Communicating Across Cultural and Language BarriersRicky Winardi, MD, MPHChief of Diversity and Multicultural Care, NVLYPrimary Care ConferenceOctober 17, 2009
Disclosure of Relevant Financial RelationshipsDisclosure of Relevant Financial Relationships
Dr. Winardi has disclosed that he has no relevant relationships with commercial or industry organizations.
The CME Department has reviewed disclosure information for the planners and developers for this program and they do not have relationships that present a relevant conflict of interest.
OBJECTIVES
* Sharing practical tips for effective communication across cultures
* Introducing “red flags” that might indicate limited health literacy
* Providing access to language and culture resources
Health Literacy
October is Health Literacy Month
Scope of the problem: 1 in 5 illiterate, average reading skills in 8th-9th grade
Low health literacy leads to increased risk of serious health outcomes
JCAHO study: 80% of medical errors are due to communication breakdown
Key risk factors for limited literacy
Elderly
Low income
Unemployed
Do not finish high school
Minority ethnic group
Recent immigration to the US
US-born with English as second language
Behaviors that may signal limited literacy
Incomplete forms
Frequently missed appointments
Non-compliance with medication regimens
Lack of follow-through with tests/referrals
They say that they are taking medications, but lab tests or other parameters do not change in the expected fashion
Responses that may signal limited literacy
“I forgot my glasses. I’ll read this when I get home” or “Can you read this to me?”
“Let me bring this home so I can discuss it with my children”
Unable to name medications
Unable to explain what medications are for
Unable to explain dosing of medications
Suggested questioning
“How happy are you with the way you read?”“What is the best way for you to learn new
things?”“How confident are you filling out medical forms
by yourself?”“How often do you need to have someone help you
when you read instructions, pamphlets, or other written materials from your doctor or pharmacy?”
Tips to improve interpersonal communication
Slow down
Use plain, non-medical language
Show or draw pictures
Limit the amount of information provided and repeat it
Use the “teach-back” technique
Create a shame-free environment
Plain language alternatives to medical terms
Anti-inflammatory
Benign
Enlarge
Heart failure
Lipids
Monitor
Referral
Toxic
Lessens swelling and irritation
Not harmful
Get bigger
Heart not pumping well
Fats in blood
Keep track/an eye on
Send to another doctor
Poisonous
Important values in Latino/Hispanic cultures
Familismo: family and community are the center of society
Respeto: respect based on age, gender and status
Personalismo: genuine concern for another person
Esmero: attention to personal appearance
Resources
Diversity Roundtables
Diversity Conferences
KP Diversity
Provider Handbooks
KP Multicultural Staff Associations
Language Assistance Services
!Muchas gracias!
Cultural competency is a journey throughout a lifetime, not a goal or an achievement.
Please feel free to email or call me: Phone 8-416-6525 at Fair Oaks
Email: [email protected]
Recommended