Communicating Across Cultural and Language BarriersRicky Winardi, MD, MPHChief of Diversity and Multicultural Care, NVLYPrimary Care ConferenceOctober 17, 2009

WELCOME

Workshop agenda

No affiliations to disclose

Cultural and Linguistic Competency

Disclosure of Relevant Financial RelationshipsDisclosure of Relevant Financial Relationships

Dr. Winardi has disclosed that he has no relevant relationships with commercial or industry organizations.

The CME Department has reviewed disclosure information for the planners and developers for this program and they do not have relationships that present a relevant conflict of interest.

OBJECTIVES

* Sharing practical tips for effective communication across cultures

* Introducing “red flags” that might indicate limited health literacy

* Providing access to language and culture resources

Health Literacy

October is Health Literacy Month

Scope of the problem: 1 in 5 illiterate, average reading skills in 8th-9th grade

Low health literacy leads to increased risk of serious health outcomes

JCAHO study: 80% of medical errors are due to communication breakdown

Key risk factors for limited literacy

Elderly

Low income

Unemployed

Do not finish high school

Minority ethnic group

Recent immigration to the US

US-born with English as second language

Behaviors that may signal limited literacy

Incomplete forms

Frequently missed appointments

Non-compliance with medication regimens

Lack of follow-through with tests/referrals

They say that they are taking medications, but lab tests or other parameters do not change in the expected fashion

Responses that may signal limited literacy

“I forgot my glasses. I’ll read this when I get home” or “Can you read this to me?”

“Let me bring this home so I can discuss it with my children”

Unable to name medications

Unable to explain what medications are for

Unable to explain dosing of medications

Suggested questioning

“How happy are you with the way you read?”“What is the best way for you to learn new

things?”“How confident are you filling out medical forms

by yourself?”“How often do you need to have someone help you

when you read instructions, pamphlets, or other written materials from your doctor or pharmacy?”

Tips to improve interpersonal communication

Slow down

Use plain, non-medical language

Show or draw pictures

Limit the amount of information provided and repeat it

Use the “teach-back” technique

Create a shame-free environment

Plain language alternatives to medical terms

Anti-inflammatory

Benign

Enlarge

Heart failure

Lipids

Monitor

Referral

Toxic

Lessens swelling and irritation

Not harmful

Get bigger

Heart not pumping well

Fats in blood

Keep track/an eye on

Send to another doctor

Poisonous

How to thrive in a multicultural world

Hispanic Culture Video: http://www.aoa.org/x12933.xml

Important values in Latino/Hispanic cultures

Familismo: family and community are the center of society

Respeto: respect based on age, gender and status

Personalismo: genuine concern for another person

Esmero: attention to personal appearance

Resources

Diversity Roundtables

Diversity Conferences

KP Diversity

Provider Handbooks

KP Multicultural Staff Associations

Language Assistance Services

Happy Thriving in Diversity and Inclusion!

!Muchas gracias!

Cultural competency is a journey throughout a lifetime, not a goal or an achievement.

Please feel free to email or call me: Phone 8-416-6525 at Fair Oaks

Email: ricky.z.winardi@kp.org