Cultural Competence training and Patient Care Associates: A Way to Improving Patient Cultural Competence training and Patient Care Associates: A Way to Improving Patient Satisfaction ScoresSatisfaction Scores

Paule Joseph, BSN, RN-BC, CRRN, ASLNC-CThe Mount Sinai Hospital ● New York, New York

The purpose of this project is to pilot an educational program for Patient care Associates (PCAs) at The Mount Sinai Hospital with the aim of improving patient care.

PURPOSE

IMPLICATIONS FOR NURSING PRACTICE

ACKNOWLEDGEMENTS

BACKGROUND AND SIGNIFICANCE

Cultural Competence has become an important topic. It is said that by the year 2042 minorities will account for nearly half the population. Our country is increasingly more culturally and linguistically diverse, and disparities in health care access, health outcomes, and health status are major issues (Swirsky, 2009).The topic of cultural competence has become well-known issue for three reasons: 1- the United States has become more diverse, 2-research has shown that culturally appropriate provider-patient communication is linked to patient satisfaction, adherence to medical instructions, and better health outcomes and 3-the Institute of Medicine (IOM) reports stresses the importance of patient-centered care and cultural competence in improving quality and eliminating racial/ethnic health care disparities (Betancourt, et. al, 2005).Cultural Competence refers to the ability to provide health care measures that are congruent with patient needs by: 1-Accepting and respecting differences and 2- Not allowing one’s personal belief to have an influence on those whose worldview is different from one’s own ( Ginger et al, 2007).

• Increase awareness and sensitivity toward diverse patient populations is a first step in understanding culturally influences health behaviors at The Mount Sinai Hospital .

• Development of Cultural Competence training for PCAs can assist in improving the quality of care for diverse patients in New York City.

• It will help to validate the role and importance of PCAs in improving patient satisfaction scores

• The importance of culturally focused PCAs education in direct relation to patient’s experiences and satisfaction

• Development of Cultural Competence training for PCAs helps to respond to demographic changes; eliminating disparities in the health status of people of diverse, ethnic & cultural backgrounds; improving quality of services and outcomes; gain a competitive edge in the marketplace.

DOCUMENTATION DEVELOPMENT/METHODOLOGY

DOCUMENTATION DEVELOPMENT/METHODOLOGY (Cont’d)

FUTURE GOALS

• Marilyn Jaffe-Ruiz, EdD, RN for her continued support and encouragement. Professor, the Lienhard School of Nursing, Pace University.New York, NY

• Patricia Reineke, PhD, RN for helping identify the needs of teaching the PCAs about Cultural Competence. Assistant Professor, The Henry P. Becton School of Nursing & Allied Health, Fairleigh Dickinson University. Madison New Jersey.

• Virginia Defina, NP, RN, Nurse Educator at The Mount Sinai Hospital for her contribution during the implementation process and her continued support and The Nursing Education Department of Mount Sinai Hospital for allowing current training of PCAs during orientation.

• Development of researched based education materials.

• Implementation of Cultural Competence training for the Patient Care Associates in BEST Orientation.

• Embracement of the Cultural Competence concept in the PCAs orientation to teach them how to provide cultural based care to patients admitted to the institution.

• Present initiative in Nursing Grand Rounds.

• Start data collection to analyze the impact of Cultural Competence Classes.

• Target PCA population not previously taught-prior to initial cohort.

Prior to the educational intervention, the following questions were asked to gain a general understanding on their views of culture:

• Where are you from?• What languages do you speak? • What cultural values do you have? • What holidays do you celebrate? • What do you do when you have cold or start feeling sick?, How do you see death and

dying? • How does your culture view time?• What do you think you would need to know to work with people of different backgrounds?• Do you have close personal relationships with people who are culturally and socio-

economically different?• Do you have the desire to integrate culturally relevant considerations into your work? And • How do your own cultural experiences and values impact they way you work?

The educational tool used were PowerPoint presentations that included videos. The videos presented showed the language as a barrier in communication in health care.

This project was part of collaboration between The Department of Nursing, The Mount Sinai Hospital and The Lienhard School of Nursing, Pace University. Graduate students had the opportunity to participate in the Cultural Competence Class, in which I became interested in developing this project. This project focused on:

• Assessment of demographic data for the population being served by Mount Sinai

• Development of PICO question: Does providing patient care associates (PCAs) with cultural competent training improve patient’s satisfaction scores?

• The project assessed the needs of the patient care associate in learning about culture.

• Assessed baseline knowledge and cultural experiences of PCAs

• Piloted a educational program on cultural competence for a group of newly hired PCAs at the hospital as part of the hospital’s BEST orientation

• A literature review was conducted to identify the current research in the influence of patient care associates training on culture and direct effect on patient satisfaction scores.

REFERENCES

• Betancourt, J., et al. (2005). Cultural Competence And Health Care Disparities: Key Perspectives And Trends. . Journal of health Affairs. 24, 2, p499-505.

• Challenges Encountered When Teaching Cultural Competence, http://medscape.com.

• Gardner, Marilyn. (nd). Communicating Across Boundaries: Beliefs and Barriers. http://www.diversityrx.org

• Giger, J. et al. (2007). American Academy of Nursing Expert Panel Report: Developing cultural competence to eliminate health disparities in ethnic minorities and other vulnerable populations. Journal of Transcultural Nursing. 18 (2): pp 95-102.

• Swirsky, L. (2009). Disparities. In covering Health Issues. 5Swirsky, L. (2009). Disparities. In covering Health Issues. 5thth Eds. Eds. The Alliance for Health ReformThe Alliance for Health Reform. Retrieved from www.allhealth.org. Retrieved from www.allhealth.org

• The State of Health Care Diversity and Disparity : A Benchmark Study of U.S. Hospitals, Institute for Diversity in Health Management, October 2008.