Thesis: Is Diversity Important in Healthcare Organizations?

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¶ … Diversity Important in Health Care?

COMING TO TERMS WITH MULTICULTURALISM

Is Diversity Important in Healthcare Organizations?

One out of four persons living in the U.S. has a different racial or ethnic origin. There are 75 million of them today and increasing every year. The American workforce and its health needs are consequently turning more and more culturally diverse in character. Two of the goals of the Healthy People 2010 equate health and well-being within a cultural context and challenge healthcare professionals to promote culturally responsive care. Healthcare disparities continue to exist among culturally diverse groups but the direction appears irreversible to enforce this new value.

Introduction

Recent statistics reveal that 30% of the American population has culturally diverse origins and the trend has been increasing. Two of the goals of the Healthy People of 2010 support the well-being and health of ethnic and racial minorities. The Institute of Medicine also endorsed this new value for health professions and organizations. The Sullivan Commission likewise made the endorsements to educational institutions. Disparities in the healthcare system have reportedly remained but these trends clearly indicate the importance of cultural diversity in healthcare organizations.

Methodology and Literature Review

Methodology

This study uses the descriptive-normative research method in recording, describing, interpreting, analyzing and comparing data from recent and authoritative sources.

Literature Review

Business Wire (2009). Healthcare Disparities at the Community Level. Business Wire: CBS Interactive, Inc. Retrieved on June 17, 2009 from http://findarticles.com/p/articles/mi_mOEIN/is_20090506/is_n31633838/?tag=content;col1

Senior Vice President David Costello of Consumer Segmentation and Engagement, in his new white paper, writes on how to serve higher-cost members, especially underserved communities and still reduce overall costs. His new white paper is entitled "Doing Well by Doing Right: Fairer Healthcare can lead to Lower Costs." He writes that the members' experience of their world and healthcare within this world is central to the mission of Health Dialog, the publisher of the white paper. Health Dialog says that through customized messaging in the community level can effectively identify, target and connect with members who experience healthcare disparities. Costello elaborates that dealing with these members within the communities will not only improve the quality of care but also reduce overall costs.

Health Dialog is a subsidiary of Bupa, a global provider of healthcare services, such as health coaching for medical decisions, chronic conditions, and wellness, population analytic solutions and consulting. Individuals can participate in their healthcare decisions, form more effective relationships with their physicians and live well-rounded lives through Health Dialog.

AHRQ (2007). The National Healthcare Disparities Report, 2006. Agency for Healthcare

Quality and Research. Retrieved on June 18, 2009 from http://www.ahrq.gov/qual/nhdr06/nhdr06.html

The bottom line in this Report is that disparities still pervade the American healthcare system in the racial, ethnic and socioeconomic realms. These disparities permeate all the system's aspects -- quality, access, levels, types, clinical conditions and care settings. Impact on quality affects quality effectiveness, patient safety, timeliness and patient centeredness, among others; on access, facilitators and barriers to care and healthcare use; on levels and types, preventive care, treatment of acute conditions and management of chronic disease; clinical conditions include cancer, diabetes, end-stage renal disease, heart disease, HIV, mental health, substance abuse, and respiratory disease; and on care settings, primary, home health care, hospice, emergency departments, hospitals and nursing homes.

The most affected subpopulations are women, children, elderly, rural residents, the handicapped, those with special needs, ethnic minorities and the poor. Blacks, Asians, American Indians and Alaska Natives, and Hispanics receive poorer quality care than Whites. The poor also receive lower quality care than the high-income individuals.

Blacks, Asians and Hispanics experienced discrimination in securing preventive services, treatment of acute illness, management of chronic disease and disability, timeliness and patient centeredness.

This Report provides new information on obesity, asthma management, hospice care, patient safety, patient centeredness in hospital care, workforce diversity, Hispanic subpopulation, language assistance and un-insurance. However, it admits that gaps still exist.

Many healthcare educational and service providers now address multicultural diversity. They are made up of organizations and individuals who subscribe to their clients' cultural values, beliefs and practices. They are thus equipped to provide culturally acceptable care. They can systematically evaluate each client and provide individualized care, promote health and prevent disease. It thus becomes imperative that these organizations become culturally knowledgeable and competent in order to serve these clients.

Jeffreys, M.R. (2005). Clinical Health Specialists as Cultural Brokers, Change Agents and Partners in Meeting the Needs of Culturally Diverse Populations. Journal of Multicultural Nursing & Health: Riley Publications, Inc. Retrieved on June 17, 2009 from http://findarticles.com/p/articles/mi_qa3919/is_200507/ai_n14825639/?tag=content;col1

Jeffreys delves into the ever-rising trend in cultural diversity in the United States partly because of the increasing number of immigrants, refugees, and individuals with multiple racial origins in the workforce. Recent statistics show that one out of four persons living in U.S. belongs to a racial or ethnic minority group or more than 75 million people in all. Furthermore, more than one million immigrants enter the U.S. every year, indicating that the U.S. is becoming more and more culturally diverse. This population trend makes culture a compelling element in healthcare and in the workforce. Furthermore, two goals of the Healthy People 2010 require cultural considerations in healthcare. One states that "quality of life" and "health and well-being" can be achieved only within the cultural context. The other seeks to eliminate health disparities in the diverse population. This position challenges healthcare professionals to promote culturally responsive care. The clinical nurse specialist, in particular, is called to function as a positive change agent and a visionary leader in the three spheres of influence. These are patient/client, nursing personnel, and organization/network.

The clinical nurse specialist or CNS is uniquely positioned to provide care to a continuously enlarging multicultural workplace and diversifying and global 21st century society. In order to fulfill the function, she must acquire cultural competency and update her knowledge of innovative strategies. Acquiring this competency is a complex, multidimensional, continuous and dynamic process for which many conceptual models are available. In her performance within the three spheres of influence, she functions directly as a cultural broker, change agent, collaborative partner and visionary leader while meeting the healthcare needs of her culturally diverse clients or patients. In the first sphere of influence, that is, with her patient, the CNS systematically assesses the dynamic patterns and cultural dimensions of the patient's particular culture, subculture or society. These dimensions include religious, kinship, political, economic, educational, technologic, and cultural aspects. She inter-relates these aspects to influence the patient's behavior within the given environmental context. She considers and examines the patient's cultural similarities and differences with other cultures. In the second sphere of influence, she fills the gap in culturally competent care and in workplace harmony. Her actions in this sphere include consultation and collaboration with a trans-cultural nurse generalist to help other health practitioners develop greater awareness, sensitiveness and cultural competence in handling diverse patient populations. Their cooperation can result in a series of personnel workshops on general trans-cultural principles and concepts and the process of cultural competence. And in her third sphere of influence, the CNS may effect a positive change in her collaborative effort with trans-cultural nurse leaders. She can plan, implement and evaluate program impact according to outcomes and satisfaction in the workplace. She becomes a change agent by identifying necessary changes in organizational policy on ethnic or racial group categories and policy alternatives. She may also initiate a scrutiny of assessment tools for culturally insensitive or adverse effects. She and a trans-cultural nurse may help provide cultural congruent care to the organization.

Purnell, L. (2005). Purnell Model for Cultural Competence. The Journal of Multicultural

Nursing & Health: Riley Publications, Inc. Retrieved on June 17, 2009 from http://findarticles.com/mi_qa3919/is_200507/ai_n14825638/?tag=content;col1

The Purnell Model of Cultural Competence can serve as guide for achieving cultural competence in many primary, secondary and tertiary settings. It can help an organization systematically appraise each client and individualize care. It uses the 12 domains of culture, needed to assess the cultural attributes of a person, family or group. These are overview, locality and topography of the subject; communication; family roles and organization; workforce issues; bio-cultural ecology; high-risk behaviors; nutrition; pregnancy and childbearing practices; death rituals; spirituality; and healthcare practices. Response to pain and the sick role may be added.

The Model also presents and discusses the primary and secondary characteristics of culture. The primary characteristics are nationality, race, color, gender, age and religious affiliation. These cannot be easily changed. The secondary characteristics include educational status, socioeconomic status, occupation, military experience, political beliefs, place of residence, enclave identity, marital status, parental status, physical characteristics, sexual orientation, gender issues, reason for migrating and length of time of stay away from native country.

Alabama Nurse (2004). ANA Review: Institute of Medicine Report on Workforce Diversity, 2004. Alabama State Nurses' Association: ProQuest Information and Learning Company. Retrieved on June 17, 2009 from http://findarticles.com/p/articles/mi_qa4090/is_200403/ai_n9465495/?tag=content;col1

Impelled by the perceived societal need for an increasingly diverse and culturally competent healthcare workforce, W.K. Kellogg Foundation asked the Institute of Medicine to review… [END OF PREVIEW]

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