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Cultural Competence Series: Communication Across Differences HR Talent Development: Diversity Programs ©2012 The University of Texas MD Anderson Cancer Center ©2012 The University of Texas MD Anderson Cancer Center Objectives The Communication Across Differences workshop will encourage participants to practice effective cross cultural communication skills in the healthcare environment and workplace by: Understanding how culture influences communication between patients and employees and between team members. Increasing self awareness of your cultural communication style. Identifying effective strategies to build trust and respect when communicating across cultures with patients and employees. 2 ©2012 The University of Texas MD Anderson Cancer Center Trust and Respect The MD Anderson Cancer Center provides culturally appropriate patient care and a culturally competent work environment. As an institution, MD Anderson strives to understand and respect the cultural beliefs, customs, and lifestyles of globally diverse individuals and groups. These efforts will enable our institution to bridge cultural differences, build trust and respect, to provide quality care, and to be the employer of choice. The Joint Commission views the delivery of services in a culturally and linguistically appropriate manner as an important healthcare safety and quality issue. For general information on standards related to cultural competency, please visit http://www.jointcommission.org/ or contact [email protected]. 3 ©2012 The University of Texas MD Anderson Cancer Center Cultural Identity 4 ©2012 The University of Texas MD Anderson Cancer Center Communication Across Cultures Communication is the process of sharing an idea or information. Being able to communicate across cultural differences is important to our patients and employees. Successful cross cultural communication is essential for individual and organizational success. 5 ©2012 The University of Texas MD Anderson Cancer Center Communication Matrix COMMUNICATION INFLUENTIAL FACTORS • • • • Communication Levels: Organizational Leader Employee Employee Employee Employee Patient MESSAGE CULTURAL INFLUENTIAL FACTORS Disclosure Levels: • Intimate (Full Disclosure & Trust) • Interpersonal (Some Trust) • Casual (Minor Trust) 6 ©2012 The University of Texas MD Anderson Cancer Center Why Our Actions Count Keep in mind, that the best of our intentions can be negatively impacted by how our words or actions are perceived. Several influencers are listed below. Communication Influencers Cultural Influencers Communication Levels Age Disclosure Levels Gender Emotions Geographic Transmission (Personal, Media, Technology) Health, Medical Beliefs Voice (Pitch, Pauses, Speed, Tone, Volume) Mental, Physical, Health Condition Body Language (Actions, Behaviors, Eye Contact, Facial Expressions, Personal Space, Touch) Organizational or Social Hierarchy Direct or Indirect Approach Focus Power and Privilege Perception Topic Focus (Health, Organizational, Personal, Relationship, Task) Race, Ethnicity Language (Native or Alternate) Sexual Orientation Words Used (Abbreviations, Colloquial Phrases, Formal, Informal, Slang) Socio-Economic Class Interruption Sources Spiritual Religious Beliefs 7 ©2012 The University of Texas MD Anderson Cancer Center Communication 8 ©2012 The University of Texas MD Anderson Cancer Center Relationships Positive Relationship Negative Relationship The relationship between a The effects of disrespect and patient and their healthcare derogatory conduct towards a providers is based upon trust healthcare provider can cause and respect. the decrease in morale, staff retention, and the quality of care. 9 ©2012 The University of Texas MD Anderson Cancer Center The Truth of the Situation Source: “Don’t Judge too Quickly” series. Ameriquest Mortgage Company. ©2005. http://theinspirationroom.com/daily/2006/ameriquest-mortgage-tv-ads-2006/ 10 ©2012 The University of Texas MD Anderson Cancer Center Patient Communication Points Admission Influencers: Cultural Communication Trust Assessment Treatment End of Life Discharge and Transfer 11 ©2012 The University of Texas MD Anderson Cancer Center Admission Identify and address patient communication needs. Language Assistance provides interpretation and translation services at no cost to the patient. Interpreters can facilitate crosscultural communication between patients and healthcare personnel who do not speak the same language. The hospital provides information to communicate with the patient who has vision, speech, hearing, or cognitive impairments in a manner that meets the patient’s needs. As an example, Sign Language Interpreters can be used to assist hearing-impaired patients. 12 ©2012 The University of Texas MD Anderson Cancer Center Assessment Always check the accuracy of the patient's name to the patient's record. Greet the patient by their last name and then introduce yourself. Identify and address patient communication needs. When possible, the hospital accommodates the patient’s cultural, religious, or ethnic food and nutrition preferences, unless otherwise instructed. Ask the patient to identify a support person. Ask the patient and their family members what they prefer regarding their cultural and/or spiritual beliefs. Communicate information about unique patient needs to the care team. 13 ©2012 The University of Texas MD Anderson Cancer Center Treatment Address the communication needs of a patient that may have sensory and/or communication impairments. Provide information to communicate with the patient who has vision, speech, hearing, or cognitive impairments in a manner that meets the patient’s needs. Identify and accommodate a patient's cultural, religious, or spiritual beliefs and practices that may influence care. Determine any cultural or alternative healing medications or practices that the patient may be integrating into their treatment plan. Confirm any individuals which are outside of the institution that the patient considers as a member of their treatment and support team. Incorporate cultural competence and patient/family-centered care concepts into care delivery. Communicate information about unique patient needs to the care team. 14 ©2012 The University of Texas MD Anderson Cancer Center End of Life Address patient communication needs during end-of-life care. Monitor changes in the patient’s communication status during end-of-life care. Involve the patient’s surrogate decision-maker and family in end-oflife care. Address patient mobility needs during end-of-life care. Identify patient cultural, religious, or spiritual beliefs and practices at the end of life. Make sure the patient has access to his or her chosen support person. 15 ©2012 The University of Texas MD Anderson Cancer Center Discharge and Transfer Access patient communication needs. Engage patients, loved ones, and care-givers in the discharge and transfer planning and instruction. Provide discharge instruction that meets the patient's needs. Identify follow-up providers that can meet the patients' unique needs. 16 ©2012 The University of Texas MD Anderson Cancer Center Patient Resources 17 ©2012 The University of Texas MD Anderson Cancer Center Language Assistance Language Assistance provides the following interpretation and translation services at no cost to our patients: Interpreters are available on site for the following languages: Arabic, French, German, Italian, Mandarin, Portuguese, Spanish, Turkish, Vietnamese 24 hour notice is required to acquire interpreters for additional languages. Telephone interpreter service is available 24 hours a day. Interpreters are also available to assist our hearing impaired patients. For more information or to request interpretation services, please call the Language Assistance department at (713)-792-7930. 18 Source: Language Assistance at: http://inside.mdanderson.org/departments/language-assistance/index.html ©2012 The University of Texas MD Anderson Cancer Center Additional Patient Resources Anderson Network: Is a unique global cancer support group of more than 1,800 current and former patients. http://www.mdanderson.org/patientand-cancer-information/guide-to-md-anderson/patient-and-familysupport/anderson-network/index.html Chaplaincy: To guide our patients on their spiritual journey. http://www.mdanderson.org/education-and-research/departmentsprograms-and-labs/departments-and-divisions/chaplaincy/index.html International Center: Welcomes our international patients and assists them with their transition into MD Anderson. http://inside.mdanderson.org/departments/ic/index.html 19 ©2012 The University of Texas MD Anderson Cancer Center Additional Patient Resources – continued. Patient Advocacy: Provides patients and families with a central department in which to register complaints or concerns. http://www.mdanderson.org/patient-and-cancer-information/guide-to-mdanderson/patient-and-family-support/patient-advocacy.html Social Work: To help patients and their families cope with the diagnosis of cancer and to eliminate through outstanding integrated programs in patient care, research, education and prevention. http://inside.mdanderson.org/departments/social-work/index.html 20 ©2012 The University of Texas MD Anderson Cancer Center Communication 21 ©2012 The University of Texas MD Anderson Cancer Center What do you really mean? Source: “If Delivery People Ran the World”. Sprint.com/nextel. ©2009. http://www.youtube.com/watch?v=vbt7SLHY72U 22 ©2012 The University of Texas MD Anderson Cancer Center Are you Talking the Talk? T – Convey mutual respect by reducing power barriers, pausing to give everyone time to speak, and be aware of non-verbal communication. A – Acknowledge the individual(s) and their contributions, ask questions, and be accountable. L – Identify the problem and create an atmosphere of equality and trust through listening. K – Keep to the point and keep the conversation at an understandable level. I – Maintain a non-emotional interaction and refrain from interrupting. N – Clarify the need of the communication or negotiation. G – Examine possible solutions, identify the goal(s) of the resolution, follow up, move on, and motivate. 23 ©2012 The University of Texas MD Anderson Cancer Center What’s your Communication Style? 1. 2. 3. 4. 5. 6. 7. Read each question in each category. If the question applies to you then answer “YES” by shading the indicator. You may shade more than one “YES” per row. If the question DOES NOT apply to you then proceed to the next question. Each shaded box is worth “ONE” point. Add the score for each style column. Write the total score for each style. Circle the highest score which indicates your most dominate communication style preference. Compare your results. 24 ©2012 The University of Texas MD Anderson Cancer Center Communicator Styles 25 ©2012 The University of Texas MD Anderson Cancer Center Self Check: Are you practicing the 5 Main Building Blocks of Trust? 1. Communication Are you clear and concise in your communications or are you sending vague hidden messages? 2. Patience Do you pause within a conversation to give the other person time to process the message, organize their thoughts, and to respond back to you? 3. Respect Do you demonstrate respect through your words, body language, and actions when interacting with another individual? 4. Cultural Consideration Do you express openness and consideration towards another individual’s perspective? 5. Honesty/Acknowledgement Do you acknowledge other individual’s contributions and ideas? 26 ©2012 The University of Texas MD Anderson Cancer Center Reminder You will receive an email containing a link to complete an online evaluation. Your input and suggestions are very important to our team because we value your feedback to improve our educational programs. Let us know if there is a diversity topic or topics that you would like to learn more about. 27 ©2012 The University of Texas MD Anderson Cancer Center How do I print my certificate? 1. Log into the Education Center at: http://inside.mdanderson.org/education/edcenter. 2. Click the MANAGE MY LEARNING Tab. 3. Select MY TRANSCRIPT from the Left Navigational Menu. 4. Confirm the START and END date range. 5. Locate the applicable course TITLE. 6. Click the PRINT CERTIFICATE OF COMPLETION link. 7. Print the certificate. 8. Log out. 28 ©2012 The University of Texas MD Anderson Cancer Center Questions 29