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Fourth
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Workshops
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| Workshop A-7: Cultural competence and organizational change: the experience of two multi-system health care organizations Organizational Strategies for Designing and Implementing a Cultural Competency ProgramDemographic changes in the U.S. population, publication of the Institute
of Medicine’s 2002 report, Unequal Treatment: Confronting Racial
and Ethnic Disparities in Healthcare, and development of the Culturally
and Linguistically Appropriate Services (CLAS) standards by the Office
of Minority Health and have resulted in a flurry of activity among health
care organizations to address health disparities. Most organizations are
struggling with the enormity of the task of identifying where to begin
in order to provide culturally responsive care. This program will assist
health care clinicians in identifying opportunities for and initiating
organizational change to foster culturally competent services within their
institutions.
A Comprehensive Cancer Center’s approach to Culturally Competent CareThe Dana-Farber/Harvard Cancer Center (DF/HCC), a seven-institution comprehensive cancer center has a primary focus to bring together population scientists, clinical and basic cancer researchers whose focus is basic research and its translation to improve cancer prevention, diagnosis and treatments. Recognizing the increasingly diverse patient population in which it serves, the cancer center has developed several strategies that address cultural competence of its members who provide patient care. The Dana-Farber/Harvard Cancer Center’s patient care institutions provided cancer care for approx. 59% of Boston’s non-white residents and 64% of Boston’s Hispanic/Latino population. In October 2001, a needs assessment was conducted to minority community members attending a symposium titled “Reducing the Unequal Burden of Cancer”. The results from the needs assessment showed a need to enhance provider’s ability to care for patients from diverse backgrounds. Additionally, feedback results received from focus groups with communities of color also identified a need for improvement in the area of patient care. The Institutes of Medicine (IOM) report. Unequal Treatment: Confronting Racial and Ethnic Disparities in Healthcare, 2002, presents data to support that care for patients from diverse backgrounds receive different care from the majority, White, population and identified the need to train healthcare professionals in Cultural Competence, and further states that the race of the clinician may impact the care that is delivered to patients from diverse backgrounds. Based on the IOM report, the result from the needs assessment and focus groups, DF/HCC reprioritized its focus areas and began the process of pursuing opportunities to improve community participation, provide cultural competence education and training to its members, develop and implement a patient navigator program, and integrate interpreter services into the cultural competency curriculum. In this workshop, we will describe a process that involves planning and implementing, a multi-institutional cross-cultural education program. We will share the experience of piloting a standardized training across three patient care institutions. In addition, we will describe the process of integrating other culturally and linguistically appropriate services. The challenges faced in the pilot of a multi-institutional cross-cultural
program were many. For instance, identifying the best way to measure impact
of the training on clinician’s competence, as well as the impact
of the training program on patient satisfaction. In addition, we found
that convincing the clinical staff that this program could enhance the
care they provide to their patients, engaging physician leadership, coordinating
schedules, and allocating time for the training was also difficult. Karen Burns White is the Assistant Director for Minority Initiatives in the Dana-Farber/Harvard Cancer Center in Boston, Massachusetts. In her capacity as Assistant Director, Ms. Burns White coordinates the planning and implementation of the Center's efforts in four distinct areas - cultural competence training, minority faculty recruitment and training, community engagement and cancer disparities research. Karen holds a B.S. in Health Information Management and a M.S. in Health Care Administration, and is a Registered Health Information Administrator. She has been an Adjunct Professor at Northeastern University in Health Information Management
Ms. Gonzalez Suarez’s primary interests include cancer prevention research, minority recruitment into the health professions and minority health. She has extensive experience in the conduct of cancer prevention research in low-income communities. In the Center for Community-Based Research, Ms. Gonzalez Suarez manages several cancer prevention studies. She is responsible for recruiting, training and supervising study staff members, as well as participates in the design of intervention and evaluation research protocols. Ms. Gonzalez Suarez has shown special talent for recruiting minority group staff members for research studies, and for developing outreach efforts to maximize participation in research by minority group members. In addition, she leads a Community Advisory Board, which provides a crucial bridge between the scientific aspects of study implementation and the realities of community partnerships. Ms. Gonzalez Suarez is an active member of the Dana-Farber Cancer Institute’s Diversity Committee. She has recently organized Cross-Cultural Care training for DFCI providers. She has also led a sub-committee to search and select a vendor to bring diversity training to the Institute. In addition, she has been working with the DFCI Diversity Committee to define diversity goals for the Institute. Ms. Gonzalez Suarez received her Bachelor and Masters in Psychology from Universidad Central de Venezuela, Caracas, Venezuela.
Sharon
Perryman is the Diversity Nurse Executive Fellow at the Dana-Farber
Cancer Institute, in this role she has developed and began the implementation
of a Cross-Cultural Education program for Nursing and Patient Care Services.
She has also participated, along with Karen Burns White and Elizabeth
Gonzalez-Suarez, in the pilot Cross-Cultural Education program led by
Dr. Joseph Betancourt. She is very active in various health disparity
committees both internally and with the Boston Public Health Commission.
She has presented a poster on the topic "Cross-Cultural Education
in Nursing: Provider Perceptions in the Clinician-Patient Relationship"
to the University of Pennsylvania School of Nursing. She was also the
first Diversity Fellow at Brigham and Women's Hospital and has been a
Nurse for 16 yrs functioning in various roles from staff nurse to Assistant
Nurse Manager, Nurse Manager and Nurse Administrator.
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| Fourth
National Conference is presented by State University of New York Downstate Medical Center, Resources for Cross Cultural Health Care, Arthur Ashe Institute for Urban Health, US Department of Health and Human Services, Joint Commission on Accreditation of Healthcare Organizations |
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| As with the rest of Diversity Rx, this section
is a work in progress and we welcome information on other efforts, programs,
and reports that will expand upon the information offered here. Please
let us know if you have other examples to include here. |
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Diversity Rx is sponsored by: |
 The National Conference of State Legislatures |
 Resources for Cross Cultural Health Care |
 Henry J. Kaiser Family Foundation |
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