Monday, August 15, 2022

New position at NHRMC seeking to address ‘cultural competency’ issues with staff

NHRMC created a new position to address their challenges with "cultural competency." Survey data shows they have their work laid out for them.

 

Hired in September, Joseph Conway is the New Hanover Regional Medical Center's first Director of Health Equity and Human Experience. (Port City Daily photo/OLIVIA PARR)
Hired in September, Joseph Conway is the New Hanover Regional Medical Center’s first Director of Health Equity and Human Experience. (Port City Daily photo/OLIVIA PARR)

NEW HANOVER COUNTY — New Hanover Regional Medical Center recently started a program aimed at addressing demographic disparities in healthcare quality.

In September, Joseph Conway was hired as New Hanover Regional Medical Center’s first Director of Health Equity and Human Experience.

According to NHRMC, health equity refers to the social reality that not all patients have the same access to health care, nor ability or opportunity to access the care that is available.

“New Hanover Regional Medical Center has done great work in reaching a point where the employee population reflects the community it serves. However, disparities still exist within the under or unrepresented populations within our own organization and the community,” Conway said. “It will be our primary focus to assess and increase the cultural competence of the organization that we may better serve our patients, their families, the community, and employees.”
 
Cultural competence is defined by Georgetown University as the ability of providers and organizations to effectively deliver health care services that meet the social, cultural and linguistic needs of patients.

Survey of NHRMC leaders

The first item on Joseph Conway’s agenda was to understand where NHRMC stands with regard to health equity and cultural competence.

In November 2017, 365 medical center leaders including managers, directors, vice presidents, administrators, executives and board of trustees members were requested to participate in an anonymous cultural competency survey. The survey was provided by Quality Interactions using the online surveying platform, Qualtrics.

The survey sought to understand perceptions of the leadership about the cultural competency of their teams. It also sought to uncover the leadership’s awareness and attitudes toward cultural competency education.

Of the 365 requests for participation, 311 responded for an 84 percent completion rate.
 

Nearly 98 percent of leaders surveyed believe it is “extremely important” or “important” to consider cultural background when providing care.

Seventy two percent say staff are rarely or never evaluated on ability to care for culturally diverse patients. Sixteen percent selected “sometimes” and 7 percent selected “not sure.”

72 percent say staff are rarely or never evaluated on ability to care for culturally diverse patients. 16 percent selected “sometimes” and 7 percent selected “not sure.” (Port City Daily/OLIVIA PARR)
Seventy two percent of surveyed New Hanover Regional Medical Center leaders say staff are rarely or never evaluated on ability to care for culturally diverse patients. Sixteen percent selected ‘sometimes’ and 7 percent selected ‘not sure.’ (Port City Daily/OLIVIA PARR)

Leaders responded that 73 percent of staff have had between 0-2 hours of cultural competency training, with another 14 percent selecting “not sure.”

Leaders say teams are underprepared to handle issues that arise for patients who:

  • Are new immigrants (67 percent)
  • Use complementary/alternative medicines (52 percent)
  • Have cultural backgrounds very different than their own (48 percent)
  • Are mistrustful of the healthcare system & providers (46 percent)
  • Are LGBTQ (45 percent)

The majority of respondents recognize the consequences cultural issues can lead to, such as non-adherence to instructions or re-admissions.

Ninety-eight percent of survey participants endorse the importance of cultural competency in healthcare and within NHRMC.

“At NHRMC we believe that improving health outcomes while eliminating demographic disparities is the key fundamental for ‘Leading Our Community to Outstanding Health,’” said NHRMC Chief Physician Executive Phil Brown, quoting the health system’s mission statement.

How NHRMC plans to move forward

In spite of the survey data results, Conway is confident the medical center will be able to address the disparities moving forward.

“The next step for us is to create training that centers around cross-cultural communication,” Conway said. “We want the hard conversations to happen. We want the staff to be able to express themselves.”

South East Area Health Education Center (SEAHEC) will offer a classroom training and computer-based learning course addressing hidden and implicit bias. SEAHEC partners with NHRMC to offer training, education and resources to healthcare providers.

In addition to the hidden and implicit bias class, NHRMC is also looking to add an aggressive sexual harassment and sexual discrimination classroom training.

“It’s not necessarily about teaching leadership and staff the right answer versus the wrong answer, but more so on how to communicate with a particular patient,” Conway said.

Currently, NHRMC is in the decision-making stage where they are trying to decide whether or not to start with supervisors and coordinators or if they want to start with the front-line staff.

“Our company’s policy in the past has always been to start with leadership so when the front-line staff needs support, leaders are informed and ready to assist,” Conway said.

NHRMC is looking to get the training programs up and running by April.

“We are going to dig deep into the community to be able to determine what they need,” Conway said. “It’s about understanding your patients from a relationship standpoint.”

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