Aligning Cultural Competency to

Improve Safety, Quality and Equity An ACHE Qualified Education (Category II) Session – 1.0 Hour CEU

Richelle Webb Dixon, FACHEVice President Ambulatory Care CHI St. Luke’s Health

ACHE-SETC is

Carlos R. Escobar, FACHEAssociate Vice President, Business Operations & FacilitiesUTMB Health -Galveston

Learning Objectives Why cultural competence and patient-centeredness are integral

components in improving health care quality

Initiatives to eliminate cultural and linguistic barriers between health care providers and patients

Recognize the importance in training culturally competent providers and design culturally competent health care systems

Emphasis on patients as individuals with unique experiences and perspectives, rather than as members of ethnic or cultural groups, thereby minimizing providers to stereotype and make inappropriate assumptions

Session AgendaI. Defining Cultural Competency

II. Social, Health and Organizational Benefits

III. Key Steps to Cultural Competency

IV. Current State of US Hospitals

V. Leading Practices

VI. Cultural Examples

VII. Summary and Resources

Defining Cultural CompetencyIn health care, cultural competency describes the ability of systems to provide care to patients with:

Diverse Values, Beliefs and Behaviors Including tailoring care delivery to meet patients’ social, cultural

and linguistic needs

Culturally competent health care systems acknowledge: Importance of culture Incorporates assessment of cross-cultural relations Recognizes potential impact of cultural differences Expands cultural knowledge Adapts services to meet culturally unique needs

Source: HRET

Why Cultural Competency? Addressing equity of care remains an imperative for hospitals and

health systems.

By 2050 working age population will be more than 54% minority – US Census Bureau

36% of the population belongs to a racial or ethnic minority

Limited English Proficiency (LEP) continues to be a significant factor influencing how a healthcare facilities ensure high standards of care

The number of patients in the U.S who do not speak English or limited English has risen in recent decades, presenting a challenge

Social Benefits

Social Benefits

– Increases mutual respect and understanding between patient and organization

– Increases trust– Inclusion of all community members– Increases community participation and involvement in health issues– Assists patient and families in their care– Promotes patient and family responsibilities for health

Source: “Becoming a Culturally Competent Health Care Organization,” Institute for Diversity in Health Management and the Health Research & Educational Trust, 2013

Health Benefits

Health Benefits

– Improves Patient data collection– Increases preventive care by patients– Reduces care disparities in the patient population– Increases cost savings from a reduction of medical errors, number

of treatments and legal cost– Reduces the number of missed medical visits

Source: “Becoming a Culturally Competent Health Care Organization,” Institute for Diversity in Health Management and the Health Research & Educational Trust, 2013

Organizational Benefits

Organizational Benefits

– Incorporates different perspectives, ideas and strategies in the decision-making process

– Decreases barriers that slow progress

– Moves toward meeting legal and regulatory guidelines

– Improves efficient-of-care services

Source: “Becoming a Culturally Competent Health Care Organization,” Institute for Diversity in Health Management and the Health Research & Educational Trust, 2013

Three Key Steps to Cultural Competency

Step One

COMMUNITY SURVEY

The hospital or health care system analyzes demographic data to determine the composition of the local community and the hospital’s patient population. With this analysis, the hospital or care system can conduct micro-targeting surveys to determine the needs for specific communities. Source: “Becoming a Culturally Competent Health Care Organization,” Institute for Diversity in Health Management and the Health Research & Educational Trust, 2013

Three Key Steps to Cultural Competency

Step Two

COMMUNITY ENGAGEMENT

The hospital or health care system communicates survey findings to community members and determines priorities. This information serves as the basis for staff education.

Source: “Becoming a Culturally Competent Health Care Organization,” Institute for Diversity in Health Management and the Health Research & Educational Trust, 2013

Three Key Steps to Cultural Competency

Step Three

STAFF EDUCATION

Working with community feedback and survey data, the hospital or care system educates staff on the importance of cultural competence and the particular cultural needs of patients with whom staff interact each day.

Source: “Becoming a Culturally Competent Health Care Organization,” Institute for Diversity in Health Management and the Health Research & Educational Trust, 2013

Leading Practices

I. CHRISTUS Health – Texas

II. Lutheran Medical Center – New York City

III. Massachusetts General Hospital – Boston

Data Collection

Data Use

When Image does not Match Words

“Hay” for Sale

“Hay” = Spanish language expression for “There is”

When Words do not Match the Image

Take by mouth “once” a day vs. Once = 11x in Spanish

InitiativesNew News /Health IT Outcomes – March 26, 2014

Nine year old Girl Dies Due to Language Barrier, Interpreting Absence at Hospital – Stratus Video Says Lack of Industry Standardization Creating Healthcare Hazard

VRI – Video Remote Interpreting

Embracing Cultural Competency Important step toward reducing health disparities

Promotes cultural and linguistically appropriate care

Collection and use of REAL data improves equity of care

Decreases medical errors, number of treatments and legal cost

Improves quality, efficacy and equity of care

Equity of Care ~ Call to ActionHospitals and health systems possess a great opportunity to affect health care disparities using three core areas:

I. Increasing the collection and use of race, ethnicity and language preference (REAL) data

II. Increasing cultural competency trainings

III. Increasing diversity in leadership and governance

Equity of Care Pledge

https://youtu.be/gLeBhKsEXKs

Richelle Webb Dixon, FACHE Richelle currently serves as the Vice President for Ambulatory Care at Baylor

St. Luke’s Medical Center in Houston, Texas. In this position, Richelle has responsibility for ambulatory services including the THI Outpatient Clinic, Heart and Lung Transplant Center, Center for Liver Disease, Kirby Glen Diagnostic and Treatment Center, Radiation Therapy and Executive Health Program. Prior to joining CHI St. Luke’s Health, Richelle held several national positions within Catholic Health Initiatives (CHI) based in Englewood, Colorado. CHI is a faith‐based healthcare system with 105 hospitals in 19 states.

Richelle is President-Elect for the National Association of Health Services Executives (NAHSE); she serves on the ACHE -SouthEastTexasChapter Board and is a Fellow in the American College of Healthcare Executives. Richelle serves as an examiner with Quality Texas ‐ a foundation that assists organizations with improving performance based upon the Baldrige performance excellence criteria. Richelle is also a board member with the Fort Bend YMCA.

Richelle received a Bachelor of Arts in Psychology and a Masters in Health Services Administration both from the University of Michigan, Ann Arbor.

Richelle Webb Dixon, FACHEVice President, Ambulatory Care

CHI St. Luke’s HealthBaylor St. Luke’s Medical Center

rdixon@stlukeshealth.org

Carlos R. Escobar, FACHE Carlos R. Escobar, BED-Arch., M.H.A., FACHE joined UTMB in July 2010. Mr. Escobar came to

UTMB with more than 25 years of experience with the U.S. Department of Veterans Affairs (VA). He began his career as an architect for the Olin E. Teague Veterans Center in Temple, TX. He has also held several progressive management positions in VA institutions in Ann Arbor, MI, Kansas City, MO, St. Louis, MO., as Interim CEO, and Houston, TX as a Chief Operations Officer. Mr. Escobar's contributions to innovations in federal health services and capital asset management have been recognized at a national level.

During his tenure at UTMB, he has been directly responsible for Environmental Health and Safety programs, Institutional Preparedness and Auxiliary Services. In March of 2012, his scope of responsibilities was expanded to include Supply Chain Operations (Purchasing, Contracting, Logistics and Accounts Payable) and Mail. He also provides leadership and operational oversight for all functions of the Business Operations and Facilities group encompassing all aspects of Capital Assets Management.

Mr. Escobar is a strong advocate of giving back to the community. He is a volunteer with the Boy Scouts of America, currently serving as an Assistant Scout Master for an area troop. He is an elected Board Member in the National Board of Directors for the National Forum for Latino Healthcare Executives (NFLHE) where his goal is to develop a Houston Chapter. He serves on the Math and Science Advisory Council at St. Thomas University at Houston, and has taught a one-day healthcare leadership seminar at the UT School of Public Health. He is currently a Senior Fellow of the American Leadership Forum (ALF), Houston Chapter Medical Class I and the Senior Executive Program of the American College of Healthcare Executives (ACHE).

Carlos Escobar, FACHEAssociate Vice President, Business Ops/Facilities

University of Texas Medical Branch

crescobar@utmb.edu

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