Excellence Every Day represents an MGH commitment to providing the highest quality, safest care that meets or exceeds all standards set by the hospital and external organizations.

May 2012—A focus on

CULTURAL COMPETENCE

Cultural and linguistic competence is a set of congruent behaviors, attitudes, and policies that come together in a system, agency, or among professionals that enables effective work in cross-cultural situations. 'Culture' refers to integrated patterns of human behavior that include the language, thoughts, communications, actions, customs, beliefs, values, and institutions of racial, ethnic, religious, or social groups. 'Competence' implies having the capacity to function effectively as an individual and an organization within the context of the cultural beliefs, behaviors, and needs presented by consumers and their communities. (Adapted from Cross, 1989).  (from the web site of the Office of Minority Health)

Foundations of the Cultural Competence in PCS

The definition of Cultural Competence used in Patient Care Cervices came out of the 1998 PCS Leadership Retreat:

"Competence reflects skills, knowledge and behaviors derived from a specific role and setting which can be observed and result in a specific behavior."

Guiding Assumptions (established 1998)

• Cultural competence is a process and not an end state
• The journey begins by each individual within the organization knowing their own cultural values, beliefs, and lifestyles as they influence our actions
• It is critical to recognize intra-cultural variation among ethnic and diverse groups
• We must be patient in our learning and knowing processes including integrating social cultural factors within a cultural context
• Knowing and improving are inseparable. We must learn about the illness and wellness states of diverse cultures to provide culturally competent care.

Goals (1998 to present)

• Recruitment and retention of a diverse workforce
• Culturally competent staff
• The ability to work within multicultural teams
• A diverse leadership structure
  

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View (at left): Cultural Competence: What are you doing about it?
(Texas Health Resources)

 

 

 

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Samples of educational offerings and tools that support a culturally competent staff:

Diversity Curriculum
Launched in 1999, an 8-hour diversity curriculum by the Cross Cultural Health Care Program, Seattle, Washington, was adapted for use at MGH. The curriculum included these select slides. Today, the curriculum is incorporated into RN orientation.

Cultural Rounds
Cultural rounds provide a clinical/educational offering that is unit based. Facilitated by the director of the PCS Diversity Program, the rounds provide an opportunity to discuss clinical cases, explore team-related issues, provide updates on what's happening in the discipline at large, or process any timely issue of interest to the staff.

Response to current events
Periodically,emerging topical issues and events in the news provide an opportunity to respond with targeted educational offerings to address the concerns of staff and/or visitors.

Leadership Curriculum on managing a diverse workforce
Designed to assist managers and those in leadership position to understand the skills and self-awareness needed to build, manage and lead a diverse workforce. To schedule a training, contact director of Deborah Washington, RN, PhD(c), director of PCS Diversity.

A tool available upon request:
The Culturegram was developed during the early days of the PCS Diversity Program for distribution to patients and families. It was about the size of an index card and laminated., and provided a way for people from differing cultural backgrounds to educate one another at a very basic level.

My Culture gram ... special information for you and me!!

The culture I most identify with is…..
The language spoken in my home is…..

In my culture:

1. It is the custom to greet me in the following way….
2. It is the custom for the following person to help me make a decision….
3. My illness is understood in the following way….

I use the following traditional medicine to treat my illness….

For spiritual care I would like……

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HEALTH DISPARITIES

Health disparities are variations in the delivery of care that suggest unequal, different or inferior outcomes because the clinical judgment, treatment or the systems supporting the delivery of care have been compromised by prejudice or stereotypes associated with an individual’s cultural or ethnic background, gender, religion, sexual orientation, appearance or other identifiable characteristics. (This definition of Health Disparities isused as a framework by MGH Patient Care Services in understanding this concept. Can be used by researchers and educators.)

The MGH Disparities Solution Center is dedicated to the development and implementation of strategies that advance policy and practice to eliminate racial and ethnic disparities in health care by serving as a change agent by developing new research and translating innovative research findings into policy and practice; developing and evaluating customized policy and practice solutions for health care providers, insurers, educators, community organizations, and other stakeholders; and, providing education and leadership training to expand the community of skilled individuals dedicated to eliminating health care disparities.

Social Determinants of Health: Population Health
The health of groups is of particular interest when the focus is minority health and the elimination of health disparities. The concern is the impact of socially constructed systems that may require new paradigms of care delivery and definitions of health as specific groups of people and their welfare are considered. Community Health Centers are a model of care that attempts to address this complex issue. Population health is a global issue this it commonly reflects the marginalized throughout the world.

Understanding Population Health: A background paper

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It all began in 1995/1996. The formal diversity program of the then, Department of Nursing, was launched as a grand event on the then unfinished 22nd floor of the new Ellison Tower. The invited keynote was Rosalyn Taylor O’Neal, a wonderful and energizing diversity consultant. Action Steps suggested by program participants in afternoon breakout sessions included more...

• In 2003, the American Organization of Nurse Executives (AONE) Institute for Patient Care Research and Education, presented its first Prism Diversity Award to Jeanette Ives Erickson, RN, DNP, FAAN, senior vice president for MGH Patient Care Services (PCS) and chief nurse. The award was created to recognize efforts to promote diversity in the nursing field and enhance understanding of diversity issues through events and activities.

• In both 2008 and 2009 respectively, the PCS Diversity Program and its director, Deborah Washington, RN, PhD(c), received Boston's prestigious Rosoff Award. Created in 1996, the Rosoff Awards recognize the area’s outstanding diversity initiatives and the amazing people behind them. more...

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PIPELINE PROGRAMS

Clinical Leadership Collaborative for Diversity (CLCDN) in Nursing Scholarship Program
The CLCDN Scholarship was established to assist in increasing the pipeline of diverse nurses caring for patients throughout the Partners HealthCare and to develop diverse nurse leaders. Applicants who identify themselves as American Indian/Alaska Native, Asian, Black/African American, Hispanic/Latino, or Native Hawaiian/Other Pacific Islander are encouraged to apply. The CLCDN program helps to address the challenges of work, home and school and chart new possibilities for nurses employed at Partners HealthCare Institutions who are interested in pursuing an advanced degree.

• Banister G, Winfrey ME, Enhancing Diversity in Nursing: A Partnership Approach, JONA 2012; 42(3)176–181.
  (internal access only)
  

Hausman Fellowship
The Hausman Fellowship is a 6 week summer experience for a junior or senior minority nursing student. The student is accepted into a 40h/week clinical learning opportunity in a one to one preceptor experience with a staff nurse. The student rotates throughout the hospital in both inpatient and outpatient departments. Sites include the Emergency Department, Medicine, Surgery, Community Health Centers, Oncology, Cardiac, Research unit, just to name a few.

• Background Information
• Hausman fellows showcase wisdom and initiative at recent graduation ceremony - Caring Headlines (9/15/11)
• The Hausman Fund for Nursing Workforce Diversity - Caring Headlines (6/6/10)
• Hausman Nursing Fellowship: a unique learning opportunity - Caring Headlines (9/18/8)
• Information about applying
• Diversity Nursing Blog

Hausman Young Scholars
In 2011, as part of the expanding commitment to diversity from the Hausman Family, patientcare Services Diversity Program initiated an innovative program focused on the
children of employees who worked in assistive roles.  The goal was to work with children
in middle school to encourage their interest in health care as a career. And secondly, to empower the young scholars to be positive voices for wellness not only for themselves,
but in their families, with their peers and as more and more families were affected
because of their efforts, then they would be powerful voices for change in their
neighborhoods. That concept is captured below in the Hausman Young Scholar’s
program conceptual framework for eliminating health disparities.

The Hausman Young Scholar’s Program is a Saturday academy based at MGH. It teaches STEM (Science, Technology, Engineering, Math)  related content. However, these concepts
are taught as they relate to careers in healthcare.  For example, science as it relates to clinical tests, technology and engineering as they relate to equipment used in the operating room as an example, and math as it relates to correct answers for questions about correct
medication dosages.

click diagram to enlarge

• Overview
• The Hausman Young Scholars Program - Caring Headlines (6/16/11)
• An interview with Raymond Hawkins, a Hausman Young Scholars mentor
  Mr. Hawkins shares his personal story that is at the same time inspiring and example of how—no matter the challenges life may offer—any individual with drive, commitment and love of healthcare will find a way to make dreams come true. As a mentor in the Hausman Young Scholars Program, Mr. Hawkins uses his story to motivate children from urban environments to pursue their own hopes for the future. (made possible through the generous support of Liang Yap, PhD   Department of Neurology)

The Hausman Fund for Foreign-Born Nurses

• Overview

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There are numerous terms and acronyms in healthcare that may be unfamiliar. Please click here to visit a Glossary of Terms that may be helpful. And please email any suggested additions.

This month's featured term: Disparities
Disparities in care are differences in the delivery of health care, access to health care services and medical outcomes based on ethnicity, geography, gender and other factors that do not include socioeconomic status or insurance coverage. Understanding and eliminating the causes of health care disparities is an ongoing effort of many groups and organizations.

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If you have questions or suggestions related to the EED portal, please contact Georgia Peirce at (617) 724-9865 or via email at gwpeirce@partners.org.

updated 5/2/12

 

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