Cultural
Competence
in Healthcare
An Important Refresher for Physicians
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Session Objectives
After this session physicians will be able to:




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Define Cultural Competence
Describe why delivering Culturally
Competent Care is important
Understand being Culturally
Competent is a continual process
Use Culturally Competent Practices
in the provision of care
Why do we focus on Cultural Competence at
Wheaton Franciscan Healthcare?
It is our Mission
• “Providing exceptional and compassionate health care
service that promotes the dignity and well being of the
people we serve.”
Clinical Excellence
• Ensure equal and individualized care
is delivered to all patients
Our Patient and Family Experience
• Nothing is more important than our
patient’s health and well being
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The next few slides are common words and
information to help you learn more about what
cultural competence is and why it matters in
healthcare and the workplace
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What is Culture?
It is the learned and shared values
of a particular group that:
- Guides thinking
- Actions
- Behaviors
- Emotional reactions to daily living
It is the sum of beliefs, practices,
habits, likes and dislikes.
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It is norms and customs that are
learned.
Culture is central to the
Delivery of Healthcare
• It influences patients’ healthcare beliefs, practices
attitudes toward care, and trust in the system and
in the individual providers
• Cultural differences affect how health information
and healthcare services are received, understood
and acted upon.
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*US Department of Health & Human Services/ Office of Minority Health
Our Patients Represent Many Cultures
Group
YEAR
WFH–North Market (WI)
Native
Hawaiian &
American
Indian
Asian
Latino/
Hispanic
African
American/
Black
FY04
FY11
FY04
FY11
FY04
FY11
FY04
FY11
FY04
FY11
.1%
.2%
1.5%
1%
2.7%
2%
27%
24%
62%
67%
71%
21%
St. Joseph, Elmbrook & Wisconsin
Heart Hospital
WFH-Central Market (WI)
White/
Caucasian
SJH
.5%
.3%
1%
1%
12%
St. Francis & Franklin & MOSH
11%
25%
7%
5%
SJH
75%
SFH
WFH-South* Market (WI)
79%
61%
SFH
.4%
.003%
.7%
.5%
8%
10%
11%
16%
79%
71%
.5%
.1%
.8%
.3%
1.6%
.6%
4%
3%
93%
94%
.2%
.03%
1%
1%
2.6%
3%
1.4%
3.3%
89%
84%
All Saints
WFH-Iowa*
Sartori, Mercy & Covenant
Marianjoy (IL)
Our Patients Represent Many
Religions and Languages
Religions
Apostolic
Church of God
Greek Orthodox
Methodist
Baptist
Congregational
Hindu, Hmong
Mormon
Buddhist
Eastern
Orthodox
Jehovah’s
Witness
Muslim/Islam
Catholic
Episcopal
Jewish,
Pentecostal
Lutheran
Presbyterian
Christian Science Evangelical
Languages
Arabic
Farsi
Japanese
Serbian
Bosnian
French
Laotian
Sign language
Chinese
Greek
Polish
Spanish
Danish
Hebrew
Punjabi
Somali Bantu
English
Italian
Russian
Vietnamese
IOWA Patient data is in bold
What is Cultural Competence?
Cultural competence is the ongoing capacity of
healthcare systems, organizations and professionals
to provide for diverse patient* populations high
quality care that is safe, patient- and familycentered, evidence-based, and equitable
The National Quality Forum
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* The term “patient” refers to the individual recipient of care – i.e. patient, client, legal surrogate or person.
Cultural Competence in Health Care
Primary concerns:
1. Eliminate misunderstandings in
diagnosis or in treatment planning
that my arise from differences in
language or culture
2. Improve patient adherences with
treatments
3. Eliminate health care disparities
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Associations We Make
What type of person do you think of when
you hear the following descriptions?
•
•
•
•
•
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Alzheimer’s patient
Black male
Asian man
Welfare recipient
Teenager
Associations We Make
The people shown below fit into the descriptions
reviewed on the previous slide
Alzheimer’s victim
Black male
Asian man
Welfare recipient
Teenager
President Ronald Reagan
Dr. Ben Carson
Jackie Chan
JK Rowling
Justin Beiber
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Associations We Make
• When we initially hear the profile of a patient,
we all make associations and assumptions
based on our past experience. We have a
perception of the person before we ever
meet them.
• Our patients make the same associations
when they meet us.
• This can be described as a component of
transference and counter-transference.
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Transference
• Transference occurs when the physicians or patients
transfer past emotions, beliefs or experiences to the present
situation.
• The feelings can be positive or negative Countertransference, but are ALWAYS a distortion of realty.
• Transference is an unconscious process. When transference
occurs around cultural issues, it becomes a serious barrier
that keeps the patient from being receptive to medical advice
and treatment.
It is up to us as Culturally Competent Providers to maintain and
convey unconditional positive regard for our patients
14
The American Journal of Psychiatry, VOL. 157, No. 9
Cultural Competence is a Continuum
• Gaining cultural competence is an ongoing
PROCESS. It is developed as cultural knowledge
increases
• In order to achieve higher levels of competence, it
is helpful to engage in self assessment
SKILLS
• Self assessment provides
direction for improvement
ATTITUDES
KNOWLEDGE
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The Center for Public Health Education
Cultural Competence is a Continuum
Moving From Basic Knowledge to Clinical Practice
KNOWLEDGE
ATTITUDES
Understanding
the meaning of
culture and its
importance to
healthcare
Having
respect for
variations in
cultural
norms
SKILLS
Eliciting
patients’
explanatory
models of
illness
Physicians must continue skill development
to learn each culture
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Journal of the Nation Medical Association, Nov. 2008
Eliciting Patient’s
Explanatory Model of Illness
Role of the Physician . .
1. Asking questions to elicit the patient’s
understanding of their illness
2. Having strategies for identifying and bridging the
different communication styles
3. Having skills for assessing decision-making
preferences and the role of family
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Journal of the Nation Medical Association, Nov. 2008
Eliciting Patient’s
Explanatory Model of Illness
4. Utilizing techniques for ascertaining the patient’s
perception of using biomedicine and his or her
use of complementary and alternative medicine
5. Having tools for recognizing sexuality and gender
issues
6. Having communication strategies for negotiating
7. Methods for bringing to bear an awareness of
issues of mistrust and prejudices and of the
impact of race and ethnicity on clinical decisionmaking
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Journal of the Nation Medical Association, Nov. 2008
The Culturally Competent Physician
• Knows competency involves a deeper
commitment to the people for whom
we provide services
• Recognizes and learns to work within
the context of different languages,
customs, worldviews, religions,
spiritual views, health beliefs, gender
roles, sexuality and family
relationships when interacting with
clients/patients
• Develops specific practice skills
The Center for Public Health Education
The Culturally Competent Physician
• Practice Skills
- Has an awareness and acceptance of
difference whereby diversity is valued
- Understands how his own culture
influences how he thinks, acts and
delivers services
- Understands the dynamics of
difference and is conscious of those
dynamics inherent when cultures
interact
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The Center for Public Health Education
The Culturally Competent Physician
• Becomes familiar with the different
aspects of various cultures in target
areas where service is provided
• Has the ability to adapt practice skills
that fit the cultural context of the
patient/client
Physicians must continue skill development
to learn each culture
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The Center for Public Health Education
Why is this important for
Physicians?
At Wheaton Franciscan Healthcare, we recognize
our patients as individuals with unique physical,
emotional, spiritual, and cultural needs.
As a compassionate, faith-based health care
provider, we believe developing a positive
relationship with our patients and families is
essential to the healing process and key to
carrying out our Mission of providing exceptional
and compassionate health care service.
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The Goal of Each Physician
To always provide culturally competent
health care services that are respectful of
and responsive to the health beliefs,
practices, cultural and linguistic needs
of our diverse patients
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Additional Resources
Please click on the picture for a
quick reference on delivery
culturally competent care.
There are also CME credits:
“A Physician's Practical Guide
to Culturally Competent Care”
at https://cccm.thinkculturalhealth.hhs.gov .
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Diversity & Inclusion Contacts
Theresa Jones
Vice President of Diversity and Inclusion Strategies
[email protected]
414-465-3433
Leslie Galloway Sherard
Director, Diversity and Inclusion Programs
[email protected]
414-465-3504
Sandy Jones
Manager, Cultural Diversity
[email protected]
414-465-3005
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Cultural Competence in Healthcare