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  1. Which health services providers have community outreach programs?
    1. Carolina’s Medical Center
    2. Novant Health
  2. What services are provided in these programs?
    1. Blood Drives
    2. CMC: Charitable Giving: United Way of Central Carolinas and The Arts and Science Council
    3. Novant: Charity Care, Discount for the Uninsured, Catastrophic Discount, Flexible Payment Plan
    4. Health Education and Wellness: Learn Well. Be Well, Run for Fun & Fitness, Maya Angelou Women’s Center, Health Fairs and Screenings, Lunch and Learns
    5. Improving Neighborhoods: Community Land Donation, Meals on Wheels, Carolina Raptor Center, Adopting Families
    6. International: World Medical Mission, Javorski Hospital Partnership
  3. Who are the collaborative partners (partnerships, other service providers)?
    1. Local Businessess (Fleet Feet)
    2. Cherokee County Meals on Wheels
    3. Carolina Raptor Center
    4. Missionary Groups
    5. Hospitals in International Countries
    6. Local Agencies
    7. Presbyterian Medical Center
    8. Winston-Salem Hospitality House
  4. What demographic do they serve? Who uses the outreach programs?
    1. All types of demographics
    2. Kids, Adults, International Facilities, Individuals in the Carolina’s
  5. What is the benefit to the organization (why do they do it)?
    1. Market the hospital, benefit the community, philanthropy, creating a healthier tomorrow
  6. Could you identify mission, vision, and values for the outreach program? The host organization?
    1. Under each website and individual community outreach either a mission, vision, or value was implied or briefly stated
  7. How do outreach programs improve the health of the community?
    1. They get the community involved to better themselves and their community. They teach them about different aspects of health and exercise and how they could benefit from healthy eating and exercise.
  1. How do critical access hospitals provide benefit in these communities?
    1. Improve access to services, engage rural communities in rural health care system development, develop collaborate delivery stems in rural communities as the hubs of rural health care, create transitions of care coordination with urban health care system alignment.

Novant: http://www.novanthealth.org/Portals/92/novant_health/documents/about_us/financial/2012_community_involvement.pdf

CMC:http://www.carolinashealthcare.org/chs-community-relations-department

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Cultural Competency Reflection:

I did two self assessments I did one where I was asked about communication styles, values and attitudes, and one that I was asked if I thought the individual in the picture was honest, lazy, hard-working, or manipulative. I learned that I am good at having a clear sense of my own ethnic, cultural, and racial identity. I’m also good at understanding my professional or moral viewpoints may differ, I accept individuals and families as the ultimate decision makers for services and supports impacting their lives. I also was able to realize I’m poor at recognizing my own biases and judgments. Through a self-assessment on myself in cultural competence I was able to learn more about the assumptions and judgments I have placed on individuals that I was unaware of. I learned that I’m not as aware of my own biases and how they affect my thinking, as I would like to be. I greatly want to improve on this before I enter my leadership role. After this self-assessment I feel as if I’ll be more aware of my immediate response when I see certain individuals that way I can better assess which individuals I have certain prejudices for and how I can manage them when I engage with them. I also realized that through my three years of Spanish, I do recall various words, therefore if I come in contact with someone of LEP I will be able to communicate with them slightly. I would benefit from attempting to learn other key words that could directly relate to healthcare, so when I become a leader in a healthcare facility, I might check into receiving some sort of education that will allow me to better understand Spanish healthcare terms to help better my facility. I have always been one to stick up for others when they are being discussed in a racial, insensitive, or prejudice way. Having had a long-term relationship with someone of a different race, I was able to first hand encounter the rude and racial remarks that some individuals have to say. I would not tolerate this in my workplace and the staff member(s) that engage in this behavior would be reprimanded immediately. Through my self-assessment I was able to learn more about the respectfulness I give and fail to give to others and how I feel about others being treated inappropriately along with my biases.

As blatant as it is, one concept I learned more about was cultural competence. Yes, I grew up being taught “treat others the way you want to be treated” and how not to judge a book by its cover but I didn’t understand the basics of cultural competency. Cultural Competency is defined as “the ability to successfully adapt to an unfamiliar cultural setting and to use knowledge about other cultures to reshape one’s think and behavior to be more sensitive and responsive to cultural differences” (Chassiakos et al 59-60). I was able to better understand how cultural competence allows for an individual to obtain the ability to acquire and use the knowledge to improve their services, strengthen their programs, and to close off the gabs that are created in health status’ among diverse groups (Management Sciences for Health). In order to better you in cultural competence there is a series of tasks, steps, and techniques that could be put into place. Completing a self-assessment, avoiding stereotypes, being self-aware, taking the time to learn about different cultures, and rid yourself of biased assumptions.

I was also able to learn about pointers that were given by Robert C. Like on how to develop and maintain culture competence. Firstly, he stated that as clinicians they need to check themselves and be able to realize and become aware of personal attitudes, beliefs, biases, and behaviors that could influence the care or interactions that are given to patients, staff, coworkers, family members, etc. His other pointer discussed cultural humility, which is another concept I was able to learn more about. Cultural humility is “the ability to maintain an interpersonal stance that is other oriented in relation to aspects of cultural identity that are most important to the person” (Waters, Asbill). Cultural humility is a life long commitment. An individual has to consistently self evaluate and self critique. To understand this one has to understand there is no finish point in Cultural humility. There is always room to learn more. The other aspect is to fix power imbalances. Whether an individual is aware of it or not, people “sub consciously” stereotype others. By fixing power imbalances one is able to recognize that each person brings something different to the “proverbial table of life” this allows for the individual to see value in each person (Waters, Asbill). The last aspect is the individual has to aspire to develop partnerships with people and groups who advocate for others. This can allow for positive change and have an impact on the systems. I will definitely strive to obtain cultural humility in my career. I think it is important to note that there are subconscious stereotypes that we, ourselves, might not even be aware of. I want to rid myself of these stereotypes, and see everyone as they are. This will benefit me greatly in the work place due to healthcare being so diverse in the staff and patients. I understand that by obtaining cultural humility once must also be self-aware, so I will analyze and critique myself in the most honest way in order to get a better grasp on culture humility.

Another pointer Robert C Like gave was there is no one way to treat any racial and ethic group. This could relate to health disparities. Health disparities are defined as “health differences in individuals’ or the public’s health that can be ascribed to social, economic, or environmental factors (Chassiakos et al 60). Dr. Like suggests that instead of grouping people into these broad classifications instead a framework of interventions that can be individualized and applied in a patient-and family-centered fashion needs to be implemented (Management Sciences for Health). It is listed on the website of The Provider’s Guide to Quality and Culture that providers may order fewer diagnostic tests for patients that are of a different background because they lack the ability to understand them, or quite frankly they might not believe them, and vice versa the patient might not adhere to medical advice because they don’t understand or trust their provider. Also, African Americans may be less likely referred for cardiac catheterization than whites. This is an ongoing issue in healthcare, and I have no tolerance for it. When I’m a leader in healthcare one way to reduce healthcare disparities is going to be for a full time translator to be on service in order to help with language barriers that may result in a lack of understanding or trust between the medical staff and the patient, this will also reduce health disparities. Also by placing a mandatory class on cultural competence for all staff will allow for them to analyze themselves and better understand their subconscious stereotypes in order to disallow them from continuing. By building personal and organizational cultural competence can reduce health disparities by resulting in more successful patient education. Culturally competent clinicians gain the ability to target, adjust, and communicate health related messages to the patient more effectively, this could directly allow for more appropriate testing and screening. It will allow for fewer diagnostic errors because communication and trust is more efficient, less errors results in less paperwork and financial dues. It can lead to an avoidance of drug complications and a greater adherence to medical advice. I want the staff in my facility to understand that every individual has different beliefs when it comes to medical advice that should be respected within my facility despite their beliefs on it. The same goes with staff, staff members practice different beliefs on a daily basis, they should not be treated differently based on those beliefs. By learning more about health disparities, I will continue to use this in my career to make sure that my staff and myself are making ethical, non-judgmental, and fair decisions and interactions with coworkers and patients.

Another concept I was able to learn about was Limited English Proficiency, which is when an individual is unable to communicate effectively because they aren’t fluent in the English language and their primary language isn’t English. LEP patients are known to have fewer physician visits, a reduced receipt of preventative services, lower rates of satisfaction, miss appointments, and drop out of treatments (Management Sciences for Health). I wouldn’t want my facility to be unwelcoming to others who don’t speak the English language, as a leader in healthcare I would strive to make sure that there is a translator available at all times because it is proven that patients who spoke through an interpreter were more satisfied with their care. I would also want to make sure that others and myself don’t get frustrated with the patient due to the lack of sufficient communication.

I was also able to better learn about how demographics within the community affect outreach programs. In my individual community 30.6% of our overall population are people under the age of 18. Therefore, my community has a good deal of outreach programs that relate to children. In my county we have a high motor vehicle crash deaths rate (Cabarrus County). The mayor of my town actually lost a son due to a drunk driver in a motor vehicle crash; therefore we also have a lot of outreach programs discussing the importance of safe and sober driving.

Lastly, I learned how to manage my prejudices by Gail Price-Wise. Which is another thing I want to take into my leadership career. I need to accept that I will never get rid of my feelings toward a certain group of people. So in order for me to do this I have to be honest with myself, and learn to not trust that feeling when I’m responsible for treating and listening to this individual fairly. When these individuals try to ignore or deny these feelings they are the ones that are more likely to display them in public. That’s not what I strive to do, if I come across an individual who I feel differently about or have an established assumption about in my career and even personal life I want to be able to put those aside and engage with this person in an honest, professional, and fair way.

Through my learning of cultural competence I believe it not made me more aware of my established prejudices, or open my eyes to health disparities, but overall made me more self-aware of my actions and beliefs. I was able to look deeper into myself and my pre-established prejudices and question why I felt that way and how I could look past them in order to give this person a fair interaction. I feel as if working in customer service, restaurants, and being on college campuses, I have always looked past my prejudices and “managed” them in a way where it didn’t determine how my interaction with these individuals would go. I strive to carry this on throughout my continuing personal and professional life.

Sources:

Waters, Amanda, and Lisa Asbill. “Reflections on Cultural Humility.” http://www.apa.org. 1 Aug. 2013. Web. 13 Nov. 2014. <http://www.apa.org/pi/families/resources/newsletter/2013/08/cultural-humility.aspx&gt;.

Chassiakos, Rubino, and Salvador Esparza. “The Culturally Competent Leader.” New Leadership for Today’s Health Care Professionals: Concepts and Cases. Burlington, Mass.: Jones & Bartlett Learning, 2014. Print.

“Getting Started and Health Disparities.” The Provider’s Guide to Quality and Culture. Web. 13 Nov. 2014. <http://erc.msh.org/mainpage.cfm?file=1.0.htm&module=provider&language=English&ggroup=&mgroup=&gt;.

“Cabarrus County.” County Health Rankings & Roadmaps. Web. 13 Nov. 2014. <http://www.countyhealthrankings.org/app/north-carolina/2014/rankings/cabarrus/county/outcomes/overall/additional&gt;.

Cultural Competence: Managing Your Prejudices. Prod. Gail Price-Wise. Perf. Gail Price-Wise. Cultural Competence: Managing Your Prejudices. N.p., 07 Sept. 2009. Web. 13 Nov. 2014.

 

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