Theses are the slides from a presentation by Cristina Reyes Smith, OTD, OTR/L and Susan Toth-Cohen, PhD, OTR/L from the 2011 AOTA Conference in Philadelphia, PA.
This document provides an overview of gerontological nursing and care of the elderly. It defines key terms related to aging and discusses the aging process. The roles of gerontological nurses are described, including providing care, education, advocacy, and leadership. Physiological changes in aging are reviewed along with theories of aging. Standards and scopes of practice for gerontological nursing are discussed.
Comprehensive geriatric assessment (CGA) is a multidimensional, interdisciplinary diagnostic process to determine the medical, psychological and functional capabilities of a frail elderly person in order to develop a co-ordinated and integrated plan for treatment and long-term follow up
The comprehensive geriatric assessment pcp slidesMarc Evans Abat
This document discusses the comprehensive geriatric assessment (CGA). It begins by defining the CGA as a multidimensional, interdisciplinary diagnostic process that develops a coordinated treatment plan emphasizing quality of life, functional status, and prognosis.
It then identifies the key components of a CGA as including medical history, physical and functional status, behavioral and emotional status, environmental and social support, and spiritual well-being. Common tools used include assessments of activities of daily living, cognition, nutrition, and fall risk.
The document explains that a CGA is recommended for older adults who are frail or have geriatric syndromes like falls or polypharmacy. Evidence shows that CGA can reduce mortality, institutionalization
Geriatric Counseling Or Gerontological CounsellingBabu Appat
Old age is an age of problems. The deteriorating physical health will give rise to a lot of mental problems too. Loss of independence, slackening freedom of movements, a feeling of alienation from the society, loss of beloveds and companions of life, fear of being incapacitated or death may prevail during this time. These problems will produce a lot of changes in the way an individual things. Senile cognitive degradation is another problems. If the person is having other mental illnesses like depression, BPD, manias or phobias, senile dementia, Alzheimer's disease, or sense of being singled out the condition can be worse. Any effort to properly understand an old person's mental and physical conditions and helping him to cope up with these changing conditions is what a counselor can do.
The document discusses communication with the elderly and outlines several key challenges and strategies. It notes that communication is important for health but declines with age due to sensory and cognitive changes. Barriers include hearing loss, vision loss, and speech/language difficulties. However, activities like social groups, one-on-one visits, and assistive tools can help overcome challenges and promote interaction. The document stresses the importance of listening skills, making elders comfortable, and finding ways for them to communicate effectively.
Here are the key steps in assessing cognition in older adults:
1. Use a standardized cognitive screening tool like the Mini-Mental State Examination (MMSE) or Mini-Cog to evaluate various cognitive domains including orientation, memory, attention and language.
2. Observe the patient's behavior and mood, looking for signs of depression, anxiety or other psychological issues that can impact cognition.
3. Get input from a family caregiver regarding any changes in the patient's cognitive or functional abilities.
4. Refer for neuropsychological testing if indicated based on screening results or concerns about specific impairments like memory problems.
5. Consider reversible causes of cognitive decline like medications, metabolic abnormalities, infections and discuss
This document discusses person-centered care for people with dementia. It outlines the principles of a person-centered approach, which focuses on viewing each person as a unique individual. As dementia progresses, individuals experience increased physical, social, and emotional impacts that affect their needs. Caregivers should meet these varied needs while respecting each person's dignity, preferences, and self-worth through effective communication, empathy, and validation. A range of support services can help address medical, social, and emotional needs for people with dementia and support their caregivers.
Manual muscle testing is used by occupational therapists to evaluate muscles' ability to generate force and assess impairments. It involves instructing a patient to hold a limb against the therapist's opposing resistance through a range of motion. Grades from 0 to 5 are used to rate strength based on whether movement can be completed against gravity and additional pressure. While useful, manual muscle testing relies on a therapist's strength; dynamometry provides more objective strength measurements but requires expensive equipment. Both types of testing only approximate muscle function during daily activities.
This document provides an overview of gerontological nursing and care of the elderly. It defines key terms related to aging and discusses the aging process. The roles of gerontological nurses are described, including providing care, education, advocacy, and leadership. Physiological changes in aging are reviewed along with theories of aging. Standards and scopes of practice for gerontological nursing are discussed.
Comprehensive geriatric assessment (CGA) is a multidimensional, interdisciplinary diagnostic process to determine the medical, psychological and functional capabilities of a frail elderly person in order to develop a co-ordinated and integrated plan for treatment and long-term follow up
The comprehensive geriatric assessment pcp slidesMarc Evans Abat
This document discusses the comprehensive geriatric assessment (CGA). It begins by defining the CGA as a multidimensional, interdisciplinary diagnostic process that develops a coordinated treatment plan emphasizing quality of life, functional status, and prognosis.
It then identifies the key components of a CGA as including medical history, physical and functional status, behavioral and emotional status, environmental and social support, and spiritual well-being. Common tools used include assessments of activities of daily living, cognition, nutrition, and fall risk.
The document explains that a CGA is recommended for older adults who are frail or have geriatric syndromes like falls or polypharmacy. Evidence shows that CGA can reduce mortality, institutionalization
Geriatric Counseling Or Gerontological CounsellingBabu Appat
Old age is an age of problems. The deteriorating physical health will give rise to a lot of mental problems too. Loss of independence, slackening freedom of movements, a feeling of alienation from the society, loss of beloveds and companions of life, fear of being incapacitated or death may prevail during this time. These problems will produce a lot of changes in the way an individual things. Senile cognitive degradation is another problems. If the person is having other mental illnesses like depression, BPD, manias or phobias, senile dementia, Alzheimer's disease, or sense of being singled out the condition can be worse. Any effort to properly understand an old person's mental and physical conditions and helping him to cope up with these changing conditions is what a counselor can do.
The document discusses communication with the elderly and outlines several key challenges and strategies. It notes that communication is important for health but declines with age due to sensory and cognitive changes. Barriers include hearing loss, vision loss, and speech/language difficulties. However, activities like social groups, one-on-one visits, and assistive tools can help overcome challenges and promote interaction. The document stresses the importance of listening skills, making elders comfortable, and finding ways for them to communicate effectively.
Here are the key steps in assessing cognition in older adults:
1. Use a standardized cognitive screening tool like the Mini-Mental State Examination (MMSE) or Mini-Cog to evaluate various cognitive domains including orientation, memory, attention and language.
2. Observe the patient's behavior and mood, looking for signs of depression, anxiety or other psychological issues that can impact cognition.
3. Get input from a family caregiver regarding any changes in the patient's cognitive or functional abilities.
4. Refer for neuropsychological testing if indicated based on screening results or concerns about specific impairments like memory problems.
5. Consider reversible causes of cognitive decline like medications, metabolic abnormalities, infections and discuss
This document discusses person-centered care for people with dementia. It outlines the principles of a person-centered approach, which focuses on viewing each person as a unique individual. As dementia progresses, individuals experience increased physical, social, and emotional impacts that affect their needs. Caregivers should meet these varied needs while respecting each person's dignity, preferences, and self-worth through effective communication, empathy, and validation. A range of support services can help address medical, social, and emotional needs for people with dementia and support their caregivers.
Manual muscle testing is used by occupational therapists to evaluate muscles' ability to generate force and assess impairments. It involves instructing a patient to hold a limb against the therapist's opposing resistance through a range of motion. Grades from 0 to 5 are used to rate strength based on whether movement can be completed against gravity and additional pressure. While useful, manual muscle testing relies on a therapist's strength; dynamometry provides more objective strength measurements but requires expensive equipment. Both types of testing only approximate muscle function during daily activities.
This document discusses the assessment of elderly patients. It outlines several key points regarding the assessment of elderly patients:
1) A geriatric assessment should be interdisciplinary and evaluate both medical and non-medical domains like function and quality of life.
2) Physiologic changes that occur with aging can impact assessment findings. For example, sensory deficits may interfere with history taking and many disorders only manifest as functional decline in elderly patients.
3) Several assessment tools are described, including the Timed Get Up and Go Test to evaluate mobility.
4) Certain findings may be misinterpreted in elderly patients. For example, fever responses can be blunted with infection and age-related crackles are common but
Lower Limb Orthotics - Dr Rajendra Sharmamrinal joshi
This document provides information on lower limb orthotics. It defines an orthosis and describes their clinical objectives in treating conditions like pain, deformities, abnormal range of motion, etc. It discusses different types of orthoses like foot, ankle-foot, knee-ankle-foot orthoses. Principles of bracing like distributing forces over large areas and applying forces to control joints are covered. Characteristics of an ideal orthosis in terms of function, comfort, cost are outlined. The document also discusses shoes, foot orthoses, ankle-foot orthoses made of plastic, metal and patellar tendon bearing designs.
This document discusses ethical issues surrounding disclosure of diagnoses, specifically Alzheimer's disease, to patients and their families. It provides guidance on assessing a patient's understanding and desire to know their diagnosis before disclosure. When disclosing Alzheimer's, it is important to arrange a joint meeting with family, allow time for questions, discuss disease progression and care plans, and involve caregivers going forward. The case study describes one family's experience where the husband decided to disclose the wife's Alzheimer's diagnosis to her in the doctor's office, but she initially reacted with disbelief and later developed aggressive behaviors towards her husband caregiver.
This document lists and describes various orthotic braces and devices for the upper body, lower body, and spine. It includes braces for the shoulder, elbow, wrist, hand, back, knee, ankle, and foot as well as cervical collars and braces used for spinal curvature and rehabilitation.
Shockwave therapy involves using pressure waves to treat tennis elbow. A study found that 61% of patients receiving shockwave therapy were pain-free after 1-2 years, while a control group reported more pain. Shockwave therapy is a safe and effective treatment for tennis elbow. It works by stimulating healing processes in the body and increasing blood flow to relieve pain. Exercises like wrist stretches can also help relieve elbow pain by strengthening muscles and increasing flexibility.
This document discusses falls in the elderly and provides guidance on assessing risk and preventing falls. It outlines a case of a 78-year-old female presenting for care and notes her reported falls and balance issues. The document reviews intrinsic and extrinsic risk factors for falls and recommends screening all patients aged 65+ annually. It provides details on components of the history, physical exam, functional assessment, and interventions including exercise, home modifications, and medication management to reduce fall risk.
A prosthesis is an artificial replacement for any part of the body that is missing. It is designed to replace the function and appearance of the missing limb as much as possible. Prostheses for lower and upper limb amputations are prescribed based on the level and cause of amputation. The main components of a prosthesis are the socket, suspension system, control system, and terminal device. The socket provides an intimate fit with the residual limb. Suspension systems like belts and harnesses help hold the prosthesis securely. Control systems can be body-powered using cables or externally powered using batteries. Terminal devices replace missing hands or feet. The goal is to restore ambulation and functional tasks using a prosthesis.
Occupational Therapy Practice Framework- American Occupational Therapy Associ...Shamima Akter Swapna
The document summarizes key constructs of the Occupational Therapy Practice Framework including occupations, performance skills, performance patterns, client factors, and contexts/environments. It defines occupations as activities people need or want to do including self-care, work, education, leisure. It identifies areas of occupation and lists client factors, performance skills, and contexts/environments that influence occupational performance. Performance patterns include habits, routines, roles, and rituals.
Aging can be defined in several ways:
1) As the time-related deterioration of physiological functions necessary for survival and fertility that affects all individuals of a species over time.
2) As a multidimensional process of physical, psychological, and social changes that occurs as humans get older.
3) As a progressive functional decline or decrease in viability that increases susceptibility to death and disease as intrinsic age-related changes accumulate over time.
The document discusses models and methods of rehabilitation. It describes rehabilitation as helping a person reach their fullest potential physically, psychologically, socially, and educationally given their limitations. Rehabilitation nursing aims to restore abilities, prevent further disability, protect abilities, and assist patients. Principles of rehabilitation include beginning rehabilitation early, restoring independence, maximizing function within limits, and focusing on specific conditions. Methods include neurological, cardiac, drug, alcohol, physical, medical, vocational, vestibular, and stroke rehabilitation as well as community-based approaches. Models of rehabilitation include the Nagi, IOM, NCMRR, and new IOM models which define concepts like impairment, functional limitation, and disability and their interactions.
1. Geriatric rehabilitation aims to help the elderly regain independence by recovering physical, psychological, or social skills lost due to aging or disability.
2. The key principles of geriatric rehab are addressing the variability in aging, preventing the effects of inactivity, and maintaining optimal health.
3. Interventions include a variety of exercises, assistive devices, and environmental adaptations delivered through different settings and providers.
1) Theories of aging attempt to explain the aging process from biological, sociological, and psychological perspectives. Biologically, aging is viewed as the accumulation of random errors and damage over time according to stochastic theories. Programmed theories propose that aging is predetermined.
2) Sociological theories include disengagement theory, which is no longer supported, and activity theory which proposes that activity is important for well-being in aging. Psychologically, Maslow's hierarchy of needs and Erikson's stages of life provide frameworks for understanding aging.
3) A comprehensive history and physical assessment of elderly patients should include demographic information, chief complaints, present and past illness, social history, and review of systems to fully evaluate
The document discusses the biomedical model of medicine and its key assumptions. It explains that the biomedical model views illness as caused by biological factors outside an individual's control. Treatment aims to change the physical body, and the medical profession is responsible for treatment. It also discusses how behavioral health and health psychology challenged some of these assumptions, viewing illness as influenced by both biological and psychological factors, with individuals playing a role in both causes and treatment of illness.
Instrumental Activities of Daily Living (IADL) refer to more complex daily tasks beyond basic self-care that are needed for independent living. These include activities like managing finances, housekeeping, preparing meals, shopping, communication management, community mobility, and health and safety maintenance. Some examples of IADLs are using the telephone, managing transportation, performing light housekeeping and laundry, grocery shopping, and medication management.
Amputation,Stump care, phantom limb pain and gait training in lower limbHarshita89
1) Phantom limb pain and sensations are perceptions ranging from slight tingling to sharp pain that amputees feel in a limb that is no longer physically attached. It is estimated to affect 49-83% of amputees.
2) There are two main types of pain after amputation - incisional stump pain localized around the scar, and phantom pain felt in the amputated limb itself. Phantom pain can be crushing or tearing.
3) While phantom sensations often occur right after amputation, phantom pain may affect 8-10% of amputees initially but can persist for years in some cases. Stump pain is usually described as pressing, throbbing or burning.
This document provides a case study of an occupational therapy assessment and intervention for an 84-year-old woman admitted to the emergency department following a fall at home. The occupational therapist assessed the woman's mobility, transfers, and ability to complete activities of daily living to determine if she could be safely discharged home. Short term goals were set for the woman to increase her mobility and confidence, which were achieved within 30-60 minutes. Referral to falls prevention services was also made. The assessment and intervention demonstrated the role of occupational therapy in facilitating safe, independent discharge from the emergency department.
This document introduces standards for social work practice in health care settings developed by the National Association of Social Workers (NASW). It provides background on the role of social workers in health care, outlines guiding principles for social work, and defines key terms. The standards are intended to enhance social workers' skills and knowledge when working with individuals, families, providers, and communities in health care.
This document discusses the assessment of elderly patients. It outlines several key points regarding the assessment of elderly patients:
1) A geriatric assessment should be interdisciplinary and evaluate both medical and non-medical domains like function and quality of life.
2) Physiologic changes that occur with aging can impact assessment findings. For example, sensory deficits may interfere with history taking and many disorders only manifest as functional decline in elderly patients.
3) Several assessment tools are described, including the Timed Get Up and Go Test to evaluate mobility.
4) Certain findings may be misinterpreted in elderly patients. For example, fever responses can be blunted with infection and age-related crackles are common but
Lower Limb Orthotics - Dr Rajendra Sharmamrinal joshi
This document provides information on lower limb orthotics. It defines an orthosis and describes their clinical objectives in treating conditions like pain, deformities, abnormal range of motion, etc. It discusses different types of orthoses like foot, ankle-foot, knee-ankle-foot orthoses. Principles of bracing like distributing forces over large areas and applying forces to control joints are covered. Characteristics of an ideal orthosis in terms of function, comfort, cost are outlined. The document also discusses shoes, foot orthoses, ankle-foot orthoses made of plastic, metal and patellar tendon bearing designs.
This document discusses ethical issues surrounding disclosure of diagnoses, specifically Alzheimer's disease, to patients and their families. It provides guidance on assessing a patient's understanding and desire to know their diagnosis before disclosure. When disclosing Alzheimer's, it is important to arrange a joint meeting with family, allow time for questions, discuss disease progression and care plans, and involve caregivers going forward. The case study describes one family's experience where the husband decided to disclose the wife's Alzheimer's diagnosis to her in the doctor's office, but she initially reacted with disbelief and later developed aggressive behaviors towards her husband caregiver.
This document lists and describes various orthotic braces and devices for the upper body, lower body, and spine. It includes braces for the shoulder, elbow, wrist, hand, back, knee, ankle, and foot as well as cervical collars and braces used for spinal curvature and rehabilitation.
Shockwave therapy involves using pressure waves to treat tennis elbow. A study found that 61% of patients receiving shockwave therapy were pain-free after 1-2 years, while a control group reported more pain. Shockwave therapy is a safe and effective treatment for tennis elbow. It works by stimulating healing processes in the body and increasing blood flow to relieve pain. Exercises like wrist stretches can also help relieve elbow pain by strengthening muscles and increasing flexibility.
This document discusses falls in the elderly and provides guidance on assessing risk and preventing falls. It outlines a case of a 78-year-old female presenting for care and notes her reported falls and balance issues. The document reviews intrinsic and extrinsic risk factors for falls and recommends screening all patients aged 65+ annually. It provides details on components of the history, physical exam, functional assessment, and interventions including exercise, home modifications, and medication management to reduce fall risk.
A prosthesis is an artificial replacement for any part of the body that is missing. It is designed to replace the function and appearance of the missing limb as much as possible. Prostheses for lower and upper limb amputations are prescribed based on the level and cause of amputation. The main components of a prosthesis are the socket, suspension system, control system, and terminal device. The socket provides an intimate fit with the residual limb. Suspension systems like belts and harnesses help hold the prosthesis securely. Control systems can be body-powered using cables or externally powered using batteries. Terminal devices replace missing hands or feet. The goal is to restore ambulation and functional tasks using a prosthesis.
Occupational Therapy Practice Framework- American Occupational Therapy Associ...Shamima Akter Swapna
The document summarizes key constructs of the Occupational Therapy Practice Framework including occupations, performance skills, performance patterns, client factors, and contexts/environments. It defines occupations as activities people need or want to do including self-care, work, education, leisure. It identifies areas of occupation and lists client factors, performance skills, and contexts/environments that influence occupational performance. Performance patterns include habits, routines, roles, and rituals.
Aging can be defined in several ways:
1) As the time-related deterioration of physiological functions necessary for survival and fertility that affects all individuals of a species over time.
2) As a multidimensional process of physical, psychological, and social changes that occurs as humans get older.
3) As a progressive functional decline or decrease in viability that increases susceptibility to death and disease as intrinsic age-related changes accumulate over time.
The document discusses models and methods of rehabilitation. It describes rehabilitation as helping a person reach their fullest potential physically, psychologically, socially, and educationally given their limitations. Rehabilitation nursing aims to restore abilities, prevent further disability, protect abilities, and assist patients. Principles of rehabilitation include beginning rehabilitation early, restoring independence, maximizing function within limits, and focusing on specific conditions. Methods include neurological, cardiac, drug, alcohol, physical, medical, vocational, vestibular, and stroke rehabilitation as well as community-based approaches. Models of rehabilitation include the Nagi, IOM, NCMRR, and new IOM models which define concepts like impairment, functional limitation, and disability and their interactions.
1. Geriatric rehabilitation aims to help the elderly regain independence by recovering physical, psychological, or social skills lost due to aging or disability.
2. The key principles of geriatric rehab are addressing the variability in aging, preventing the effects of inactivity, and maintaining optimal health.
3. Interventions include a variety of exercises, assistive devices, and environmental adaptations delivered through different settings and providers.
1) Theories of aging attempt to explain the aging process from biological, sociological, and psychological perspectives. Biologically, aging is viewed as the accumulation of random errors and damage over time according to stochastic theories. Programmed theories propose that aging is predetermined.
2) Sociological theories include disengagement theory, which is no longer supported, and activity theory which proposes that activity is important for well-being in aging. Psychologically, Maslow's hierarchy of needs and Erikson's stages of life provide frameworks for understanding aging.
3) A comprehensive history and physical assessment of elderly patients should include demographic information, chief complaints, present and past illness, social history, and review of systems to fully evaluate
The document discusses the biomedical model of medicine and its key assumptions. It explains that the biomedical model views illness as caused by biological factors outside an individual's control. Treatment aims to change the physical body, and the medical profession is responsible for treatment. It also discusses how behavioral health and health psychology challenged some of these assumptions, viewing illness as influenced by both biological and psychological factors, with individuals playing a role in both causes and treatment of illness.
Instrumental Activities of Daily Living (IADL) refer to more complex daily tasks beyond basic self-care that are needed for independent living. These include activities like managing finances, housekeeping, preparing meals, shopping, communication management, community mobility, and health and safety maintenance. Some examples of IADLs are using the telephone, managing transportation, performing light housekeeping and laundry, grocery shopping, and medication management.
Amputation,Stump care, phantom limb pain and gait training in lower limbHarshita89
1) Phantom limb pain and sensations are perceptions ranging from slight tingling to sharp pain that amputees feel in a limb that is no longer physically attached. It is estimated to affect 49-83% of amputees.
2) There are two main types of pain after amputation - incisional stump pain localized around the scar, and phantom pain felt in the amputated limb itself. Phantom pain can be crushing or tearing.
3) While phantom sensations often occur right after amputation, phantom pain may affect 8-10% of amputees initially but can persist for years in some cases. Stump pain is usually described as pressing, throbbing or burning.
This document provides a case study of an occupational therapy assessment and intervention for an 84-year-old woman admitted to the emergency department following a fall at home. The occupational therapist assessed the woman's mobility, transfers, and ability to complete activities of daily living to determine if she could be safely discharged home. Short term goals were set for the woman to increase her mobility and confidence, which were achieved within 30-60 minutes. Referral to falls prevention services was also made. The assessment and intervention demonstrated the role of occupational therapy in facilitating safe, independent discharge from the emergency department.
This document introduces standards for social work practice in health care settings developed by the National Association of Social Workers (NASW). It provides background on the role of social workers in health care, outlines guiding principles for social work, and defines key terms. The standards are intended to enhance social workers' skills and knowledge when working with individuals, families, providers, and communities in health care.
The document outlines a framework for promoting participation for health from 2009-2013. It discusses [1] key social and economic determinants of health, [2] population groups and action areas, [3] settings for action, [4] intermediate and long-term outcomes. The goals are to facilitate community and group involvement, self-efficacy, respectful relationships, and access to resources through inclusive, evidence-based programs at multiple levels from individual to societal.
Guidance During Week Five, you will be responsible for rea.docxwhittemorelucilla
Guidance
During Week Five, you will be responsible for reading Chapters 8 and 9 of the required
textbook by Frates (2014). Chapter 8: Communication in Health Organizations addresses
the vital role of communication, with a brief discussion of conceptual foundations a nd a
pragmatic recognition of supportive communication and coaching and counseling skills for
the healthcare manager. Unique aspects of communication in healthcare organizations
conclude the chapter.
Chapter 9: Values, Vision, Culture and Ethics discusses the role of vision and values in
health care organizations which are primarily (or should be) mission driven and patient
centered, and how leaders at every level of the organization express their commitment to
both by their behavior – or fail to. Culture is addressed from two perspectives, considering
both corporate culture and a health care organization’s cultural proficiency to serve an
increasingly diverse patient population with nontraditional needs and service preferences.
This week, Discussion 1:
asks students to discuss effective listening. From a theoretical perspective, the role of
communication highly depends on the prevailing environment, organization’s culture,
structure, and leadership (Robbins & Judge, 2015). The size and type of organization,
organization’s culture, and leadership style de termine what approaches of communication
should be adopted (Adelman & Stokes, 2012; Frates, 2014). Conflicts occur because
thoughts and feelings have not been communicated well enough to others or have been
misinterpreted. Misunderstandings often happen but can be corrected or avoided. To have
effective communications, leaders need to establish feedback mechanisms to check for
understanding (Adelman & Stokes, 2012; Robbins & Judge, 2015). There are some ways
leaders can do such as paraphrasing, asking que stions for clarification, and asking other
people’s point of view or suggestions.
Discussion 2:
covers values, vision, and culture. Johnson (2009) argued that organizational culture is
made up of “values, norms, language (i.e., acronyms), beliefs, symbols, and assumptions
that develop over time and begin with the founder of the organization” (p. 114).
Organizational culture and organizational leadership are mutually connected. The
leadership affects organizational culture and organizational performance , while the
organizational culture will also affect leaders' leadership styles and organizational
effectiveness (Frates, 2014; Johnson, 2009). Leadership’s responsibility includes
strategically addressing the organization’s culture, planning the provision of services,
acquiring and allocating resources, and setting priori¬ties for improvement (Eriutlu, 2011).
Patient safety should be the number one concern of any division of the health care industry
(Popescu, 2013). Healthcare leaders need to assess their organizational culture as a part of
the strategic pl ...
The document discusses key concepts in community occupational therapy including health, community, occupation, and community-based rehabilitation. It describes occupational therapists' focus on the interactions between a person, their occupations, and their environment. The overall goal of occupational therapy in a community setting is to help people develop skills for independent living and decrease hospitalization.
157Families in society the Journal of contemporary socialAnastaciaShadelb
This survey of 159 social workers in the United States aimed to understand practitioner perspectives on evidence-based practice (EBP). The survey found that practitioners consider proximal similarity, trustworthiness, and applicability when deciding whether to apply research evidence in practice. However, barriers like lack of workplace support, time constraints, and concerns about relevance limit EBP implementation. While practitioners value EBP, organizational factors are also important for successful adoption of new interventions. The study highlights the need for clearer dissemination of research and support for practitioners to integrate evidence into real-world practice settings.
ACT implementation may include a variety of
community stakeholders as well as both local and state
health authorities. If an organization is providing
effective ACT services, many systems which interface
with ACT clients (e.g., behavioral healthcare, primary
healthcare, criminal justice) have an investment in the
outcomes generated by ACT, because clients will not
be showing up in those systems as frequently. Courts,
hospitals, managed-care companies, and the local
mental health authority all interact with the
individuals you are serving. Therefore, it is important
to engage these key stakeholders in the
implementation process.
This document provides a framework to guide recovery-oriented practice in the Victorian specialist mental health system. It defines key terms like recovery and recovery-oriented practice. It outlines that the framework was developed through a policy analysis, literature review, and consultation with an advisory committee. The literature review identified important aspects of recovery-oriented practice at both the organizational and individual practitioner levels. The framework is structured around nine domains of recovery-oriented practice to align the work of the mental health workforce with recovery principles.
Re-imagining occupational therapy clients as communities: Presenting the Comm...Nerida Hyett
Re-imagining occupational therapy clients as communities: Presenting the Community-Centred Practice Framework
Dr Nerida Hyett PhD, MHSc, B.OT
Prof Amanda Kenny, Dr Virginia Dickson-Swift, and Dr Carol McKinstry
Occupational Therapy Australia 27th National Conference, Perth 2017
Twitter: @neridahyett
Cultural Competency In Health Service Management.docxstudywriters
This document discusses cultural competency in health service management. It outlines several key principles of cultural competency that are relevant for health service management, including understanding customers/societies, governance and accountability for change, identifying community needs, and generating partnerships. It also discusses NHMRC guidelines on taking a generic approach and considering various domains like organization and individuals. Ensuring culturally safe practices for both health professionals and consumers is important, such as acknowledging how one's own beliefs could affect others and providing dignified care without discrimination. Overall cultural competency is important for reducing health disparities, improving access to services, and achieving positive health outcomes.
Historical Community Health Nursing in Context Community Assessment and Popul...bkbk37
This document provides an overview of community health nursing and public health. It discusses the historical context and definitions of key terms. The three main points are:
1. Community health nursing aims to promote and protect the health of populations through disease prevention, health promotion, and addressing broad health determinants. It focuses on individuals, families, and communities.
2. Public health involves assessing health needs and risks in communities, developing policies to address issues, and ensuring access to health services. Its core functions are assessment, policy development, and assurance.
3. Healthy People 2020 provides national objectives and frameworks to guide public health priorities and activities, focusing on 42 topic areas to promote health and prevent disease.
Interprofessional learning crossroads feb 12scohenkonrad
This document outlines the objectives and importance of interprofessional education and collaborative practice. It discusses 4 learning objectives: teamwork and collaboration, cultural awareness, cultural knowledge, and health literacy/communication. Interprofessional education aims to improve collaboration and quality of care by different professions learning from and with each other. The document emphasizes the importance of interprofessional skills to understand roles, implement teamwork, and center care around the patient. It provides examples of settings that can benefit from interprofessional education like emergency care.
Module 2 Foundations For Ot Practice Audiobenjatchison
The document discusses core beliefs and principles of occupational therapy, particularly for pediatric populations. It outlines areas of occupation and the occupational therapy practice framework, which views people as occupational beings and engagement in occupations as important for health. The framework examines client factors, performance skills and patterns, and the therapy process of evaluation, intervention planning, and outcomes measurement. A variety of intervention approaches and methods are presented, along with examples of how frames of reference and legitimate tools of practice can be applied.
Research ArticleCultural Adaptation of Interventionsin R.docxrgladys1
Research Article
Cultural Adaptation of Interventions
in Real Practice Settings
Flavio F. Marsiglia1 and Jamie M. Booth2
Abstract
This article provides an overview of some common challenges and opportunities related to cultural adaptation of behavioral
interventions. Cultural adaptation is presented as a necessary action to ponder when considering the adoption of an evidence-based
intervention with ethnic and other minority groups. It proposes a roadmap to choose existing interventions and a specific approach
to evaluate prevention and treatment interventions for cultural relevancy. An approach to conducting cultural adaptations is
proposed, followed by an outline of a cultural adaptation protocol. A case study is presented, and lessons learned are shared as
well as recommendations for culturally grounded social work practice.
Keywords
evidence-based practice, literature
Culture influences the way in which individuals see themselves
and their environment at every level of the ecological system
(Greene & Lee, 2002). Cultural groups are living organisms
with members exhibiting different levels of identification with
their common culture and are impacted by other intersecting
identities. Because culture is fluid and ever changing, the process
of cultural adaptation is complex and dynamic. Social work and
other helping professions have attempted over time to integrate
culture of origin into the interventions applied with ethnic
minorities and other vulnerable communities in the United
States and globally (Sue, Arredondo, & McDavis, 1992). In
an ever-changing cultural landscape, there is a renewed need
to examine social work education and the interventions social
workers implement with cultural diverse communities.
Culturally competent social work practice is well established
in the profession and it is rooted in core social work practice
principles (i.e., client centered and strengths based). It strives
to work within a client’s cultural context to address risks and
protective factors. Cultural competency is a social work ethical
mandate and has the potential for increasing the effectiveness
of interventions by integrating the clients’ unique cultural assets
(Jani, Ortiz, & Aranda, 2008). Culturally competent or culturally
grounded social work incorporates culturally based values,
norms, and diverse ways of knowing (Kumpfer, Alvarado,
Smith, & Bellamy, 2002; Morano & Bravo, 2002).
Despite the awareness about the importance of implementing
culturally competent approaches, practitioners often struggle
with how to integrate the client’s worldview and the application
of evidence-based practices (EBPs). When selecting and
implementing social work interventions, practitioners often
continue to unconsciously place themselves at the center of
the provider–consumer relationship. Being unaware of their
power in the relationship and undervaluing the clients per-
spective in the selection of EBPs tends to result in a typ.
The document discusses diversity in the workplace, specifically in healthcare. It notes that as workplaces become more diverse, issues related to different cultures must be addressed respectfully. Training is essential for diversity issues to foster mutual understanding and allow all staff to perform to their full potential. Diversity has benefits like improving patient care by allowing staff to better communicate with those from various backgrounds. The document advocates for diversity policies and procedures to be implemented effectively at all levels of an organization.
This document discusses training for culturally competent care. It outlines 8 principles for knowledge and skills training, including having a broad definition of diversity, ongoing training, job-specific focus, and practical application. Goals of training are increasing quality care, clinical excellence, reducing disparities, and a diverse workforce. Knowledge and skills are important for administrators to oversee care, for clinicians in areas like communication and treatment, and for supporting staff's front-line roles. Assessment ensures training effectiveness.
Similar to Cultural Caring: Bringing Occupational Therapy into High Definition for Clients Across Cultures (2011 AOTA Conference Presentation) (20)
These lecture slides, by Dr Sidra Arshad, offer a quick overview of the physiological basis of a normal electrocardiogram.
Learning objectives:
1. Define an electrocardiogram (ECG) and electrocardiography
2. Describe how dipoles generated by the heart produce the waveforms of the ECG
3. Describe the components of a normal electrocardiogram of a typical bipolar lead (limb II)
4. Differentiate between intervals and segments
5. Enlist some common indications for obtaining an ECG
6. Describe the flow of current around the heart during the cardiac cycle
7. Discuss the placement and polarity of the leads of electrocardiograph
8. Describe the normal electrocardiograms recorded from the limb leads and explain the physiological basis of the different records that are obtained
9. Define mean electrical vector (axis) of the heart and give the normal range
10. Define the mean QRS vector
11. Describe the axes of leads (hexagonal reference system)
12. Comprehend the vectorial analysis of the normal ECG
13. Determine the mean electrical axis of the ventricular QRS and appreciate the mean axis deviation
14. Explain the concepts of current of injury, J point, and their significance
Study Resources:
1. Chapter 11, Guyton and Hall Textbook of Medical Physiology, 14th edition
2. Chapter 9, Human Physiology - From Cells to Systems, Lauralee Sherwood, 9th edition
3. Chapter 29, Ganong’s Review of Medical Physiology, 26th edition
4. Electrocardiogram, StatPearls - https://www.ncbi.nlm.nih.gov/books/NBK549803/
5. ECG in Medical Practice by ABM Abdullah, 4th edition
6. Chapter 3, Cardiology Explained, https://www.ncbi.nlm.nih.gov/books/NBK2214/
7. ECG Basics, http://www.nataliescasebook.com/tag/e-c-g-basics
Basavarajeeyam is a Sreshta Sangraha grantha (Compiled book ), written by Neelkanta kotturu Basavaraja Virachita. It contains 25 Prakaranas, First 24 Chapters related to Rogas& 25th to Rasadravyas.
TEST BANK For Basic and Clinical Pharmacology, 14th Edition by Bertram G. Kat...rightmanforbloodline
TEST BANK For Basic and Clinical Pharmacology, 14th Edition by Bertram G. Katzung, Verified Chapters 1 - 66, Complete Newest Version.
TEST BANK For Basic and Clinical Pharmacology, 14th Edition by Bertram G. Katzung, Verified Chapters 1 - 66, Complete Newest Version.
TEST BANK For Basic and Clinical Pharmacology, 14th Edition by Bertram G. Katzung, Verified Chapters 1 - 66, Complete Newest Version.
TEST BANK For Basic and Clinical Pharmacology, 14th Edition by Bertram G. Katzung, Verified Chapters 1 - 66, Complete Newest Version.
Promoting Wellbeing - Applied Social Psychology - Psychology SuperNotesPsychoTech Services
A proprietary approach developed by bringing together the best of learning theories from Psychology, design principles from the world of visualization, and pedagogical methods from over a decade of training experience, that enables you to: Learn better, faster!
Integrating Ayurveda into Parkinson’s Management: A Holistic ApproachAyurveda ForAll
Explore the benefits of combining Ayurveda with conventional Parkinson's treatments. Learn how a holistic approach can manage symptoms, enhance well-being, and balance body energies. Discover the steps to safely integrate Ayurvedic practices into your Parkinson’s care plan, including expert guidance on diet, herbal remedies, and lifestyle modifications.
share - Lions, tigers, AI and health misinformation, oh my!.pptxTina Purnat
• Pitfalls and pivots needed to use AI effectively in public health
• Evidence-based strategies to address health misinformation effectively
• Building trust with communities online and offline
• Equipping health professionals to address questions, concerns and health misinformation
• Assessing risk and mitigating harm from adverse health narratives in communities, health workforce and health system
share - Lions, tigers, AI and health misinformation, oh my!.pptx
Cultural Caring: Bringing Occupational Therapy into High Definition for Clients Across Cultures (2011 AOTA Conference Presentation)
1. CULTURAL CARING
BRINGING OCCUPATIONAL THERAPY INTO HIGH
DEFINITION FOR CLIENTS ACROSS CULTURES
Cristina Reyes Smith, OTD, OTR/L, Coastal Therapy Services, Inc., Charleston, SC
Susan Toth-Cohen, PhD, OTR/L, Thomas Jefferson University, Philadelphia, PA
2. Objectives
Identify professional guidelines for clinical
practice when serving clients across diverse
cultures
Discuss supports and barriers to care uniquely
experienced by clients across diverse cultures
Discuss strategies and resources for
enhancing clinical practice related to clients
across cultures
Discuss reflections on own culture/values and
how they relate to practice
4. Now and into the future:
AOTA’s Centennial Vision
"We envision that occupational
therapy is a powerful, widely
recognized, science-driven, and
evidence-based profession with a
globally connected and diverse
workforce meeting society's
occupational needs.“
http://www.aota.org/News/Centennial.aspx
5. Settings…
Assisted living
Community
mental health
Corporations
Early intervention
Home health
Hospitals & clinics
Private practice
Schools
Skilled nursing facilities
Other community-based
programs
7. World Population Distribution by
Region
Based on United Nations Population Division, Briefing Packet, 1998 Revision
of World Population Prospects; and World Population Prospects, The 2006
Revision.
9. National Standards on Culturally and
Linguistically Appropriate Services
(CLAS)
Published by U.S. Department of Health & Human
Services Office of Minority Health (OMH), 2007
Directed at health care organizations and
providers
For integration in partnership with communities
Topics include:
Culturally Competent Care (Standards 1-3)
Language Access Services (Standards 4-7)
Organizational Supports for Cultural Competence
(Standards 8-14)
(OMH, 2007)
10. CLAS Standards
Mandates for Federal fund recipients:
Standards 4, 5, 6, and 7*
Recommended adoption by accrediting
agencies:
Standards 1, 2, 3, 8, 9, 10, 11, 12, and 13
Voluntary adoption by health care
organizations:
Standard 14
(OMH, 2007)
11. List of CLAS Standards (1-4)
Health care organizations should:
Standard 1: Ensure patients/consumers receive
effective, understandable, and respectful care compatible
with cultural health beliefs, practices, and language.
Standard 2: Implement strategies to recruit, retain, and promote
diverse staff and leadership representative of the service
area.
Standard 3: Ensure staff at all levels/disciplines receive ongoing
education and training in culturally and linguistically
appropriate service delivery.
*Standard 4: Offer and provide free language assistance
services for each patient/consumer at all times.
(OMH, 2007)
12. List of CLAS Standards (5-8)
*Standard 5: Provide verbal and written notices in preferred
language informing patients of right to language assistance
services.
*Standard 6: Assure competence of language assistance
provided by interpreters and bilingual staff. (Family and
friends not used unless requested by the patient/consumer).
*Standard 7: Provide easily understood patient-related
materials and signs in commonly encountered languages in
the service area.
Standard 8: Develop, implement, and promote written
strategic plan to provide culturally and linguistically
appropriate services.
(OMH, 2007)
13. List of CLAS Standards (9-11)
Standard 9: Conduct initial and ongoing organizational self-
assessments of CLAS-related activities and integrate related
measures into audits and performance improvement
programs.
Standard 10: Ensure data on the individual
race, ethnicity, and language (spoken and written) are
collected, integrated, and periodically updated.
Standard 11: Maintain current demographic, cultural, and
epidemiological community profile and needs assessment for
planning/implementing services.
Standard 12: Develop participatory, collaborative partnerships
with communities and facilitate involvement in
designing/implementing CLAS-related activities.
(OMH, 2007)
14. List of CLAS Standards (12-14)
Standard 13: Ensure conflict and grievance resolution
processes are culturally and linguistically sensitive and
effective for cross-cultural conflicts or complaints.
Standard 14: Regularly provide public information about
progress/successful innovations in implementing CLAS
standards and about availability of the information.
(OMH, 2007)
15. OT Resources to Guide Practice
Occupational Therapy Code of Ethics
(AOTA, 2010)
OT Practice Framework (AOTA, 2008)
On Cultural Competency and Ethical Practice
(Wells, 2005)
Five Competencies for the Future
(Moyers, 2003)
16. Occupational Therapy Code of
Ethics
Public statement of principles for the profession
Promotes inclusion, diversity, independence, and
safety
Relates to all recipients in various stages of
life, health, and illness
Aims to empower all OT beneficiaries
Extends to recipients as well as
colleagues, students, educators, businesses, and
the community
(AOTA, 2010)
17. Occupational Therapy Code of
Ethics
Occupational therapy personnel shall:
Principle 1. Beneficence
Demonstrate a concern for the well-being and safety of the
recipients of their services.
Principle 2. Nonmaleficence
Intentionally refrain from actions that cause harm.
Principle 3. Autonomy and Confidentiality
Respect the right of the individual to self-determination.
Principle 4. Social Justice
Provide services in a fair and equitable manner.
(AOTA, 2010)
18. Occupational Therapy Code of
Ethics
Principle 5. Procedural Justice
Comply with institutional rules, local, state, federal, and
international laws and AOTA documents applicable to the
profession of occupational therapy.
Principle 6. Veracity
Provide comprehensive, accurate, and objective information
when representing the profession.
Principle 7. Fidelity
Treat colleagues and other professionals with
respect, fairness, discretion, and integrity.
(AOTA, 2010)
19. OT Practice Framework: Domain and
Process
2nd Edition published by AOTA in 2008
Explains promotion of health and participation
through engagement in occupation
Relates to people, organizations, and populations
Core beliefs of profession include:
positive relationship between occupation and
health
people are occupational beings
(AOTA, 2008)
20. OT Practice Framework (cont.)
“All people need to be able or enabled to engage
in the occupations of their need and choice, to
grow through what they do, and to experience
independence or
interdependence, equality, participation, security
, health, and well-being” (Wilcock &
Townsend, 2008, p. 198).
21. OT Practice Framework (cont.)
Area of Client Performance Performan Context and Activity
Occupation Factors Skills ce Environmen Demands
Patterns t
Activities of Values, Sensory Habits Cultural Objects Used
Daily Living Beliefs, Perceptual Routines Personal and Their
(ADL) and Skills Roles Physical Properties
Instrumental Spirituality Motor and Rituals Social Space
Activities of Body Praxis Skills Temporal Demands
Daily Functions Emotional Virtual Social
Living (IADL) Body Regulation Skills Demands
Rest and Structures Cognitive Skills Sequencing
Sleep Communication and Timing
Education and Social Skills Required
Work Actions
Play Required
Leisure Body
Social Functions
Participation Required
Body
Structures
Figure 4. Aspects of Occupational Therapy’s Domain
22. On Cultural Competency & Ethical Practi
Advisory Opinion released by AOTA
Ethics Commission
Highlighted ethical care requires
acknowledging the relationship
between
trust,
culturalcompetence, and
the therapeutic relationship.
(Wells, 2005)
23. Five Competencies for the Future
Integrates concepts from Health Professions
Education: A Bridge To Quality (Institute of
Medicine, 2003)
For professional development and entry-level
education
I. Client-centered care:
Understand client differences, values, preferences, and expressed
needs.
Effective communication skills (listen carefully, clearly inform
client, etc.).
Collaborative clinical decision-making between client and clinician.
Knowledge of how community health is influenced by health of each
citizen.
Community engagement in occupations influences individual health.
24. Five Competencies for the Future
II. Working in teams and integrating services
Providing continuity of care (reliable processes to manage
health needs continuously and without disruption).
III. Evidence-based practice
Using best available research evidence with clinical expertise
and client values to select strategies for optimum care.
IV. Quality improvement competencies
Knowledge of standardization and simplification.
Improvement strategies for changes in systems and
processes.
V. Informatics
Technological management to enhance patient care and
reduce error.
(Moyers, 2003)
25. Current Evidence
Numerous studies have been conducted including:
improving attitudes and reducing resistance towards
addressing cross-cultural communication (Kaul &
Guiton, 2010),
improving patient satisfaction for patients with
limited English proficiency
(Fung, Lagha, Henderson, & Gomez, 2010), and
measuring attitudes toward caring for immigrant
patients (Hudelson, Perron and Perneger, 2010)
26. Kaul & Guiton, 2010
Reduced resistance and improved students’
attitudes towards medical cross-cultural
communication by
Utilizing upper-level students with clinicians as
instructors
Providing opportunities to relate to culture
personally and medically
Providing opportunities to practice skills to
address culture
27. Fung, Lagha, Henderson, &
Gomez, 2010
Found that addressing interpreter position
significantly impacted patient satisfaction
Instructed interpreter to sit behind patient to
support clinician-patient eye contact
28. Hudelson, Perron and Perneger, 2010
More likely to think providers should adapt to needs of
immigrant patients
Medical students, hospital doctors, women, those
trained in cultural competence, and those interested in
immigrant care
Had greater interest in caring for immigrant patients
Medical students, doctors with more immigrant
patients, and those trained in cultural competence
Gave greater importance to psychosocial contexts for
immigrant patients
Medical students, women, those younger, those
trained in cultural competence, and those interested in
immigrant care
30. Strategies for OT Practice
Promote Language
Language Interpreting
Access Proficiency
Cultural Community
Competence Partnerships
31. Promoting Language Access
Effective medical language interpretation
conductedby individual fluent in conversational
and medical vocabulary in both languages
Effective medical document translation
Verified
for meaning, grammatical, and contextual
accuracy
Effective signs and patient information
Verified
for meaning, grammatical, and contextual
accuracy
32. Promoting Language Interpreting
Proficiency
Recruit interpreters and translators from
Entitiesserving cultural groups in the community
Diverse university, religious, and social groups
Language-oriented organizations and businesses
Medical interpreting education/certification
programs
Collaborate with academic or community
entities for Medical Interpreting workshops
Utilize non-medical interpreters for non-
medical patient encounters
33. Promoting Cultural Competence
Coordinate or collaborate with cultural
celebration events
Hold small/focus group discussions for
reviewing articles, topics, or resources
Explore personal cultural identities and their
influences on health and occupation
Invite individuals from diverse cultures to
share their stories and occupations
Distribute resources on cultural competence
34. Promoting Community Partnerships
Provide services at community health fairs and cultural
festivals
Partner with media and publications to promote health
and wellness events, resources, or information
Collaborate with public or advocacy groups to address
social conditions which impact health and well-being
Collaborate with educational institutions incorporating
student learning into practice
35. Potential Community Partnership
Groups
Poverty and Student groups
homelessness Civic groups
Racism and social
inequality Media and
broadcasting
Crime prevention
Domestic and child Small Businesses
abuse prevention Corporations
Professional ESL and language
associations organizations
Cultural groups
Religious groups
36. Resources on Cultural Competence
“Unnatural Causes” PBS documentary series on socio-
economic and racial inequalities in health
(Adelman, Smith, & Herbes-Sommers, 2008):
www.unnaturalcauses.org
“Provider's Guide to Quality and Culture” (Management
Sciences for Health, 2008):
http://erc.msh.org/mainpage.cfm?file=1.0.htm&module=
provider&language=English
National Center for Cultural Competence:
http://www11.georgetown.edu/research/gucchd/nccc/
AARC Cultural Diversity Resources:
http://www.aarc.org/resources/cultural_diversity/assessi
ng_competency.cfm
37. Resources on Self-Assessment &
Growth
ASHA Self-Assessment for Cultural Competence:
http://www.asha.org/practice/multicultural/self.htm
Cultural Competence Health Practitioner Assessment
(CCHPA):
http://www11.georgetown.edu/research/gucchd/nccc/features/
CCHPA.html
“A Guide to…Planning and Implementing Cultural
Competence Organizational Self-Assessment”
(Goode, Jones, & Mason, 2002):
http://www11.georgetown.edu/research/gucchd/nccc/docume
nts/ncccorgselfassess.pdf
“Conducting A Cultural Competence Self-assessment”
(Andrulis, Delbanco, Avakian, and Shaw-Taylor, n.d.):
http://www.consumerstar.org/pubs/Culturalcompselfassess.pd
39. Case Study
1y.o. AA male patient “Alexander”
Born premature at 23 weeks
PMHx Grade IV IVH with post hemorrhagic
hydrocephalus, sensorineural hearing
loss, CVI, and dysphagia
Lives with great-
grandmother, grandmother, mother, and young
cousins
Family resides in inner city community
40. Case Study (cont.)
Supports Barriers
Stable family structure Limited family income
Family language/literacy Limited family education
Family familiarity with Some distrust of
healthcare system
healthcare system
Medical complications
Family organizational Limited transportation
skills High provider turnover
Access to early Limited provider
intervention services communication
41. Patient “Alexander” Outcomes
Created journal to enhance provider communication
Included provider contact info and pt. medication
list
Informally inquired about the “lived experience” of
the patient and family
Collaborated with family on goals and objectives
Integrated home programs into family routines
Educated family on interventions, potential
outcomes, and medical resources
Directed family to community-based resources for
additional funding and supplies
42. Case Study
55 y.o. female patient “Dina”:
Recently diagnosed with diabetes
Lives with husband and 2 middle-aged sons
Low income, high crime community
Pt. speaks only Spanish
43. Case Study (cont.)
Supports Barriers
Stable family structure Limited family income
Family organizational Limited family
skills education
Access to charitable Limited language
healthcare services fluency
Some transportation Limited literacy
Limited familiarity with
healthcare system
Limited trust of
healthcare system
44. Patient “Dina” Outcomes
Patient was able to access free medical clinic
Provided language interpreter services to facilitate
clinical encounter
Provided medical information in native language
Educated on medications, potential outcomes, and
medical resources
Educated on necessary lifestyle changes (i.e. diet
and exercise, etc.)
Educated on relevant features of the healthcare
system
46. Organizational Case Study
Faith-based medical clinic “DCC” opened Jan.
2009
Free medical services for uninsured local
residents
Low-income, low-education, & high-crime area
Racially diverse community (White, AA, &
Hispanic)
Staffed by medical and non-medical volunteers
(mostly from neighboring communities)
47. Organizational Case Study (cont.)
Supports to Organizational Cultural
Competence
Incorporated, non-profit charitable organization
Enthusiastic coordinators and volunteers
Large volunteer base (over 300 initially)
Free-standing facility acquired in October 2008
Informed by Community Health Needs
Assessment
Established sub-committees for various needs
Relationship established with community and host
church
Website established for communication
48. Organizational Case Study (cont.)
Barriers for Organizational Cultural
Competence
Limited patient access (hours and transportation)
Limited staff training and experience in the setting
Limited knowledge of potential cultural challenges
Limited resources to facilitate cultural
competence
Limited staff to assist non-English speaking
patients
Limited trust from community groups
Limited referral systems for culturally-relevant
49. Key Players &
Stakeholders
Organizational
Supports &
Environment Barriers
& Culture
Cultural
Competence
Plan
Organization
National CLAS
Mission
Statement Standards
Development of Cultural Competence Plan
50. Organizational Case Study (cont.)
Objectives:
Promote communication across language
barriers
Provide culturally-sensitive clinical care
Establish sense of trust and safety for patients
Access community resources to address
issues
51. Organizational Strategies for
“DCC”
Translator and Interpreter Training:
mission and background of clinic
concept of “cultural caring”
need for enabling language access
roles/qualifications for interpreters & translators
interpreter etiquette
ethical/legal considerations
resources for further study
52. Organizational Strategies for “DCC”
Patient-
Centered
Respectful of
Knowledgeable
Others
Seeking Humbly
Understanding Educating
Ambassador
Skillful
Communicator of Cultural Leading
Caring
Interpreters & translators as “Ambassadors of Cultural Caring”
53. Organizational Strategies for “DCC”
Meeting held for staff and volunteers:
Discussed values, beliefs, and behaviors
Discussed importance of patient access to skilled
language interpreting services
Discussed importance of sensitivity to cultural issues for
“cultural caring”
Discussed individual and organizational strategies for
working across cultures
54. Small Group Discussion (15
min)
Your cultural
identity and how
it relates to
practice
Observed
barriers to care
in various
practice settings
related to
cultural factors
Strategies for
•
developing
culturally
competent
clinicians and
organizations in
your practice
area
55. Large Group Discussion and
Synthesis
Insights
and
innovations
Continued
challenges
or questions
Additional
resources
for further
study
57. References
AOTA. (n.d.). The Road to the Centennial Vision. Retrieved from
http://www.aota.org/News/Centennial.aspx
AOTA. (2010). Occupational therapy code of ethics. American
Journal of Occupational Therapy, 64, in press. Retrieved from
http://www.aota.org/Practitioners/Ethics/Docs/Standards/38527.asp
x
AOTA. (2008). Occupational therapy practice framework: Domain
and process 2nd edition. American Journal of Occupational
Therapy, 62(6), 625-683.
Adelman, L. (Executive producer), Smith, L. M. (Co-executive
Producer) & Herbes-Sommers, C. (Senior Producer). (2008).
Unnatural Causes: Is Inequality Making Us Sick? [Television
Broadcast]. San Francisco: California Newsreel in association with
Vital Pictures, Inc.
58. References (cont.)
Andrulis, D., Delbanco, T., Avakian, L., and Shaw-Taylor, Y. (n.d.).
Conducting a Cultural Competence Self-Assessment. Retrieved
from http://www.consumerstar.org/pubs/Culturalcompselfassess.pdf
Fung, C. C., Lagha, R. R., Henderson, P., & Gomez, A. G. (2010).
Working with interpreters: how student behavior affects quality of
patient interaction when using interpreters. Medical Education
Online, 15. doi: 10.3402/meo.v15i0.5151
Goode, T. D., Jones, W., & Mason, J. (2002). A Guide to…Planning
and Implementing Cultural Competence Organizational Self-
Assessment. Retrieved from
http://www11.georgetown.edu/research/gucchd/nccc/documents/nc
ccorgselfassess.pdf
59. References (cont.)
Hudelson, P., Perron, N. J., & Perneger, T. V. (2010). Measuring
physicians' and medical students' attitudes toward caring for
immigrant patients. Evaluation & the Health Professions. Retrieved
from
http://ehp.sagepub.com.proxy1.lib.tju.edu:2048/cgi/rapidpdf/016327
8710370157v1
Institute of Medicine. (2003). Health professions education: A bridge
to quality. Washington, DC: National Academy Press.
Kaiser Family Foundation. (2010). Distribution of U.S. Population by
Race/Ethnicity, 2010 and 2050. Retrieved from
http://facts.kff.org/chart.aspx?ch=364
Kaul, P., & Guiton, G. (2010). Responding to the challenges of
teaching cultural competency. Medical Education, 44(5):506.
60. References (cont.)
Management Sciences for Health. (2008). The culturally competent
organization. Provider's Guide to Quality and Culture. Retrieved
from
http://erc.msh.org/mainpage.cfm?file=9.1.htm&module=provider&la
nguage=English
Moyers, P. (2003). Five competencies for the future. OT
Practice, 8(20), 8.
Population Reference Bureau. (2011). World Population Distribution
by Region, 1800–2050. Retrieved from
http://www.prb.org/Educators/TeachersGuides/HumanPopulation/Po
pulationGrowth/QuestionAnswer.aspx
Wallace, E. A., & Duffy, F. D. (2010). Cultural competency training
and performance measures to reduce racial disparities in health
care quality. Annals of Internal Medicine, 152, 685.
61. References (cont.)
Wells, S. A. (2005). On Cultural Competency and Ethical Practice.
Retrieved from
http://www.aota.org/Practitioners/Ethics/Advisory/36525.aspx
U.S. Department of Health & Human Services Office of Minority
Health. (2007). National Standards on Culturally and Linguistically
Appropriate Services (CLAS). Retrieved from
http://www.omhrc.gov/templates/browse.aspx?lvl=2&lvlID=15