NEW REQUIREMENTS AND CHALLENGES:  JOINT COMMISSION CULTURAL COMPETENCY REQUIREMENTS AND CLAS STANDARDS August 23, 2011 Pre...
COMMUNICATION IN HEALTH CARE <ul><li>Communication is the cornerstone of patient safety. </li></ul><ul><li>Health care is ...
HEALTH LITERACY <ul><li>Research indicates that half of all American adults have difficulty understanding and acting upon ...
<ul><li>Of great concern, 14% of adults (30 million Americans) are unable to perform even the simplest every day literacy ...
A REVIEW OF CLAS STANDARDS <ul><li>The communication between patients and health-care providers leads to patient’s satisfa...
<ul><li>There are 14 CLAS standards in place.  </li></ul><ul><li>These standards concentrate on three main areas:  cultura...
<ul><li>Only 1 of these groupings – language access services – is required in order to receive federal funds under Title V...
FOCUS ON “ORGANIZATIONAL SUPPORTS” <ul><li>Sub-themes include:  strong commitment to cultural competence at every level of...
WHAT DOES ALL THIS HAVE TO DO WITH THE JOINT COMMISSION ON ACCREDITATION OF HEALTH CARE ORGANIZATIONS (JCAHC)? <ul><li>CLA...
JCAHO <ul><li>JCAHO is a non-for-profit committed to improving the quality of health care in the U.S. by developing standa...
<ul><li>In 2010, JCAHO published a monograph to help hospitals integrate communication and cultural competence practices i...
<ul><li>The Roadmap makes it clear that a hospital’s ability to advance effective communication, cultural competence, and ...
WORKFORCE <ul><li>There are a number of suggested checklist items to improve effective communication in this area includin...
FOR RECRUITMENT TO INCREASE POOL OF DIVERSE AND BI-LINGUAL CANDIDATES <ul><li>Roadmap suggests the following: </li></ul><u...
STAFF TRAINING <ul><li>Roadmap suggests that staff training should include some of the following: </li></ul><ul><ul><li>Pr...
IDENTIFY STAFF CONCERNS OR SUGGESTED IMPROVEMENTS FOR PROVIDING CARE THAT MEETS UNIQUE PATIENT NEEDS. <ul><li>Roadmap sugg...
<ul><li>GOALS - Staff Training and Education </li></ul><ul><li>ORIENTATION </li></ul><ul><ul><li>Sensitivity to cultural d...
<ul><ul><li>ONGOING EDUCATION AND TRAINING </li></ul></ul><ul><ul><li>Improvement of cultural diversity on care </li></ul>...
<ul><li>Questions to be Asking Yourself </li></ul><ul><ul><li>Are you currently training your staff on these issues and if...
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New Requirements And Challenges Joint Commission Cultural Competency Requirements And Clas Standards

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New Requirements And Challenges Joint Commission Cultural Competency Requirements And Clas Standards

  1. 1. NEW REQUIREMENTS AND CHALLENGES: JOINT COMMISSION CULTURAL COMPETENCY REQUIREMENTS AND CLAS STANDARDS August 23, 2011 Presented by Marvin L. Weinberg, Esq. Fox Rothschild LLP [email_address] (215) 299-2836
  2. 2. COMMUNICATION IN HEALTH CARE <ul><li>Communication is the cornerstone of patient safety. </li></ul><ul><li>Health care is communication-dependent and accurate information is needed for several important processes. </li></ul><ul><li>Direct communication can be affected by a number of factors including: </li></ul><ul><ul><li>Language </li></ul></ul><ul><ul><li>Culture </li></ul></ul><ul><ul><li>Health Literacy (degree to which individuals have the capacity to obtain, process and understand basic health information to make decisions). </li></ul></ul>
  3. 3. HEALTH LITERACY <ul><li>Research indicates that half of all American adults have difficulty understanding and acting upon health information. </li></ul><ul><li>Certain populations are more likely to have limited health literacy including: racial and ethnic groups other than white, recent refugees and immigrants, and non-native speakers of English. </li></ul>
  4. 4. <ul><li>Of great concern, 14% of adults (30 million Americans) are unable to perform even the simplest every day literacy tasks </li></ul><ul><li>42% of these adults are more likely to report their health as poor and 28% lack health insurance. </li></ul>
  5. 5. A REVIEW OF CLAS STANDARDS <ul><li>The communication between patients and health-care providers leads to patient’s satisfaction and positive health outcomes. This concept of understanding relates to a new term within our health-care system – Cultural Competency. </li></ul><ul><li>In 2002, the Office of Minority Health, attached to the U.S. Department of Health and Human Services, completed a review on evaluating methods and practices for improving cultural competency for family physicians. This review was the foundation for the National Standards for Culturally and Linguistically Appropriate Services (CLAS). </li></ul><ul><li>These standards are the only national standards in place for health-care organizations with respect to cultural competency. </li></ul>
  6. 6. <ul><li>There are 14 CLAS standards in place. </li></ul><ul><li>These standards concentrate on three main areas: culturally competent care, language access services and organizational support. </li></ul>
  7. 7. <ul><li>Only 1 of these groupings – language access services – is required in order to receive federal funds under Title VI of Civil Rights Act of 1964. </li></ul><ul><li>Title VI – no person shall be discriminated based on race, color, national origin from participating in any program receiving federal funding. </li></ul>
  8. 8. FOCUS ON “ORGANIZATIONAL SUPPORTS” <ul><li>Sub-themes include: strong commitment to cultural competence at every level of the organization. </li></ul><ul><li>The importance of community involvement. </li></ul><ul><li>Recruitment of minority staff and community health workers. </li></ul><ul><li>Training, professional development and organizational assessment. </li></ul><ul><li>Remember cultural competence does not end at medical staff level: present at all levels. </li></ul>
  9. 9. WHAT DOES ALL THIS HAVE TO DO WITH THE JOINT COMMISSION ON ACCREDITATION OF HEALTH CARE ORGANIZATIONS (JCAHC)? <ul><li>CLAS standards have been adopted by JCAHC </li></ul><ul><li>Standards don’t have much punch without accountability </li></ul><ul><li>Accreditation programs create accountability! </li></ul>
  10. 10. JCAHO <ul><li>JCAHO is a non-for-profit committed to improving the quality of health care in the U.S. by developing standards that health-care organizations must meet to receive seal of approval. </li></ul><ul><li>Many health-care organizations must be accredited by JCAHO to receive certain federal funds and participate in programs (Medicare and Medicaid). </li></ul><ul><li>In 2008, JCAHO began development of accreditation requirements for hospitals to advance issues of effective communication, cultural competence, and other care. </li></ul><ul><li>Implementation occurred in January 2011. However, accreditation decisions are not until January 2012 at earliest. </li></ul>
  11. 11. <ul><li>In 2010, JCAHO published a monograph to help hospitals integrate communication and cultural competence practices into their organizations. </li></ul><ul><li>This monograph is titled “Advancing Effective Communication, Cultural Competence, And Patient And Family-Centered Care: A Road Map for Hospitals.” </li></ul><ul><li>The purpose of the Road Map is to “inspire” hospitals to integrate concepts from communication, cultural competence, and other fields into their organizations. </li></ul><ul><li>JCAHO views effective communication and cultural competence to be important components of safe, quality care. </li></ul><ul><li>JCAHO recognizes that every organization’s journey to improve communication and cultural competence will be unique. </li></ul>
  12. 12. <ul><li>The Roadmap makes it clear that a hospital’s ability to advance effective communication, cultural competence, and other care rests on its “state or organization readiness.” </li></ul><ul><li>Five domains for organization and readiness are identified: leadership, data collection and use, workforce, provision of care, treatment and services and patient, family, and community engagement. </li></ul><ul><li>Each domain represents a key area the hospital should address to make sure necessary systems and processes exist to meet the needs of each patient. </li></ul><ul><li>I want to focus on workforce and HR issues. </li></ul>
  13. 13. WORKFORCE <ul><li>There are a number of suggested checklist items to improve effective communication in this area including: target recruitment efforts to increase the pool of diverse and bi-lingual candidates, ensure the competency of individuals providing language services, incorporate the issues of effective communication, cultural competence, and patient/family centered care into new or existing staff training curricula and identify staff concerns or suggested improvements for providing care that meets unique patient needs. </li></ul>
  14. 14. FOR RECRUITMENT TO INCREASE POOL OF DIVERSE AND BI-LINGUAL CANDIDATES <ul><li>Roadmap suggests the following: </li></ul><ul><ul><li>Advertise job openings in targeted foreign language publications and other media </li></ul></ul><ul><ul><li>Define policies that accommodate and address the hair styles and daily religious practices of the local workforce whenever possible </li></ul></ul><ul><ul><li>Support training and career development activities to help culturally and linguistically diverse non-clinical staff advance to a patient care position </li></ul></ul><ul><ul><li>Develop relationships with local community colleges that offer health-care career training </li></ul></ul><ul><ul><li>Encourage the transition of English as a second language (ESL) students into healthcare careers by partnering with community-based organizations that offer ESL courses. </li></ul></ul>
  15. 15. STAFF TRAINING <ul><li>Roadmap suggests that staff training should include some of the following: </li></ul><ul><ul><li>Provide information and guidance about the hospital’s efforts to address unique patient cultural, religious, spiritual, mobility, or other needs </li></ul></ul><ul><ul><li>Provide staff training opportunities at intervals throughout the year </li></ul></ul><ul><ul><li>Encourage staff to improve their overall communication skills </li></ul></ul><ul><ul><li>Address unique patient needs in relevant policies and procedures (i.e., visitation, access to chosen support person, non-discrimination) </li></ul></ul><ul><ul><li>Inform staff about federal and state laws and regulations that support effective communication, cultural competence and patient and family centered care. </li></ul></ul>
  16. 16. IDENTIFY STAFF CONCERNS OR SUGGESTED IMPROVEMENTS FOR PROVIDING CARE THAT MEETS UNIQUE PATIENT NEEDS. <ul><li>Roadmap suggests that staff should have the opportunities to voice any concerns with or suggest improvements </li></ul><ul><ul><li>To this end, conduct a staff survey to evaluate the staff’s current ability to meet patient needs, including their experiences using language services and auxiliary aides, barriers to accommodate any cultural or spiritual needs, and any other issues </li></ul></ul><ul><ul><li>create an environment that welcomes diverse staff members, which in turn, welcomes diverse patients </li></ul></ul><ul><ul><li>protect staff from discrimination based on age, race, ethnicity, religion, culture, language, etc. </li></ul></ul>
  17. 17. <ul><li>GOALS - Staff Training and Education </li></ul><ul><li>ORIENTATION </li></ul><ul><ul><li>Sensitivity to cultural diversity of staff and patient populations </li></ul></ul>
  18. 18. <ul><ul><li>ONGOING EDUCATION AND TRAINING </li></ul></ul><ul><ul><li>Improvement of cultural diversity on care </li></ul></ul><ul><ul><li>Improvement of staff cultural diversity on team communication, collaboration and care </li></ul></ul><ul><ul><li>How to use available communication tools </li></ul></ul>
  19. 19. <ul><li>Questions to be Asking Yourself </li></ul><ul><ul><li>Are you currently training your staff on these issues and if so, how? </li></ul></ul><ul><ul><li>What obstacles do you anticipate for implementing these requirements? </li></ul></ul>

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