this report really opened my eyes to the importance of cultural competence in the field of health care. As I am not in the health care field myself, and because I have never been personally affected by it, I guess I hadn’t ever really thought about the issue of health care disparities faced by many minorities. As I read through the report I stopped often to think about my own experiences with my healthcare providers and how it compared to what people of diverse ethnicities and languages must go through to receive quality services. For example, if I need to see a new doctor/specialist for some reason and I call to make an appointment, there have been instances where the receptionist belittles me and makes me feel like a complete idiot for not knowing the offices hours of operation or knowing if I need a referral. I can’t even imagine what it must be like for a non-English speaking individual to try to make an appointment with a doctor, much less be able to convey their health concerns and be assure appropriate treatment when staffing cannot accommodate their cultural needs. I don’t even want to get into communicating between doctor’s offices, hospitals, and insurance companies. I am twenty eight years old and whenever I get a medical bill or summary in the mail I immediately bring it to my mother to translate into non-medical terms, but to think how helpless a person must feel when they can’t even have medical documents translated must be so frustrating.
ReplyDeleteAs the report mentioned America has changed drastically over the years in terms of its diversity and thus healthcare needs to change as well to provide quality care for every person no matter their culture, ethnicity, or language. I liked the way in which the report was broken down throughout into the four programs which are models of cultural competence in each healthcare component, that were involved in the interviews, and shared what each one was doing to improve cultural competence in the healthcare field, while also providing key concepts that can be taken from these programs to help spread cultural competence within the field. Before reading this report I had no idea any of these healthcare programs existed, but was fascinated to learn that most of them started in response to culturally diverse changes seen in communities, which required a change in healthcare programs. I also appreciated that although this report had plenty of information in regards to what can be done to improve cultural competence within healthcare, it was also very realistic about the goal and the obstacles which stand in the way.
Its easy to understand what the concept of this report was going for. How come our nation doesn't provide a free-care that is accepted everywhere? Healthcare providers are supposed to provide for patients, why does insurance matter so much?There was alot of talk about the language barrier. I honestly think that if you are someone who is from another country and is seeking help, you should have to provide your own interpretation. Chances are they didn't migrate alone. I feel like there wouldn't be so many issues if people just used their own FREE resources, such as family foreign language to English. I experience cultural competence firsthand everyday. I work at a local rehabilitation facility and mostly what i do is speak to patients and verify insurance. There are certain insurances that we do not accept, why? Because they don't give the hospital enough money. If we're so worried ab ut a low census and how we cant meet goal for the week, let alone the month, why cant we just take anybody, freecare or not?! Cultural competence is about diversity and alot of the diverse people cant afford expensive insurances that is accepted every where like Blue Cross or Delta Dental, so how are they supposed to get help? Most diverse people aren't accepted by healthcare jobs because of their "background" or even their name! I honestly just don't understand and I'm outraged. People are culturally competent for the image and not for the people themselves.
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