American Academy of Pediatrics

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American Academy of Pediatrics Saturday, August
16, 2008 Dennis Vickers, MD, Chairman Theresa
McDaniel, M.A. Director, Organizational
Development Mcdt_at_sinai.org The speakers in this
session have no relevant financial relationships
with the manufacturer(s) of any commercial
product(s) and/or provider of commercial services
discussed in this CME activity. The speakers
will not discuss or demonstrate pharmaceuticals
and/or medical devices that are not approved by
the FDA and/or medical or surgical procedures
that involve an unapproved or off-label use of
an approved device or pharmaceutical.
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Learning Objectives

• Understand and discuss the importance of
  community integration and involvement in advising
  and setting direction for your health care
  organization.
• Describe an example of how one urban healthcare
  institution (SHS) partnered with a local
  community-based organization to achieve strategic
  goals
• Describe potential next steps for your
  organizations for developing effective
  partnerships and collaboration

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Learning Objectives

• Understand and discuss the importance
• of community integration and
• involvement in advising and setting
• direction for your health care
• organization.

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Why Engage the Community?

• Helping to obtain funding
• Access to target patient populations
• Building your organizations capacity
• Increased support for organizational goals and
  strategies
• Gaining trust and respect from community members

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Why Engage the Community?

• Healthier communities
• Decrease in health disparities
• Provision of culturally and linguistically
  appropriate services
• Increased patient satisfaction
• Increased collaborations
• Input on services and processes

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Why Engage the Community

• Laws Guidelines
• Title VI
• Office of Minority Health
• CLAS Standards

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CLAS Standards

• 14 Standards Three Themes
• Culturally Competent Care (3)
• Language Access Services (4)
• Organizational Supports (7)

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• Culturally Competent Care
• Ensure that patients receive effective,
  understandable, and respectful care - compatible
  with their cultural health beliefs and practices
  and preferred language
• Implement strategies to recruit, retain and
  promote at all levels - a diverse staff that
  are representative of the service area
• Ensure that staff at all levels receive on-going
  education and training

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• Language Access Services
• Offer and provide language assistance services at
  all points of contact (bi-lingual
  staff/interpreters) at no cost
• Provide in their preferred language,
  verbal/written notice of rights to receive
  language assistance services
• Assure competence of language assistance provided
  Family and friends should not be used
• Make available patient-related materials and
  signage in languages of service area

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• Organizational Supports
• Develop/implement a strategic plan for CLAS
  standards
• Conduct initial/on-going assessment of CLAS
  activities
• Race, ethnicity and spoken language are collected
• Maintain current demographics of patient
  population
• Partnership with community (CLAS activities)
• Conflict resolution/grievance process that is C/L
  sensitive
• Make available progress towards CLAS standards

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Why Engage the Community?

• A young Cambodian patient has been in a car
  accident. She is
• in a coma, showing no brain activity at all,
  being kept alive
• by life support systems. Her doctors
  professional opinion is
• that there is no hope for a recovery, and feel
  that it is time to
• end life support. The patients parents, both of
  whom are
• devout Buddhists, are struggling with this
  suggestion, as they
• believe that everything that happens to a person
  in his or her
• lifetime has a purpose. To end a life before its
  appointed time
• is murder and can affect the hopes of
  reincarnation of both the
• person whose life is ended and the one who ends
  the life.

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Learning Objectives

• Describe an example of how one urban
• healthcare institution (SHS) partnered
• with a local community-based
• organization to achieve strategic goals

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• Sinai Health System
• Mount Sinai Hospital
• Sinai Childrens Hospital
• Sinai Community Institute
• Sinai Medical Group
• Schwab Rehabilitation Hospital

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Sinai Caregiver Demographics African-American
36 Latino 20 Caucasian
17 Asian/Pacific Islander 20
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Sinai Patient Demographics African-American
56 Latino 20 Caucasian
17 Asian/Pacific Islander
.2 Other 1
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We actively seek to address language or cultural
disparities for our patients
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Our staff look and talk like our patients and
are sensitive and respectful to differences in
beliefs and attitudes toward health and illness.
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Mujeres Latinas en Accion Celebrating 35 years
of empowering Latinas and their families
A bilingual/bicultural agency, seeks to empower
women, their families and youth to be
self-reliant and able to take full advantage of
available opportunities and create new
opportunities to improve the quality of their
lives
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Mujeres Latinas en Accion Celebrating 35 years
of empowering Latinas and their families

• Domestic Violence
• Sexual Assault
• Women in Transition
• Peace Program
• Parent Support

• Proyecto Juventud
• Latina Leadership
• Child Care Services
• SASS
• Sanctuary
• Mother and Daughter

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• Impact to Organizational Goals
• Customer Service
• Employee Satisfaction
• Health outcomes
• Partnerships/CEO priority

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• Navigation and Way-Finding

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• Translation Review

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• Physical environments and improved patient
  experience

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• Internal Education Training
• Co-Facilitation
• Validation

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• External Education Training
• Co-Facilitation
• Validation

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Patient Advocacy
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Community Outreach
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• Collaboration with Mujeres/others
• 17 hospital speakers provided
• 48 presentations
• 16 health fairs,
• a health information table at the nearby Mexican
  Consulate for Chicago.

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Learning Objectives

• Describe next steps for your
• organizations for developing effective
• community partnerships and
• collaboration

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What is a Community?

• a framework for living rather than
• political jurisdiction a complex
• network of people, institutions,
• shared interests, locality and a sense of
• psychological belonging

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The Communities You Serve

• Nationality
• Ethnicity
• Sexual identity
• Religious beliefs
• Age group
• Physical attributes
• Cultural
• Class

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Engaging Communities

• Getting to know and understand your
• communities requires engaging in a broad
• range of activities thinking creatively to
• involve traditional partners as well as non-
• traditional partners.

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Key Individuals

• Informal leaders who may not have titles but are
  influencers in the community
• Who are significant sources of information and
  are critical to communicating with diverse
  residents

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Media

• Directed at those from diverse cultures and/or
  who speak a primary language other than English
• Including print/newspapers (formal/informal)
• Radio
• Television

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Primary Places of Contact

• Schools
• Religious organizations
• Community centers
• Markets
• Community organizations

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How to Engage Communities

• Obtain data on your communities
• Focus groups
• Other organizations
• Survey/census/community reports
• Collect and document demographics

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How to Engage Communities

• Integrate into your organization
• Community educators
• Input on policy
• Advisory groups
• Drills/fairs/meetings/education
• Tours
• Hire from the community

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How to Engage Communities

• Selection of partner organizations
• Similar mission, vision, values
• Supplementary service
• Location
• Existing relationships
• Serve patient population

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Next Steps

• Selection of partner organizations
• Identify your communities
• Collect data
• Determine outcomes and goals
• Get involved!

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Bibliography

• The Hospitals, Language Culture Research
  Framework Domain six Community Engagement
• The Cultural Competency Self-Assessment Protocol
  for Managed Care Organizations, Lumetra
• Cultural Competency QIO Regional Training, August
  2005