Chapter 6 - Inclusive practices in Healthcare

Diversity, Equity, Inclusion (DEI)

• Cultural competence shift towards cultural humility

• Learned or achieved

The more you learn about another culture, the better you are prepared to work with them

Healthcare for diverse population

health inequities and health disparities

• social determinants of health

  • Education, income, gender, age

  • Someones health isn’t determined by how they take care of themselves

Cultural humility

• Inclusive

• Begins with self awareness → better awareness of others

• Cultural competence = knowledge of another culture = better competence in practice

  • It’s achievable end goal

• Cultural humility = Fuel to get competent

• Cultural competemility = combines cultural competence and humility

  • Healthcare providers should maintain knowledge/skills working across diff cultures

  • Humility + self awareness during cultural encounters

Culture

• Race, ethnicity, gender identity, sexual orientation, age, etc

• Beliefs and practices differ

Stereotyping

• Assuming individual based on membership of group

Ethnocentrism

• Viewing another culture through standards of your own

• Considering own culture practices as normal or superior

Culturally inclusive framework

Cultural humility is dynamic and ongoing process (self exploration, awareness, critique, knowledge)

Cultural competency continuum

Cultural destructiveness

• Most harmful

• Forced assimilation

• Denial of rights

Cultural incapacity

• Racism

• Stereotype

• Unfair hiring

Cultural blindness

• I treat everyone the same

• Ignore individual needs

Cultural precompetence

• Explore cultural issues

Cultural competence

• Recognize diff cultures

• Culturally diverse staff

Cultural proficiency

• Implement change

Inclusive communication

Verbal communication

• Use plain language so people can understand

• Avoid using family, children as interpreters (talk to the patient not interpreter)

Nonverbal communication

• Eye contact, facial expressures, gestures, body language

Written communication

• Cant read well

Collectivisitc vs individualistic cultures

Collectivistic orientation

• Emphasis on family, group, community

Individualistic orientation

• Emphasis on autonomy, independence

General culture patterns = dont assume for all individual patients

DH diagnosis and care planning

Implementation

• Culturally acceptable

• Ask why reject oral rec based on belief

Evaluation

• Talk w/ patient to improve cultural communication and gain perspective

Documentation

• Document all process