in organizational culture change via cultural competency · keynote speaker: j.r. martinez...
TRANSCRIPT
Patient Roles In Organizational Culture Change
via Cultural Competency
Bernard Roberson, MSM, BA, HSC
Administrative Director Patient- and Family- Centered Care
David Andrews
GRMC Patient Advisor
Objectives
• Understand our framework and rationale for enhancing cultural competency.
• Outline the various components of our organizational strategies to improve cultural competency.
• Describe the role of patient advisors in a long-term cultural change process.
• Apply strategies for enhanced patient experience in areas of long term cultural change
Our Mission
• Why cultural competency?
a. Accreditation
b. Quality Improvement
c. PFCC success
d. Diverse workforce
e. Point of distinction
Rationale
Why Cultural Competency?
Cultural Competency
Customer Satisfaction
Strategic Plan
SACS COC
Academic Program
Accreditation
Hospital Accreditation
Quality Healthcare
Institute of Medicine Report
(Health equity and reduce
disparities)
Agency for Healthcare Research
and Quality (AHRQ)
Patient Engagement (PFCC)
Transitioning Forward
Strategic Priority 3: Goal 3
Strategic Priority 4: Goal 3
Strategic Priority 6: all 3 goals
Joint Commission Standards
Culturally and Linguistically
Appropriate Services (CLAS)
Standards ( new standards)
AACN, AAMC, ACGME, ARC-PA, ACOTE,
AMSA, APTA, CODA, LCME, NLNAC
Core Requirement 2.12
Comprehensive Standard 3.3.2
Healthy Respect- Civility project
Patient satisfaction
Student Satisfaction (80+ countries)
Patient- and family-centered care is an approach to the
planning, delivery and evaluation of health care that is
grounded in mutually beneficial partnerships among
patients, families, and health care practitioners. It is
founded on the understanding that the family plays a vital
role in ensuring the health and well being of patients of all
ages.
Patient- and Family- Centered Care
Patient- and Family- Centered Care Linked
with Cultural Competency
D I G N I T Y and R E S P E C T
I N F O R M AT I O N S H A R I N G
PA R T I C I PAT I O N
CO L L A B O R AT I O N
Four Core Concepts
D I G N I T Y and R E S P E C T
Health care practitioners listen to and honor
patient and family perspectives and choices.
Patient and family knowledge, values, beliefs and
cultural backgrounds are incorporated into the
planning and delivery of care.
I N F O R M AT I O N
S H A R I N G
Health care practitioners communicate and
share complete and unbiased information with
patients and families in ways that are affirming
and useful.
Patients and families receive timely, complete
and accurate information in order to effectively
participate in care and decision-making.
PA R T I C I PAT I O N
Patients and families are encouraged and
supported in participating in care and decision-
making at the level they choose.
CO L L A B O R AT I O N
Patients, families, health care practitioners, and
hospital leaders collaborate in policy and
program development, implementation and
evaluation; in health care facility design; and in
professional education, as well as in the delivery
of care.
Healthy Perspectives Framework
Content Delivery
Target Groups Cultural
Competency Learning
*Employees
VINSIM
Facilitated Online Course
Students
QI
*Employees also have yearly refresher as part of annual compliance training.
• Understand our framework and rationale for enhancing cultural competency.
OBJECTIVE REVIEW
– Healthy Perspectives Trainings
– Cultural activities
– Community Partners
Current Cultural Competency Strategies
What is it Cultural Competency?
A set of practice skills, knowledge and attitudes that must encompass five elements:
1. awareness and acceptance of difference;
2. awareness of one's own cultural values;
3. understanding of the dynamics of difference;
4. development of cultural knowledge;
5. ability to adapt practice skills to fit the cultural context
of the client.
Source: Goode, T.D. and Harrison S. (2000, Summer). Cultural Competence Continuum. Policy Brief 3, 5, Washington, D.C.: National Center for Cultural
Competence-Bureau of Primary Health Care Component, Georgetown University Child Development Center..
Which is darker 1 or 2?
1. Improve self-efficacy to perform in cross cultural situations
2. Demonstrate improved communication skills when interacting with culturally diverse patients, families, and health professionals.
Healthy Perspectives Goals
Healthy Perspectives is partially funded through a grant from the Healthcare Georgia Foundation
Course Overview
Self- Awareness
Specific Cultures
Knowledge Skills, &
Attitudes
Pre- Post Changes (N=784)
Assessment Pre score Post score P value Goal
Health Belief Attitude Survey
79.8 85.2 <.0001 1
Quality Interactions
75.2 90.5 <.0001 1, 2
Clinical Cultural Competency
Sub categories
• Health disparities,
• Sociocultural issues,
• Stereotypes and Biases
<.0001
1
VINSIM (Goal 2)
25 decision points linked to CLAS standards: Mean final score 93%
Asian-Pacific American Month May
Diversity Summit 2013 Featured Speaker:
Gary Guller
Motivational Speaker
Acclaimed Mountaineer
Friday, September 12, 2014 9 a.m. - 4 p.m. The Augusta Marriot at the Convention Center
Keynote Speaker:
J.R. Martinez
• Outline the various components of our organizational strategies to improve cultural competency.
OBJECTIVE REVIEW
Roles for Patient and Family Advisors
• Task force members • Members of committees
hiring new staff • Advocates • Participants in focus groups • Program evaluators • Family Faculty • Mentors for other families • Participants in quality
improvement initiatives • Reviewers of audiovisual and
written materials • Advisory board members
• Researchers • Grant reviewers • Program staff or policy
consultants • Members of the board of
trustees • Participants at conferences
and working meetings • Co-trainers for in-service
sessions • Fundraisers
Our Definition of an Advisor?
An advisor is any role or activity that enables families to
have direct input and influences on education, policies,
programs, research, and practices affecting care and
services for patients and families.
Advisor Recruitment Process • Who to Recruit
• Persons who voiced concern but offered solution
• Persons who were eager to learn about their care process
• Provide them with Training & Support • Advisor classes
• Personal coaching
• Recruitment Responsibility • All Staff
• Other Advisors
Advisor Identified
Completes Application
Role Defined
Orientation Certificate
Becoming an Advisor?
• Patient advisors attend and hour long orientation conducted by the Department of Family Services Development.
• During this orientation topics of discussion are:
the definition of PFCC and patient advisory Confidentiality HIPAA the roles and responsibilities of the patient advisor opportunities to serve traits of a good advisor education about Georgia Regents Health System.
Orientation
There are patient advisor certificate classes offered to the patient advisor to further their education and skill sets. The classes last 2 hours and are taught twice a year. In these classes, the patient advisor will learn how to : • be a true partner to our hospital and clinics • manage the emotions involved in advising • Describe the structure of the clinic environment and
opportunities to serve in the clinic environment • develop and tell their stories as faculty • serve on a hospital committee • be an ambassador at home and nationally • interview potential employees
Patient Advisor Certificate Classes
Specific to Cultural Competency
We only use advisors threes times.
Focus Group Composition
3 Focus Groups – 2 hours
• N = 22 (9, 7, 6)
Ethnic / cultural
• African American - 5 males; 8 females
• Caucasian – 1 male; 6 females
• Native American – 1 female
• Latino – 1 female (CLAS staff)
Age 30 - 70+ years
Education High school, post-secondary (MSW); health professions (RT, PT, LPN)
Cultural Competency Focus Group
Introductions & Agenda Review
Background
Discussions
• Large group (N=22) CC defined, advisors own words
• Small group work N=(6-9) review competencies list; rank top 5
Report out small group: Knowledge, Attitudes, Skills
What’s missing? Patient advisors’ advice “My illness does not defined me.”
Patient Perspective: Cultural Competency
Cultural Competency
Beyond the facts, values Beliefs – medical, health, religious
Read the patient, body language
Practice PFCC
Show interest – nod, give attention, reply/respond
“Competent is to know, understand, and empathize.” “Our definition is emotionally rich, the literature is sanitized.”
Patient Perspective: Cultural Competency
Attitude
Humility, respect, accept similarities/differences, show concern, no stereotypes, open to Q & suggestions, “Help me help you.”
Skills Listen for pt. concerns, empathy, treat pt. as a person, respect, negotiate, teamwork, communicate (drawings/photos, body language), translate medical terms to “common language,” ask for assistance with cultural issues, use trained interpreters
Patient Advisor’s Impact
• Influenced the changed from disease model • Changed language in modules • Supported use of working with interpreters • Incorporated ‘real’ situations • Help support funding
Beyond the traditional role
• Examples – Healthy Perspectives Advisory Council
– Strategic Planning
– Policy Input
– Presentations/Dissemination
– Community Outreach -cultural events
• Outline the various components of our organizational strategies to improve cultural competency.
OBJECTIVE REVIEW
Strategies
• Always ask
• Equal partners
• No title needed
• Trust and truth
• Accommodate schedules
• Engagement- Did you learn or grow?
Traditional paradigm Current and Emerging
Deficit/Discrimination Asset/Excellence
Tolerance Open-minded and responsive
Reactive Proactive –future facing
Needs of a select few Benefit to all
Compliance Strategic enabler, improve business agility
Social injustice Social norm
Add on Required prerequisite for advancing
As we Proceed
Final thoughts
Objectives
• Understand our framework and rationale for enhancing cultural competency.
• Outline the various components of our organizational strategies to improve cultural competency.
• Describe the role of patient advisors in a long-term cultural change process.
• Apply strategies for enhanced patient experience in areas of long term cultural change
Questions
Bernard Roberson, MSM, BA, HSC
Georgia Regents Medical Center
David Andrews, Patient Advisor
Georgia Regents Medical Center
Contact Information
Quiz Time
A. 10%
B. 20%
C. 25%
D. >50%
What % of new hires in the Children's Hospital of GA interview with patient
advisors?
What % of GR Health committees have patient advisors included?
A. 10%
B. 20%
C. 25%
D. >70%
A. 20-30
B. 50-60
C. 100-200
D. >200
How many patient advisors do we have at GRU?
A. Patient centered
B. Physician centered
C. Nursing centered
D. Reimbursement centered
What do all models of interprofessional team healthcare
have in common?