Cultural Competency

Mercy Care believes that as our community continues to grow and become more ethnically diverse, the care that we provide is constantly evolving and becoming more complex. In our system of care, providers are encouraged to become more culturally competent, as well as to recognize the importance of health literacy. Addressing member’s concerns according to their literacy and culture, as well as providing language access services and culturally competent care are the priorities of Mercy Care's Cultural Competence Department. To achieve this, Mercy Care has developed a Cultural Competency Plan that addresses the diverse needs of our system, fosters internal and external collaboration, and ensures provision of high quality language services at no cost to the member.

How you can help patients get optimal care

Over time, our health care system has become increasingly complex, and the care we provide is constantly evolving and becoming more complicated. Meanwhile, our community continues to grow more ethnically diverse. That’s why it’s incumbent on providers to make sure patients understand their care regimen.

There are two key things you can do to help ensure your patients get the best care possible and that they understand the care they’re receiving.

1. Become a more culturally competent provider

This means understanding different cultures, especially your patients’ cultures, and how they view and access health care services. Additional resources pertaining to Cultures and Spiritual Traditions can be found with the U.S. Department of Health and Human Services Office of Minority Health and the National Center for Biotechnology Information (NCBI).  

Despite advances in health care diagnostic and treatment protocols, disparities remain. For example, Blacks are more likely to experience heart failure, stroke and high blood pressure than other ethnic groups. And while minority women are less likely to be diagnosed with breast cancer than Whites, Black women are more likely to die from disease.

To learn more about specific health care disparities, visit Healthy People 

There are various causes behind disparities in health care. Health insurance policies and facilities locations contribute to these disparities as do lifestyles that may be common in some minority communities. So, what can you do?

As a health care provider, even unconscious clinical decision-making, stereotyping and bias can have an impact. Studies have shown that minorities are more likely to feel their preferences are not respected, to feel less of a partnership with their doctors and to be dissatisfied with their health care encounters.

It’s important to educate yourself on the meaning of culturally competent care and how to further develop your own cultural competence.

It’s important to understand some key traits of culturally competent providers. A culturally competent provider:

  • Is aware of his or her biases
  • Is knowledgeable about other cultures
  • Is aware of health disparities
  • Establishes common ground
  • Builds trust
  • Respects patients’ beliefs and values
  • Maintains and conveys unconditional positive regard
  • Uses interpreter services when needed

Source: National Medical Association

There are various models of cross-cultural communication. These models have been designed to provide doctors and nurses with simple, straightforward ways to view and approach patient communication.

One model is the LEARN approach:

  • Listen with sympathy and understanding to the patient's perception of the problem.
  • Explain your perceptions of the problem.
  • Acknowledge and discuss the differences and similarities.
  • Recommend treatment.
  • Negotiate treatment.

Following these simple steps helps bring patients into the decision-making process – a process minorities often feel left out of.

Training resources for our providers

As part of our cultural competency program, we encourage our providers to access information on the Office of Minority Health's A Physician's Guide to Culturally Competent Care. The American Medical Association, American Academy of Family Physicians and the American College of Physicians endorse this program, which provides up to 9.0 hours of category 1 AMA credits at no cost.

2. Recognize the importance of health literacy

Oftentimes, providers communicate at a level that exceeds a patient’s ability to comprehend. This can lead to errors, poor outcomes and even malpractice suits.

Health literacy refers to a person’s ability to obtain and understand basic health information and services and to follow instructions for treatment. It is estimated that more than one-third of American adults lack adequate health literacy.

Low health literacy rates are more common among the elderly, the poor, minorities and non-native English speakers. A more patient-friendly communication style — one that encourages questions — can help patients with limited health literacy better understand their diagnoses and therapies. Plus, it increases the chances of positive outcomes and lowers your risk of malpractice lawsuits.

 

Those with limited health literacy:

  • Report poorer overall health
  • Are less likely to make use of screening
  • Present in later stages of disease
  • Are more likely to be hospitalized
  • Have poorer understanding of treatment
  • Have lower adherence to medical regimens

If you or your staff notices that forms are incomplete or not filled out accurately, that a patient frequently misses his or her appointments, doesn’t comply with medication regiments or doesn’t get prescribed lab or imaging tests, the patient may have limited health literacy.

It’s important to make sure you engage in patient-friendly communication, using easy-to-understand language in both conversation and your written materials. Here are some things you can do to help patients understand their medical care.

10 tips for clearer patient communication:

  1. Ask patients to bring in their medications, so they don’t have to name them all during their appointment.
  2. Offer help in filling out forms.
  3. Make sure forms are provided in the patient’s language.
  4. Make sure any handouts are easy to read and understand.
  5. Speak more slowly.
  6. Don’t overwhelm the patient with too much information. Keep it short and simple.
  7. Avoid medical jargon.
  8. Consider showing or drawing pictures to aid in understanding.
  9. Ask patients to repeat your instructions, so that you can make sure they understand.
  10. Encourage questions. Using the Ask Me 3 program can help patients feel comfortable.

For more tips on communicating with patients and improving health literacy, download the manual for physicians, Health Literacy and Patient Safety

Source: Health Literacy and Patient Safety: Help Patients Understand, © 2007 American Medical Association Foundation and American Medical Association.