Spiritual Care and Cultural Competencies

Session 1Joint Commission and Cultural

Competencies: A Roadmap

Spiritual Care Champions 2012-2014 Catholic Health East

October 10, 2012

Beth Lenegan PhDDirector, Pastoral Care Department

Roswell Park Cancer Institute

Buffalo, New York

The first task in approaching

Another people

Another culture

Is to take off our shoes

For the place we are approaching

Is holy ground.

Else we may find ourselves

Treading on another’s dream.

More serious still, we may forget

That God was there upon our arrival-Author Unknown

Goal

• To provide an environment where patients, families and staff are treated with courtesy and respect regardless of personal characteristics including but not limited to race, age, sex, gender, religion, nationality or disability.

• This environment will enable the community of the health care institution to live out their religious and cultural beliefs, practices and values.

Objectives For Three Month Sessions

• Become familiar with the document: Advancing Effective Communication, Cultural Competence, and Patient- and Family-Centered Care: A Roadmap for Hospitals.

• Understand what diversity means and the dimensions of it.

• To define culture, religion and spirituality and to recognize how these affect healthcare

• To define Culturally Competent

• To recognize the make-up of the population that your Institution serves.

• To understand that the diversity of your Institution is reflected among those who work there and those from whom we care

• To introduce two projects to enhance diversity in your Institution

FoundationThe Joint Commission for the Accreditation of

Healthcare Organizations (JACHO)

Holds hospitals accountable for addressing and maintaining patient rights. These rights include “respecting and acknowledging one’s psychosocial, spiritual and cultural values and how they impact a patient’s response to their care.”

• “Patients have a fundamental right to considerate care that safeguards their personal dignity and respects their cultural, psychosocial and spiritual values.” (1998)

FoundationAdvancing Effective Communication, Cultural

Competence, and Patient-and Family-Centered CareA Roadmap for Hospitals

JACHO (2011)• Hospitals are to integrate concepts from the fields of communication,

cultural competence and patient and family centered care into their organizations.

• A hospital must embed effective communication, cultural competence and patient and family centered practices into the core activities of its system of care delivery – not considering them stand alone initiatives – to truly meet the needs of the patients, families and communities served.

• The Joint Commission views effective communication, cultural competence and patient-and family-centered care as an important components of safe, quality care.

FoundationA Roadmap for Hospitals

• In January 2010 The Joint Commission released a set of new and revised standards for patient-centered communication as part of its project to advance effective communication, cultural competence, and patient- and family centered care. The standards will be published in the 2011 Comprehensive Accreditation Manual for Hospitals (CAMH): The Official Handbook.

• The roadmap provides methods for hospitals to begin or improve upon their efforts to ensure that all patients receive the same high quality care.

• The Roadmap for Hospitals provides recommendations to help hospitals address unique patient needs, meet the new Patient-Centered Communication standards, and to comply with existing Joint Commission requirements.

FoundationA Roadmap for Hospitals

Chapters• Admission

• Assessment

• Treatment

• End of Life Care

• Discharge and Transfer

• Organization Readiness

A Roadmap to HospitalsChapters

• Checklist of Recommended Issues to Address (Appendix A)

• Helpful Tips

• Joint Commission Requirements (Appendices B & C)

• Laws and Regulations (Appendix D)

• Resource Guide (Appendix E)

• Glossary

A Roadmap for Hospitals Ways to Implement

• To Improve Performance

• To Train Staff

• To Help Inform Policy

• To Evaluate Compliance with Relevant Laws, Regulations and Standards

Admission Issues

• Inform Patients of their Rights

• Preferred Language

• Sensory or Communication Need

• Collect patient race and ethnicity data

• Assistive Devices

• Any Other Pertinent information

• Communicate Information about Unique Patient Needs to the Care Team

Assessment Issues• Identify and Address Patient Mobility Needs

During Assessment

• Support patients ability to understand and act on Health Information

• Identify Patient Cultural, Religious or Spiritual Beliefs or Practices that Influence Care

• Dietary Needs, Support Person

• Communicate Information to Health Care Team

Treatment Issues• Address Patient Communication Needs

• Monitor Changes in the Patient’s Communication Status

• Involve Patients and Families in the Care Process

• Accommodate Patient Cultural, Religious or Spiritual Beliefs and Practices

• Monitor Dietary Changes/Mobility Needs

• Communicate Issues to Health Care Team

End of Life Care Issues

• Patient Communication Needs

• Monitor Changes in Communication Status

• Involve the Patient’s Surrogate Decision-Maker and Family

• Identify Patient Cultural, Religious, or Spiritual Beliefs and Practices at the End of Life

• Communicate to the Health Care Team

Discharge and Transfer Issues

• Communication Needs

• Educate Patient and Family on Discharge and Transfer

• Discharge Instruction

• Follow-up Providers That Can Meet Unique Patient Needs

Organization ReadinessDecember

A Roadmap for HospitalsProvision of Care, Treatment, and

Services• Create an Environment that is Inclusive of all Patients

• Develop a System to Provide Language Services

• Assess the Communication Needs of the Patients

• Integrate Health Literacy Strategies into Patient Discussions and Materials

• Incorporate Cultural Competence and Patient and family Centered Care Concepts into Care Delivery

Next Month

• What Does it Mean to be Culturally Competent?

• Definitions

• Skills Needed to be Culturally Competent

• Resources Available

• Other?