Going to the doctor’s office for a non-emergency related cause is fairly stress free for me. Sure, I might be bothered by whatever cold or ailment I think I’ve caught, but I am able to easily drive there. Filling out forms and billing information is easy when I know that I’ll have coverage. When I meet the doctor, we easily communicate because we both speak the same language. I am able to understand what they are saying and ask questions when I need to. These are all things that seem simple and I often take for granted. I was reminded how this is not the case for a lot of people in America after hearing a local executive speak. In our Management class we recently heard from the CEO of a Federally Qualified Health Center. This CEO discussed how his facilities serve very diverse populations. Over 60% of his patients at one facility do not speak English as a first language. This makes it critical to have interpreters and care that focuses on being culturally competent. His facilities also provide care no matter if the person can pay or not. You could clearly see this CEO was truly passionate about the work he does serving the communities that need it most. After listening to this CEO speak I was interested in looking into the benefits of culturally competent care and what role it plays within an organization. The Commonwealth Fund did research into the importance of culturally competent care and found that not only does it decrease disparities in care, but that it can also improve quality of care across an organization. The article quotes an Administrator for the U.S. Department of Health and Human services who said, “What we’re talking about in terms of cultural competency...is providing quality care to individuals who in the past have not received it...and when I think of quality care, that’s what we're looking for for all Americans”’ Cultural competence is a key part to improving the quality of care in an organization. Although it may not be as easy to measure as reimbursement rates or patient encounters, it is invaluable when it comes to providing patient-first care. I hope to continue learning more about cultural competency and how to implement best practices into an organization.
Link to The Commonwealth Fund’s Report:
http://www.commonwealthfund.org/usr_doc/betancourt_culturalcompetence_576.pdf
Language and cultural differences can be a big barrier to productive healthcare communication. Joint Commission requires hospitals to provide translators (either bilingual staff, videoconference with certified contractor, etc.). The challenges I've encountered include trying to consent a deaf patient for a labor epidural at 2 a.m., where I don't have any sign language translator available. The legal challenge: is it appropriate to use the husband to sign for me in the consent process? (I never got a clear answer to that question). Yes, the patient can read and ultimately put their signature on the consent form, which is packed with dense legalese, but I'm challenged with answering questions they might have about the consent. But then I'm faced with doing the anesthetic pre-procedure evaluation, for which the patient has nothing to read.
ReplyDeleteAnother cultural challenge where the happy medium is sometimes difficult to find: being called to place a labor epidural at 2 a.m. in a Muslim woman married to man who forbids another man from touching his wife. They are insisting on an all-female healthcare team. Well, at 2 a.m. it's just me available as the on-call anesthetist. At what point do the patient's rights and wishes get superseded by the realities and practicalities of the hospital's resources. In my particular situation the Muslim patient refused to consent to me placing the epidural, and she ultimately went through labor getting just I.V. pain medication (a poorly effective method). And then they filed a complaint against the hospital.
As you go into management, you will be periodically faced with these challenges where there is no clear-cut easy answer. It's good you're being exposed to these murky healthcare situations as a student and can consider how you might address them. It can be a dance between the patient's rights, hospital resources, practicality, law, Joint Commission standards, time, and other considerations.
Thank you for sharing these different situations! It really puts into perspective how sometimes there is no clear right answer. I will continue to think about these tough situations and how I might approach them as a future professional. As always, thanks for the food for thought!
DeleteGlad you enjoyed our guest. It's inspiring to spend time with people like him.
ReplyDelete