Cultural Competency Understanding What Makes People Unique

Overview Goals / Objectives Define Cultural Competency The 14 CLAS Standards History How cultural competency affects healthcare Understanding the importance of cultural

competency Current efforts to improve cultural

competency

Goals / Objectives Understanding and tolerating others and their actions Cultural Competency is a required training with most MTM

Clients Benefits of Cultural Competency

What is Cultural Competency? Cultural Competency refers to the ability to understand, appreciate and

interact with persons from cultures and/or belief systems other than one’s own, based on various factors. (Segen’s Medical Dictionary 2011)

Being culturally competent is to understand there are many factors that make people who they are, including, but not limited to:• Ethnicity/Cultural background• Values/Beliefs/Attitudes• Traditions/Customs• Experiences/Behaviors• Language/Communication/Religion

14 CLAS Standards• Established by the Health and Human Services Department, Office of Minority Health

CLAS: Culturally and Linguistically Appropriate Services Culturally Competent Care

• Health care organizations should 1) Ensure that patients/consumers receive effective, understandable, and

respectful care that is provided in a manner compatible with their cultural health beliefs and practices and preferred language.

2) Implement strategies to recruit, retain, and promote at all levels of the organization a diverse staff and leadership that are representative of the demographic characteristics of the service area.

3) Ensure that staff at all levels and across all disciplines receive ongoing education and training in culturally and linguistically appropriate service delivery.

CLAS Standards

Language Access Services (Mandated)4) Health care organizations must offer and provide language assistance services, including

bilingual staff and interpreter services, at no cost to each patient/consumer with limited English proficiency at all points of contact, in a timely manner during all hours of operation.

5) Health care organizations must provide to patients/consumers in their preferred language both verbal offers and written notices informing them of their right to receive language assistance services.

6) Health care organizations must assure the competence of language assistance provided to limited English proficient patients/consumers by interpreters and bilingual staff. Family and friends should not be used to provide interpretation services (except on request by the patient/consumer).

7) Health care organizations must make available easily understood patient-related materials and post signage in the languages of the commonly encountered groups and/or groups represented in the service area.

CLAS Standards (continued)

Organizational Supports for Cultural Competence8) Health care organizations should develop, implement, and promote a written

strategic plan that outlines clear goals, policies, operational plans, and management accountability /oversight mechanisms to provide culturally and linguistically appropriate services.

9) Health care organizations should conduct initial and ongoing organizational self-assessments of CLAS-related activities and are encouraged to integrate cultural and linguistic competence-related measure into their internal audits, performance improvement programs, patient satisfaction assessments, and outcomes-based evaluations.

10) Health care organizations should ensure that data on the individual patient’s/consumer’s race, ethnicity, and spoken and written language are collected in health records, integrated into the organization’s management information systems, and periodically updated.

CLAS Standards (continued)

CLAS Standards (continued)

Organizational Supports for Cultural Competence (continued)11) Health care organizations should maintain a current demographic, cultural, and

epidemiological profile of the community as well as a needs assessment to accurately plan for and implement services that respond to the cultural and linguistic characteristics of the service area.

12) Health care organizations should develop participatory, collaborative partnerships with communities and utilize a variety of formal and informal mechanisms to facilitate community and patient/consumer involvement in designing and implementing CLAS related activities.

13) Health care organizations should ensure that conflict and grievance resolution processes are culturally and linguistically sensitive and capable of identifying, preventing, and resolving cross-cultural conflicts or patients/consumers.

14) Health care organizations are encouraged to regularly make available to the public information about their progress and successful innovations in implementing the CLAS standards and to provide public notice in their communities about the availability of this information.

History Why is Cultural Competency an important issue now?

• Health Care outcomes can be drastically effected if there is a lack of knowledge• Language barriers/judgments may be made based on appearances or social

status• People of different cultures may approach health care differently than other

main-stream groups• Potential to delay making important medical decisions

History (continued)

An example of how a lack of Cultural Competency can have an impact on someone’s health care:

Ms. B. is an African American mother of a child with special health care needs. Frequently, when she walks up to the front desk, she is automatically asked for her Medicaid card. Her family is not eligible for any Medicaid waivers and has private insurance through her husband’s employer. She does not appreciate that the front desk automatically assumes that because she is African American, she is poor. National Center for Cultural Competence (NCCC)

History (continued)

An example of how a lack of Cultural Competency can have an impact on someone’s health care:

Ms. L. has a Hispanic surname and speaks with an accent. She is often upset when she calls a health care provider’s office or goes in for a visit, and staff assumes she does not speak or understand English. Sometimes this assumption leads staff to speak slowly and loudly. Other times they will have a bilingual staff person interact with her. Although she is pleased that some health care providers make an effort to have bilingual staff for families who require this level of language assistance, she wishes they would ask about her specific needs. National Center for Cultural Competence (NCCC)

How Cultural Competency Affects Health Care

Many things can result from a lack of Cultural Competency and understanding, including but not limited to:• Health Care Professionals can come across as being very disrespectful (not

intentionally) based on the person’s beliefs• Health outcomes can be delayed and decisions not made timely due to

communication problems• People may feel like they cannot access health care because they do not feel

they are “understood” by people in the health care industry• It can be a life or death situation for the patient

Who is Effected by Cultural Competency?

Everyone is effected by Cultural Competency in some way; you are the person trying to understand or you are the person trying to be understood

You work with people that may not have the same background you do or the same core values you have

You meet people everyday that don’t have the exact same history that you do so being open to learning and understanding is key

Understanding and respecting everyone and their uniqueness is being Culturally Competent

Education, Training & Outreach

Education• There are countless sources for education

available to the public on-line• Take advantage of all work training programs

offered to you • Educate yourself

Training• As with education, there are a tremendous

number of training models available to the public on-line (Internet)

• Take advantage of all work training programs offered to you

What Needs to Happen Next?

Outreach• As with education and training, the Internet is a great resource for

outreach ideas and tools• Particularly if you are in a situation where there could be a lack of

understanding due to Cultural differences, don’t be afraid to ask questions to gain understanding from both sides of the aisle

• Once you have a firm understanding of Cultural Competency, help others understand with you – become an advocate for Cultural Competency

When do we need to be Culturally Competent?

As soon as possible would be effective and beneficial

Being as Culturally Competent as possible in all situations will help in several ways, including but not limited to:• Better understanding for the person

seeking health care and the person helping provide the health care

• Better access to health care for those in need

• Better health care outcomes and results

Conclusion

What to take away from this training:• An understanding of what Cultural Competency is and what it means• What can happen when there is a lack of cultural competency• Examples of individual cases where a lack of Cultural Competency had

an impact on someone• Who needs to know about Cultural Competency• Going forward - How can the problem be fixed/minimized

Information Sources Segen’s Medical Dictionary Centers for Medicare & Medicaid Services (CMS) National Center for Cultural Competence (NCCC) U.S. Department of Health and Human Services – Office of

Minority Health