An Overview: Strategies for HIV/AIDS Providers Co-Presented by: : Ms. Tawara Goode, MA, Director,...
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An Overview: Strategies for HIV/AIDS Providers Co-Presented by: : Ms. Tawara Goode, MA, Director, National Center for Cultural Competence and Ms. Wendy
An Overview: Strategies for HIV/AIDS Providers Co-Presented by:
: Ms. Tawara Goode, MA, Director, National Center for Cultural
Competence and Ms. Wendy Jones, Director, Children & Youth with
Special Health Care Needs project of the National Center for
Cultural Competence National Center for Cultural Competence,
Georgetown University Medical Center
Slide 2
At the completion of this webinar each participant will: state
the importance of the 15 CLAS Standards and their relevance to
HIV/AIDS care and treatment. identify at least one implementation
strategy relative to HIV/AIDS care and treatment for each of the 15
Standards.
Slide 3
In 2013, U.S. Department of Health and Human Services, Office
of Minority Health, reissued a new set of CLAS standards. The new
15 CLAS Standards promote the advancement of health equity,
improving the deliver of quality care, and the elimination of
health care disparities. All of the CLAS Standards are of equal
importance The New CLAS Standards 3
Slide 4
The Introductory Statement: The National CLAS Standards are
intended to advance health equity, improve quality, and help
eliminate health care disparities by establishing a blueprint for
health and health care organizations to: Principle Standard 1)
Provide effective, equitable, understandable and respectful quality
care and services that are responsive to diverse cultural health
beliefs and practices, preferred languages, health literacy and
other communication needs.
Slide 5
Theme 1) 2-4: Governance, Leadership, and Workforce Theme 2)
5-8: Communication and Language Assistance Theme 3) 9-15:
Engagement, Continuous Improvement, and Accountability
Slide 6
Cultural Competence behaviors attitudes policies structures
practices requires that organizations have a clearly defined,
congruent set of values and principles, and demonstrate behaviors,
attitudes, policies, structures, and practices that enable them to
work effectively cross-culturally (adapted from Cross, Bazron,
Dennis and Isaacs, 1989) Slide Source: 2011 - National Center for
Cultural Competence
Slide 7
Five Elements of Cultural Competence Organizational Level value
diversity conduct cultural self-assessment manage the dynamics of
difference institutionalize cultural knowledge adapt to diversity -
policies - structures - values - services (Cross, Bazron, Dennis
and Isaacs, 1989) Slide Source: 2011 - National Center for Cultural
Competence
Slide 8
Five Elements of Cultural Competence Individual Level (Cross,
Bazron, Dennis and Isaacs, 1989) acknowledge cultural differences
understand your own culture engage in self-assessment acquire
cultural knowledge & skills view behavior within a cultural
context Slide Source: 2011 - National Center for Cultural
Competence
Slide 9
LINGUISTIC COMPETENCE POLICY PRACTICES STRUCTURESPROCEDURES
DEDICATED PERSONNEL RESOURCES DEDICATED FISCAL RESOURCES Slide
Source: 2011 - National Center for Cultural Competence LINGUISTIC
COMPETENCE FRAMEWORK Goode & Jones, Revised 2009, National
Center for Cultural Competence
Slide 10
Values and Guiding Principles for Cultural Competence Cultural
competence: embraces the principles of equal access and non-
discriminatory practices in service delivery. is achieved by
identifying and understanding the needs and help-seeking behaviors
of individuals and families. involves working in conjunction with
natural, informal support and helping networks within culturally
diverse communities. Source: National Center for Cultural
Competence, Foundations/Guiding Values and Principles
http://nccc.georgetown.edu/foundations/frameworks.html
Slide 11
Values and Guiding Principles for Linguistic Competence
Services and supports are delivered in the preferred language
and/or mode of delivery of the population served. Written materials
are translated, adapted, and/or provided in alternative formats
based on the needs and preferences of the populations served.
Interpretation and translation services comply with all relevant
Federal, state, and local mandates governing language access.
Consumers are engaged in evaluation of language access and other
communication services to ensure for quality and satisfaction.
National Center for Cultural Competence, Foundations/Guiding Values
and Principles Source: National Center for Cultural Competence,
Foundations/Guiding Values and Principles
http://nccc.georgetown.edu/foundations/frameworks.html
Slide 12
Culture influences the way people interact with health and
mental health care systems including: Participation in health
prevention and promotion programs Access to health information and
services Choices and decisions related to health and mental health
services Understanding of and priorities related to health and
illness Help-seeking behavior and adherence to recommended
treatment
Slide 13
Systems of care poorly designed for diverse populations Poor
cross-cultural communication between providers and patients
Patient/client fears and distrust Cultural stigma Lack of diversity
in health care leadership and workforce
Slide 14
Why should your organization implement the CLAS Standards?
EVIDENCE INDICATES IMPROVEMENT Care Services Supports Outcomes
EffectivenessAccessSatisfactionAcceptability Slide Source: 2011 -
National Center for Cultural Competence
Slide 15
gain knowledge about cultural values and beliefs of the patient
and apply that knowledge in a health care context. interact
effectively with people whose cultures and belief systems are
different than your own. provide quality care that is respectful
and nonjudgmental. deliver health care, services, and supports in
the primary languages spoken be patients/clients and their families
identify and respond effectively to the preferences and needs of
populations served.
Slide 16
The remainder of this Webinar series will discuss each Standard
and strategies organizations might pursue to implement CLAS. We
will use the case studies that we asked you to download when you
registered to illustrate various points. This Webinar series is
designed to increase your awareness and knowledge of how you
deliver care. Remember, how patients/clients see you may not be how
you see yourself.
Slide 17
Slide 18
Provide effective, equitable, understandable, and respectful
quality care and services that are responsive to diverse cultural
health beliefs and practices, preferred languages, health literacy,
and other communication needs. Creates a safe/welcoming environment
appreciation of diversity/focuses on patient-centered care
Individuals receive services in a culturally and linguistically
appropriate manner to enable them to meet their communication
needs/understand their care & participate in their care To
eliminate discrimination and disparities 18
Slide 19
Provide processes to ensure staff are trained on the civil
rights laws that affect equitable healthcare service delivery
Develop policies and procedures to ensure patients are provide
information on their rights to receive health care services that
address that cultural and linguistic needs Institute cross-cultural
training for front-line and clinical staff on the health care needs
of cultural/linguistically diverse populations
Slide 20
Advance and sustain organizational goverance and leadership
that promote CLAS and health equity through policy, practices, and
allocated resources.
Slide 21
Implementation Strategies: Develop a mission statement/core
values/vision statement-that promotes health equity Seek commitment
from top board, management leadership Management/board should set
policy/program goals, development of strategic plan of promoting
organizational diversity, providing CC care, eliminating health
disparities; written policies, practices, procedures, programs,
etc. Provide fiscal, human resources, tools, skills, and knowledge
to support a culturally competent organization. 21
Slide 22
Recruit, promote, and support a culturally and linguistically
diverse governance, leadership, and workforce that are responsive
to the population in the service area.
Slide 23
Obtain patient feedback on their preference for patient-
provider concordance (e.g. race, ethnicity, language, sexual
orientation, gender, gender identity). Assess the degree to which
staff demographics match patient preferences.
Slide 24
Establish staff diversity as recruitment, hiring, and retention
goals for your organization. Post notices of job announcements and
vacancies in forums, venues, and in varied languages to increase
the likelihood of attracting diverse applicants. Where possible,
recruit and hire qualified individuals (including past and current
patients/clients) of the populations and communities impacted by
the HIV epidemic. Assist individuals from culturally and
linguistically diverse groups to complete required training needed
to qualify for varied positions within the health and/or mental
health care setting.
Slide 25
Provide ongoing training and mentoring to all staff, including
new hires, to enhance their cultural competency and their capacity
to communicate effectively cross-culturally (including but not
limited to patients/clients and their families who speak languages
other than English, those who have disabilities, and individuals
who are deaf or hard of hearing). Include criteria for cultural and
linguistic competence in staff performance evaluations. Provide
staff with an open and safe forum and a process to raise and
address issues related to individual and the organizational
capacity to deliver culturally and linguistically competent
services.
Slide 26
Educate and train governance, leadership, and workforce in
culturally and linguistically appropriate policies and practices on
an ongoing basis.
Slide 27
Periodically query staff about their perceived learning needs
in the area of cultural and linguistic competence. Designate
interested and knowledgeable staff the responsibility of
coordinating in-service training/professional development. Provide
cross- and discipline-specific training in cultural and linguistic
competency that is responsive to staffs expressed interests, needs,
and learning styles. Keep abreast of current trends and emerging
evidence about culturally and linguistically competent care to
include in all in- service training and professional development
efforts.
Slide 28
Staff performance evaluations should include criteria that
addresses active participation in and completion of
training/professional development activities. Support professional
development by offering varied modalities for learning (e.g.
Web-based, self-directed and self-paced curricula, coaching and
mentoring, continuing education, journal/book clubs, discussion
groups). Address cultural and linguistic competency as a routine
component of staff meetings and retreats. Establish meaningful
incentives and special recognition awards for cultural and
linguistic competency within the organization.
Slide 29
Offer language assistance to individuals who limited English
proficiency and/or other communication needs, at no cost to them,
to facilitate timely access to all health care and services.
Slide 30
Conduct an annual assessment of languages (other than English)
spoken within the geographic locale served by the organization to
ensure language access. Include data on the population of people
who are deaf or hard of hearing. Update the organizations language
access plan on an annual basis. Ensure that there are adequate
resources (fiscal and personnel) for the provision of language
access services. Ensure that all staff are knowledgeable of
organizational policy, procedures, and practices for language
access, including individual responsibility according to job
function.
Slide 31
Ensure that language access services include sign language
interpretation. Ensure that all legally binding documents are
professionally translated into the languages spoken by the
patient/client population. Such documents may include, but is not
limited to, consent forms, confidentiality and patient rights
statements, release of information, eligibility and applications
for services. Ensure that medical orders, patient education, and
health/mental health promotion resources are translated into the
languages spoken by the patient/client population. Such documents
should also be offered in Braille.
Slide 32
Inform all individuals of the availability of language
assistance services clearly and in their preferred language,
verbally and in writing.
Slide 33
Post signage in prominent locations stating patients/clients
rights to receive language access services (at no cost) in the
health/mental health facility. Ensure that staff provide both
verbal and written notification of patients/clients rights to
receive language access services at no cost.
Slide 34
Case Presentation: More than Language
Slide 35
National Center for Cultural Competence, Georgetown University
Medical Center
Slide 36
National Center for Cultural Competence, Georgetown University
Medical Center Goulda Downer, Ph.D., RD, LN, CNS - Principal
Investigator/Project Director (AETC-NMC) Josepha Campinha-Bacote,
PhD, MAR, PMHCNS-BC, CTN-A, FAAN I. Jean Davis, PhD, DC,PA Denise
Bailey, MEd.
Slide 37
National Center for Cultural Competence, Georgetown University
Medical Center