Professionalism/Customer Service in the Health Care Environment

1. Professionalism/Customer Service in the Health Care Environment Ethical and Diversity Issues Related to Communication and Customer Service Diversity Issues – Lecture b This material (Comp 16 Unit 7) was developed by The University of Alabama at Birmingham, funded by the Department of Health and Human Services, Office of the National Coordinator for Health Information Technology under Award Number 1U24OC000023. This material was updated in 2016 by Bellevue College under Award Number 90WT0002. This work is licensed under the Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International License. To view a copy of this license, visit http://creativecommons.org/licenses/by-nc-sa/4.0/

2. Diversity IssuesLearning Objectives • Identify different dimensions of diversity. • Discuss the value of diversity. • Describe ways to promote an inclusive work environment. • Identify common cross-cultural differences. • Describe ways to communicate effectively with individuals with disabilities. • Discuss key elements of cultural competency in health care.

3. Dimensions of Diversity • Age • Gender • Race • Ethnicity • Culture • Sexual orientation • Education level • Socioeconomic status • Religion • Physical abilities

4. Commonalities That Can Supersede Surface-Level Differences • Values • Personality • Interests • Work style

5. Increasing Diversity in the United States • By 2020 more than half of the children born in the United States are expected to be part of a minority race or ethnic group • In some states, minorities already represent 50% of the population • Percentage of foreign-born Americans also expected to increase

6. Value of Diversity Image by Sira Anamwong

7. Creating an Inclusive Work Environment: Organizational Level • Explicitly state diversity as an organizational value. • Provide diversity training for employees. • Ensure hiring and promotion processes are equitable.

8. Creating an Inclusive Work Environment: Individual Level • Check your own biases and stereotypes. • Ensure that your actions don’t exclude any groups or individuals. • Give people the benefit of the doubt; withhold judgment. • Be curious.

9. Cross-Cultural Differences • Eye contact • Personal space/physical contact • Communication styles • Collectivist vs. individualist approach • Task vs. relationship focus

10. Cross-Cultural Communication: Eye Contact

11. Cross-Cultural Communication: Personal Space Image by Ambro

12. Cross-Cultural Differences: Communication Styles

13. Cross-Cultural Difference: Individualist vs. Collectivist Orientation

14. Cross-Cultural Differences: Task vs. Relationship Focus • Focus on a particular task • Success = getting the job done and series of achievements • Group identity important • Consensus decision making common

15. Implications of Diversity for Health Care Delivery • Research indicates that in many cases, minority groups do not receive the same quality of care as nonminority groups. • Culture can influence patients’ health beliefs, medical practices, attitudes toward medical care, and levels of trust. • Cultural differences can impact how health information is received, understood, and acted upon. • Clinical barriers occur when cultural differences are not adequately addressed. National Quality Forum, 2009; IOM, 2002; CDC, 2013

16. Cultural Competency • Cultural competency is an organizational strategy to address cultural differences. • Cultural competency is the “ongoing capacity of healthcare systems, organizations and professionals to provide for diverse patient populations high quality care that is family- and patient-centered and equitable.” National Quality Forum, 2009

17. Key Elements of Cultural Competency National Quality Forum, 2009; Image by CAST, CC-BY

18. Effective Communication with Those with Disabilities • About 8% of Americans with limitations based on disabilities • American with Disabilities Act (ADA) • Prohibits discrimination • Requires reasonable accommodation in the workplace • U.S. Department of Justice initiative to ensure necessary access to health care • Ethical and legal imperative for equitable treatment of those with disabilities • Disability etiquette = tips for appropriate interactions with those with disabilities

19. Disability Etiquette Image by franky242

20. Disability Etiquette: Hearing Impaired Individuals • Ensure the individual can see your facial expressions. • Don’t rely on lip-reading for important conversations. • Consider needs when planning a presentation or training. • Ask if an interpreter should be present. • Ensure videos have (accurate) closed captions. • When using an interpreter, look at and talk to the individual, not the interpreter.

21. Disability Etiquette: Vision Impaired Individuals • Ensure that websites and documents are accessible. • When planning training sessions or presentation, ensure that materials are accessible.

22. Diversity IssuesSummary – Lecture b • Increasing workforce and patient diversity is impacting health care delivery. • Diversity includes many types of differences. • When managed effectively, diversity can be a key driver of innovation and creativity.

23. Diversity IssuesSummary – Lecture b Continued • Examine your own biases and stereotypes. • Demonstrate inclusive behavior in the workplace. • Be aware of common cultural differences that can impact communication and relationships. • Employ disability etiquette in the workplace.

24. Diversity IssuesReferences – Lecture b References Barta, T., Kleiner, M., & Neumann, T. (2012). Is there a payoff from top-team diversity? McKinsey Quarterly. Retrieved from http://www.mckinsey.com/business-functions/organization/our-insights/is-there-a-payoff-from-top-team-diversity Blanding, M. (2013). How cultural conflict undermines workplace creativity. Forbes. Retrieved from http://www.forbes.com/sites/hbsworkingknowledge/2013/12/09/how-cultural-conflict-undermines-workplace-creativity/#4be023ee111c Centers for Disease Control and Prevention. (2013). CDC Health Disparities and Inequalities Report — United States, 2013. Morbidity and Mortality Weekly Report. Retrieved from http://www.cdc.gov/MMWR/pdf/other/su6203.pdf Cohen, J. (n.d.) Disability etiquette: Tips on interacting with people with disabilities. Eastern Paralyzed Veterans Association. Retrieved from http://ada.osu.edu/designguidance/disability%20ettiquite.pdf. Chua, R. Y. J. (2011). Innovating at the world’s crossroads: How multicultural networks promote creativity [working paper. Harvard Business School. Retrieved from http://www.hbs.edu/faculty/Publication%20Files/11-085.pdf Clark, D. (2014). How to succeed in a cross-cultural workplace. Forbes. Retrieved from http://www.forbes.com/sites/dorieclark/2014/06/19/how-to-succeed-in-a-cross-cultural-workplace/#676ad92f52fb Daft, R. L. (2008) Management, 12th ed. Mason, OH: South-Ester Cengage Learning. EuroMed Info. (n.d.). How culture influences health beliefs. Retrieved from http://www.euromedinfo.eu/how-culture-influences-health-beliefs.html

25. Diversity IssuesReferences – Lecture b Continued Goldberg, A. (2013). It matters how we define health care equity. National Academy of Medicine Perspectives. Retrieved from http://nam.edu/perspectives-2013-it-matters-how-we-define-health-care-equity Humes, K. R, Jones, N. L., & Ramirez, R. R. (2011). Overview of race and Hispanic origin: 2010 census briefs. Retrieved from http://www.census.gov/prod/cen2010/briefs/c2010br-02.pdf Kakade, M. (2016). Decode a culture—Task oriented vs. relationship oriented. Retrieved from http://manasikakade.com/2015/04/decode-a-culture-task-oriented-vs-relationship-oriented National Quality Forum (NQF). (2009). A comprehensive framework and preferred practices for measuring and reporting cultural competency: A consensus report. Retrieved from http://www.qualityforum.org/Publications/2009/04/A_Comprehensive_Framework_and_Preferred_Practices_for_Measuring_and_Reporting_Cultural_Competency.aspx Robbins, S. P. & Judge, T. A. (2017). Organizational behavior. San Francisco: Pearson. Smedley B. D., Stith A. Y., & Nelson, A. R. (Eds). (2002). Unequal treatment: Confronting racial and ethnic disparities in healthcare. Institute of Medicine (IOM). Washington, DC: National Academies Press. Retrieved from http://www.nationalacademies.org/hmd/Reports/2002/ Unequal-Treatment-Confronting-Racial-and-Ethnic-Disparities-in-Health-Care.aspx. U.S. Department of Justice Office of Civil Rights. (2013). Barrier-free health care initiative. Retrieved from http://www.ada.gov/usao-agreements.htm. U.S. Department of Justice Office of Public Affairs. (2012) Justice Department Announces Americans with Disabilities Act Barrier-free Health Care Initiative by Us Attorney’s Offices Nationwide. Justice News. Retrieved from https://www.justice.gov/opa/pr/justice-department-announces-americans-disabilities-act-barrier-free-health-care-initiative.

26. Diversity IssuesReferences – Lecture b Continued 2 VonSchrader, S., Lee, C. G. (2015). Disability Statistics from the Current Population Survey (CPS). Ithaca, NY: Cornell University Yang Tan Institute (YTI). Retrieved from http://www.disabilitystatistics.org Walters, E. (2014). Reaping the benefits of diversity for modern business innovation. Retrieved from http://www.forbes.com/sites/ekaterinawalter/2014/01/14/reaping-the-benefits-of-diversity-for-modern-business-innovation/#3d03218b6476 Watershed Associates. (n.d.). Task orientation vs. relationship orientation. Retrieved from http://www.watershedassociates.com/learning-center-item/task-orientation-vs-relationship-orientation.html Wolf, J. A. (2010). Organization development in healthcare: Conversations on research and strategies. (Vol. 10). Bingley, UK: Emerald Group. Images Slide 6: Sira Anumwong. (2015). Perpetual motion with light bulbs stock photo. Retrieved from http://www.freedigitalphotos.net/images/perpetual-motion-with-light-bulbs-photo-p353862 Slide 9: Geralt. Community. Retrieved from https://pixabay.com/en/community-friends-globe-continents-909149 Slide 10: Beautiful close-up. Retrieved from https://pixabay.com/en/beautiful-close-up-eye-eyebrows-2314 Slide 11: Ambro. (2011). Hand shaking business people stock photo. Retrieved from http://www.freedigitalphotos.net/images/Business_people_g201-Hand_Shaking_Business_ People_p40854.html

27. Diversity IssuesReferences – Lecture b Continued 3 Slide 12: Linforth, P. (2008). Retrieved from https://pixabay.com/en/business-internet-web-technology-1012761 Slide 13: Geralt. Silhouettes. Retrieved from https://pixabay.com/en/silhouettes-against-nonconformist-616913 Slide 17: CAST. Cultural competency. Retrieved from https://oli.cmu.edu/jcourse/workbook/activity/ page?context=153a1a0680020ca60000b3f77365b3f9 Slide 19: Franky 242. (2015). Portrait of a man in a wheelchair. Retrieved from http://www.freedigitalphotos.net/images/portrait-of-a-man-in-wheelchair-photo-p338830

28. Professionalism/Customer Service in the Health Care EnvironmentEthical and Diversity Issues Related to Communication and Customer ServiceLecture b This material was developed by The University of Alabama at Birmingham, funded by the Department of Health and Human Services, Office of the National Coordinator for Health Information Technology under Award Number IU24OC000023. This material was updated in 2016 by Bellevue College under Award Number 90WT0002.