Cultural beliefs affect people’s healthcare practices and their health seeking behaviors.
by Kerrin Henshaw – Wednesday, 3 April 2024, 1:05 PM
Number of replies: 0
Introduction
Cultural beliefs affect people’s healthcare practices and their health seeking behaviors. Often, an individual will not seek healthcare related to the culture of the health care organization that provides treatment (Andrews & Boyle, 2016). The culture of healthcare organizations create cultural barriers that increase the lack of trust and reluctance that individuals have in seeking the care that they need (Andrews & Boyle, 2016). Conversely, an organization that focuses on cultural competence facilitates trusting healthy relationships that reduce health inequalities and disparities (Andrews & Boyle, 2016). An organizational cultural care assessment was conducted at Vassar Brothers Medical Center (VBMC) looking at three influential factors, these included language, technology, and education.
Language and Ethnohistory Assessment with Proposal
The primary language spoken at VBMC is English. Many employees speak additional languages, these include Spanish, Russian, Chinese, Thai, Punjab, and French. The lines of communication are both formal and informal. The dissemination of information occurs through discussions, townhall meetings, informational sessions, and casual conversations. Memos, emails, posters, and the hospital web page are additional methods used to communicate information. Each unit hosts a “take five” where specific unit concerns are discussed daily. Verbal communication is the most effective way of dispersing information. Between providers and nursing staff, the hospital provides a secure method of texting to quickly communicate the needs of the patients. There is a hierarchical governance in the hospital including many layers of associate managers, managers, and directors that report to the chief nursing officer and the hospital president. The hospital is a part of a network of five different institutions that have an additional governing hierarchy. In general, the network of health systems has slowed down the process of change. A change made at one hospital is expected to be made throughout all five facilities. Getting the five hospitals to agree has proven to be a difficult task. VBMC opened in April of 1897 and treated 80 patients in its first year. Over more than a century, the hospital has exponentially expanded in size and treatments serving people in the city of Poughkeepsie, and surrounding communities (New York Heritage Digital Collections, n.d.). The focus on serving the community remains a focus of VBMC. A new hospital was constructed and opened in 2021. The new building is twice the size of the original. The new hospital was constructed to meet the demands of current technology and needs of the growing community.
The US Department of Health and Human Services’ Office of Minority Health developed CLAS, which stands for Culturally and Linguistically Appropriate Standards (CLAS) in health care. These standards address health disparities created by race, ethnicity, and language and it provides suggestions for improvement and accountability for healthcare institutions. One proposal includes offering language assistance to those who do not speak the primary language (Office of Minority Health, U.S. Department of Health and Human Services, n.d.). Having an interpreter service, and diversity of staff members can ease the difficulties experienced with translation. At VBMC, it is challenging to find the translation device at the hospital as there are not many available for use. Providing more of these devices would ensure adequate communication with patients who are not fluent in English.
Technology Assessment with Proposal
The hospital relies on technology for many daily functions and all staff members use technology in different forms. Providers document electronically and use computerized order entry. All employees have access to email, and most of the workstations have computers. Technology in VBMC goes beyond computer systems, current treatments often require the use of new medical devices. Each specialty unit has the technology and equipment specific to the vital functions of the unit. For example, in the emergency room this includes a machine for massive blood transfusions, a “Lucas” device for prolonged CPR, Istat machines for emergent bedside lab work. More technology is in place in the critical care areas including intra-aortic balloon pumps, Impella heart support devices, continuous dialysis machines, and machines for ECMO and EKOS therapies. As new cutting-edge treatments and technology become available, the hospital purchases and educates the staff on its use. Although the hospital commits to new therapies, current equipment remains in use until it is beyond repair. The new hospital building is furnished with repurposed equipment from the old building. Often, the equipment is broken and is not replaced until parts cannot be purchased for necessary repairs. The management team is responsible for purchasing equipment and needs to remain within a set budget when doing so.
Technology can be challenging and create health inequalities for patients that have limited access to broadband and for those who struggle using different devices. While the hospital utilizes state-of-the-art equipment, the patients may not have the capacity to manage this advanced technology. A proposal to improve cultural competence in technological literacy includes providing patients with a resource for technological support (Yao et al., 2022). This service will allow those patients that struggle with technology the ability to build their confidence and skills to manage devices that provide them better health outcomes (Yao et al., 2022).
Education Assessment with Proposal
The advancement of technology requires ongoing education. A well-educated work force is key to improving the quality of health to the population served. Ongoing education provides current knowledge of evolving practices and skills that expand perspectives on practices that promote disease prevention and improve general wellbeing (Dickerson, 2023). While education is necessary, it is not often a primary focus in healthcare institutions. At VBMC staff members that wish to attend classes, seminars, and training sessions must do so in addition to working their required shifts. Educational pay is provided, however the staff are instructed not to exceed 40 hours in a work week, to avoid overtime fees. Classes are offered to prepare nurses for certifications, and the fee for the exam is reimbursed only if a passing grade is obtained. Certified nurses are paid a differential, however there is a limit of two pay differentials for all certifications obtained. This does not encourage the staff to obtain certifications in the different service lines that the hospital provides. Bachelors prepared nurses do have a pay differential for their degree. The hospital does provide clinical learning experiences for medical, nursing, and many other healthcare professional students. The students are valued at the hospital. They are respected for their input, knowledge, and different perspectives in providing patient care. Advanced Practice Nurses are utilized in many different areas in the hospital. This includes the ICU, hospitalist team, Cardiothoracic surgery, and emergency room. There is a tuition reimbursement plan offered for nurses who wish to further their education. The reimbursement is not sufficient as it does not cover the full cost of two classes per year at Mount Saint Mary College. The educational background of the staff nurses includes those with associates, bachelors, and masters educated nurses. Nurse managers and leaders are expected to be educated at the master’s level. Competing hospitals demonstrate the same level of educational background for the nursing staff. Licensed practical nurses are not utilized, and only nurses with associate, bachelors, and master’s degrees provide patient care.
Education is a shared responsibility of the individual and the healthcare organization. The individual needs to be accountable for their current practice and knowledge base as the profession continues to evolve and change. The healthcare organization is responsible for promoting a learning environment that is supportive of ongoing professional development and learning (Dickerson, 2023). The healthcare organization culture shapes the perception of continuing education. A supportive environment motivates learning and education. When there are perceptions of barriers such as scheduling and reimbursement, professional development is viewed negatively. To promote lifelong learning, organizations need to make education more accessible, realistic, and relevant to engage more providers (Mlambo et al., 2021). This can be accomplished by encouraging staff members to attend seminars and make accommodations with scheduling to facilitate attendance. Time should be allocated for education and all employees should be expected to attend seminars in their specialty field.
Conclusion
Healthcare providers are facing many different challenges as the population ages and becomes increasingly more diverse. To provide culturally competent care an organizational assessment should be conducted. This assessment can aid in identifying the needs of the community and how the hospital culture can best meet the healthcare demands. This paper assessed the factors of language, technology, and education at VBMC. It was identified that there is potential to improve the delivery of care by providing better access to interpreter services, by providing technological assistance, and by improving access to education for the hospital’s employees. To be culturally competent, healthcare facilities need to respond to the diverse cultural needs of the population served. Performing ongoing assessments helps identify these needs and facilitate access to quality healthcare.
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