Cultural Competency/Health Literacy (CC/HL): An … · Cultural Competency & Health Literacy ....
Transcript of Cultural Competency/Health Literacy (CC/HL): An … · Cultural Competency & Health Literacy ....
Wilma Alvarado-Little, AlvaradoLittle Consulting, LLC
September 29, 2016
Albany Medical Center PPS Delivery System Reform
Incentive Payment (DSRIP)
Cultural Competency/Health Literacy (CC/HL): An Introduction
Agenda • Welcome & Introductions – Expectations for participation
• Overview of Cultural Competency, Language Access and Health Literacy
• Learn about where we are as an organization and how strategy will guide next steps towards well-being and healthy outcomes
• Next steps
• Questions
Cultural Competency and Health Literacy
We don’t see things as they are, We see things as we are.
Anais Nin
Objectives Learning objectives include: – Discuss health literacy and cultural and linguistic barriers to accessing healthcare – Develop an awareness of federal, state and local mandates – Provide resources regarding the provision of quality culturally and linguistically appropriate services (CLAS) to address barriers contributing to health disparities within our communities
CC/HL Champions
• Everyone’s active participation in CC/HL is critical for the success of DSRIP. – True system transformation will require cultural changes in our
patients, providers, and organizations
• CC/HL Champions: – Collaboration is essential – Be willing to share any CC/HL-related
best practices – Become a change agent for your organization – Bring information and initiatives back to your organization to
disseminate and implement
Cultural Competency and Health Literacy
• Patient-centered care is communication-based and
the frontline to addressing issues contributing to health disparities
• When we do not speak the language of the patient we must use an additional set of skills to continue to provide excellent, patient-centered care.
Cultural Competency “The ability of providers and organizations to effectively deliver health care services that meet the social, cultural, and linguistic needs of patients.” Cultural Competence in Health Care: Is it important for people with chronic conditions? (2004). Retrieved from https://hpi.georgetown.edu/agingsociety/pubhtml/cultural/cultural.html.
Ethics
Grooming and
presence
Health and
Medicine
Language
Recreation
Values
Time
Significant event
Manners of
interacting
Workplace
Rural Urban
Adolescents
Elder community
Transportation
Domain 1: Organizational Components
Domain 2, 3 & 4: Project Components
Better care, less cost
Domain 2: System Transformation
A. Create Integrated Delivery Systems
1. Create IDS for PHM
2. Health Home At-Risk
3. Create Medical Village in Nursing Homes
A. Behavioral Health 6. Integration
of PC & BH services
7. BH community crisis stabilization services
B. Care Coordination &Transitional Care Programs 4. ED Care
Triage for At-Risk Population
Governance Financial Stability
Cultural Competency & Health Literacy
Workforce Strategy
Population Health
Management
Practitioner Engagement
Clinical Integration
Performance Reporting
IT Systems & Processes
Domain 3: Clinical Improvement
Domain 4: Population Wide Projects
B. Prevent Chronic Diseases 10. Promote tobacco use
cessation among low SES populations
11. Increase Access to Preventive Care and Management (Cancer)
B. Cardiovascular Health 8. E-B
strategies for managing Hypertension
D: Utilizing Patient Activation to Expand Access 5. Implement
Patient Activation Activities (PAM)
C. Asthma 9. Implement
E-BM guidelines
According to the AMCH PPS Partner Surveys…
of organizations responded that they use appropriate language services (e.g., trained medical interpreters) with patients who prefer a language other than English.
has a policy that minimizes the use of family members as interpreters.
conducts staff training on the use of interpreters.
uses sign language interpreters to provide interpretation services.
uses certified or trained medical interpreters to provide interpretation services.
However
A Word about Language Access
State New York State Code of Rules and Regulations Section 405.7 New York State health Insurance and Managed Care Laws and Regulations State of New York Executive Order No. 26 Statewide Language Access Policy
New York Lawyers for Public Interest Language Access Legal Cheat Sheet www.nylpi.org
What’s the difference? Bilingual vs. Interpreting vs. Translation •Bilingual- someone who professes to speak two
languages. •Interpreting- Oral communication •Translation- Written Communication
What’s the difference?
Interpreting vs. Translation
These require two different skill sets
and at times fall under different mandates.
More from the AMCH PPS Partner Surveys…
of organizations has funds allocated for cultural competence activities/initiatives.
has active initiatives within their organizations for the promotion and retention of a culturally diverse workforce.
of organizations has a diverse governing body or policy-influencing group with representatives from populations and community served.
responded that their organization requires or facilitates individual provider assessments regarding cultural competence.
Have you ASKED?
Source: Campinha-Bacote et al., Transforming the face of Health Professions through Cultural and Linguistic Competence Education: The Role of the HRSA Centers of Excellence (p. 37). Prepared for, the U.S. Department of Health and Human Services, Health Resources and Services Administration
Health Literacy
According to the Institute of Medicine, health literacy is “the degree to which individuals have the capacity to obtain, process, and understand basic health information and services needed to make appropriate health decisions.” Institute of Medicine. (2004).
Health literacy: A prescription to end confusion. Board on Neuroscience and Behavioral Health, Nielson-Bohlman, L., Panzer, A.M., Kindig, D.A., Editors, Institute of Medicine and the National Academies. The National Academies Press: Washington, D.C.
Effective communication? • Patient’s sister: “Why are his hands so swollen?” • ICU RN: “Well, it’s a physiological explanation.” • ICU RN (looking me and then at the family) “That’s
the only explanation I have. ” • ICU RN (to patient’s sister) “Um, well, did you
understand that?” • Patient’s sister: “No. I don’t know what that
means.”
Policies The Affordable Care Act One key to the effectiveness and success of the exchanges will be the ability of consumers to understand and navigate the process of choosing a plan and becoming insured. The ACA acknowledges this and incorporates requirements to ensure that cultural and linguistic competence be part of the exchange process in order to help as many people as possible, including those of limited English proficiency.
Andrulis, D. et al (2013) The Affordable Care Act & Racial and Ethnic Health Equity Series (2013) http://www.texashealthinstitute.org/uploads/1/3/5/3/13535548/thikp_exchange_report_final_03.06.2013.pdf
Mandates Federal Title VI of the Civil Rights Act of 1964 - Prohibition against
exclusion from participation in, denial of benefits of, and discrimination under federally assisted programs on ground of race, color, or national origin. www.justice.gov
American with Disabilities Act - Federal disability discrimination laws mandate equal access to and an equal opportunity to participate in and benefit from health care services, and effective communication with individuals who are deaf or hard of hearing. http://www.nad.org/issues/health-care/providers/questions-and-answers
Partnerships “To effectively communicate we must realize that we are all different in the way we perceive the world and use this as a guide to our communication with others.” Tony Robbins
Resources The Patient Protection and Affordable Care Act https://www.govtrack.us/congress/bills/111/hr3590/text Section 1557 of the Patient Protection and Affordable Care Act http://www.hhs.gov/civil-rights/for-individuals/section-1557/ American with Disabilities Act https://nad.org/issues/health-care/providers/questions-and-answers US Department of Health and Human Services Office for Civil Rights Title VI http://www.hhs.gov/ocr/civilrights/resources/specialtopics/tanf/crrequirementstvi.html
Resources Institute of Medicine Ten Attributes of Health Literate Health Care Organizations http://www.iom.edu/Global/Perspectives/2012/HealthLitAttributes.aspx National Academies of Sciences, Engineering and Medicine http://www.nationalacademies.org/hmd/Activities/PublicHealth/HealthLiteracy.aspx US Department of Health and Human Services Office of Minority Health National Standards for Culturally and Linguistically Appropriate Services in Health and Health Care (The National CLAS Standards): https://www.thinkculturalhealth.hhs.gov/clas/standards Think Cultural Health! https://www.thinkculturalhealth.hhs.gov/ Institute for Healthcare Advancement https://www.iha4health.org/
Resources NCIHC Code of Ethics and Standards of Practice http://www.ncihc.org/ethics-and-standards-of-practice American translators Association https://www.atanet.org/publications/getting_it_right.php National Board of Certification for Medical Interpreters http://www.certifiedmedicalinterpreters.org/ Certification Commission for Healthcare Interpreters http://www.cchicertification.org/ Registry of Interpreters for the Deaf, Inc. (RID) http://rid.org/
What questions do you have?
Wilma Alvarado-Little, MA MSW AlvaradoLittle Consulting, LLC
Albany, NY 12208 Office: 773.301.6438
Fax: 518.207.1913 [email protected]
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