Building Toward Cultural Competency: A Patient Safety Issue

1. Building Toward Cultural Competency:A Patient Safety Issue Mary “Toni” Flowers RN Director Health Disparities & Cultural Competency MPRO – Michigan’s Quality Improvement Organization

2. “Men hate each other because they fear each other, and they fear each other because they don’t know each other, and they don’t know each other because they are often separated from each other.” Martin Luther King, Jr.

3. What is Cultural Competency Refers to demonstration, an observable performance of acquired knowledge, skills and abilities to address the specific culturally bound attitudes, belief or practices of ethnically or culturally diverse populations

4. How Do Physicians Become Culturally Competent?* • Listen with sympathy and understanding to the patient's perception of the problem • Explain your perceptions of the problem and your strategy for treatment. • Acknowledge and discuss the differences and similarities between these perceptions. • Recommend treatment while remembering the patient's cultural parameters. • Negotiate agreement. It is important to understand the patient's explanatory model so that medical treatment fits in their cultural framework. * Berlin EA, Fowkes WC. Teaching framework for cross-cultural care: Application in Family Practice. West J Med. 1983;139(6):934-938.

5. Five Constructs of Cultural Competency* • Cultural Awareness • Cultural Knowledge • Cultural Skill • Cultural Encounter • Cultural Desire *Campinha-Bacote, 1999). The Process of Cultural Competence In the Delivery Of Healthcare Services: A Culturally Competent Model of Care (3rd ed).

6. Cultural Awareness • The ability for health care providers to appreciate and understand their clients' "values, beliefs, life ways, practices, and problem solving strategies." Self-awareness is also a vital part of this construct. This allows health care providers to analyze their own beliefs to avoid bias and prejudice when working with clients.

7. Cultural Skill • The ability for health care providers to conduct an accurate and culturally competent history and physical examination.

8. Cultural Knowledge • The ability for health care providers to have an educated knowledge base about various cultures to better understand their clients. It also requires health care providers to be knowledgeable about "physical, biological, and physiological variations" among cultural groups.

9. Cultural Encounter • The ability for health care providers to competently work directly with clients of culturally diverse backgrounds. This is demonstrated by verbal and non-verbal messages by the health care provider and the client.

10. Cultural Desire • The ability for the health care provider to possess a drive to achieve cultural competence.

11. Have I Asked the Right Questions* Awareness Am I aware of my biases and prejudices towards other                        cultural groups, as well as racism in healthcare? Skill Do I have the skill of conducting a cultural assessment? Knowledge Am I knowledgeable about the worldviews of different  cultural and ethnic groups, as well as knowledge in the field of biocultural ecology? Encounters Do I seek out face-to-face, and other types of interactions with individuals who are different  from myself? Desire            Do I really "want to" become culturally competent?   * Campinha-Bacote, J (2002b). Cultural competence in psychiatric nursing: Have you “ASKED” the right questions? Journal of Nursing Education, 8(5), 203-207

12. Interactive • Case Studies • Questions

13. "The great question that has never been answered and which I have not yet been able to answer, despite my thirty years of research into the feminine soul, is "What does a woman want?" Sigmund Freud

14. “You must be the change you wish to see in the world.” Mahatma Gandhi

15. Contact Information Mary “Toni” Flowers RN Director Health Disparities & Cultural Competency MPRO – Michigan’s Quality Improvement Organization 22670 Haggerty Road, Ste 100, Farmington Hills MI 48335 mflowers@mpro.org