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Learn from Princeton University's experience in implementing a cultural competency initiative. Discover the steps, challenges, and strategies to begin your own initiative.
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Launching a Cultural Competency Initiative: One School’s Experience Presented by: Melva Hardy, MHSA Princeton University American College Health Association May 29, 2009
Cultural Competency How do I move from having a concept to a plan I can make happen? Where will I find the time? What do I need to get started? Where do I start? How long will it take?
Cultural Competency part of the culture of an organization
Change TheoryIn the model as of 1997, change is a "process involving progress through a series of six stages": • Pre-contemplation - "people are not intending to take action in the foreseeable future, usually measured as the next 6 months" • Contemplation - "people are intending to change in the next 6 months" • Preparation - "people are intending to take action in the immediate future, usually measured as the next month"[nb 1] • Action - "people have made specific overt modifications in their life styles within the past 6 months" • Maintenance - "people are working to prevent relapse," a stage which is estimated to last "from 6 months to about 5 years“
Workshop Goals Identify what you and your organization need to begin a cultural competency initiative. Identify the steps of a process to move your organization towards obtaining cultural competence. Identify strategies to overcome potential challenges or pitfalls.
Developing the Plan Putting Together What Works For You And Your Institution
University Health ServicesPrinceton University Approximately 7, 000 students 7 MDs 6 NPs 2 PAs 2 MAs Counselors and Psychiatrists Services include Counseling, Medical, Athletic Medicine, Inpatient, Sexual Health and Wellness, Employee Health,
Princeton’s History with Cultural Competency Past Staff Retreat / Meetings on the topic Work Environment Task Force: Fall 2002 Cultural Competency Work Group Holiday Decorations Policy Development
Princeton’s History with Cultural Competency Disjointed Programs across the Health Service Counseling and Psychological Services initiated a reading group Brought in a speaker for a 2 hour training of all staff Cultural Awareness Boards Launched Cultural Competency Work Group: December 2005
Princeton’s Launch of the Cultural Competency Initiative • Determined the team members / staff person accountable for moving the initiative along • Prepare team members / accountable staff person • Literature on cultural competence in healthcare organizations • Resources that will be available to you during the process • Review population data / Set up mechanisms to collect data • Outline goals of the workgroup • Obtain leadership approval
When you think about launching a Cultural Competency initiative at your school . . . . . .what are some of the questions or concerns that come to your mind?
What you need to begin Resources and Connections Goals A plan A Champion / team of champions
Examples of Resources To Explore • CLAS Standards--- Culturally and Linguistically Appropriates Services in health care • Accreditation Standards on Cultural Competence • State Regulations • Betancourt and Alexander articles • DiversityRx.com (list serve, communities of practice initiative) • Conference on Healthcare for Culturally Diverse Populations
Examples of Resources To Explore • Dennis Andrulis, Drexel University School of Public Health • National Center for Cultural Competence (Georgetown University) • Publication that demonstrates roadblocks • Free assessment tools • Thomas LaVeist , PhD (Johns Hopkins University) COA-360 • Paul T. Doyle and Associates www.paultdolye.com
What you need to begin Resources and Connections Goals A Champion / team of champions A plan
Goal Setting GROUP ACTIVITY: Use the worksheet to come up with goals for a project you will work on today
Princeton’s Work Group Goals • Incorporate cultural competence as a value in professional practice. • Referring to clients and systems • To incorporate cultural awareness in working relationships • To incorporate cultural understanding in thoughts and behaviors. *Relationships = clients, colleagues, peers, and hierarchical within the organization
Exploration of Internal Reservations and External Concerns Gain a clear perspective of our current culture and environment regarding cultural competency in the different departments of the health service Establish the role of the work group in the implementation process Desire to avoid repeating past mistakes Avoid offending people Expectations about confrontation Establish common expectations Avoid one person or small group carrying the burden for success Maintain a focus on the agenda for cultural competency throughout the process
What you need to begin Resources and Connections Goals A Champion / team of champions A plan
Workshop Goals • Identify what you and your organization need to begin a cultural competency initiative. • Resources and Connections • Goals • Champion / team of champions • A plan • Identify the steps of a process to move your organization towards obtaining cultural competence. • Identify strategies to overcome potential challenges or pitfalls.
Cultural Competency Launching Process Develop a project plan Define Cultural Competency for your organization Communicate the plan and definition throughout the organization and your campus
Task Development GROUP ACTIVITY: Brainstorm tasks for the project your group has chosen to work on today
Task Development GROUP ACTIVITY: Categorize tasks that you brainstormed in your group
Princeton’s Plan: Category of Tasks Assessment and Education Research Communication Skill Building Process / Program Management Work Group Preparation / Internal Needs Scope of Work / Conceptual Clarity Outreach / Collaboration
Process Mapping GROUP ACTIVITY: Place the tasks in order that they would come in the project. The outcome will be the draft of your group’s project plan.
Task Analysis GROUP ACTIVITY: Use the worksheet to determine how long it will take to complete each task and set deadline dates to each task in your project plan
Strategic Plan Establish a start date Task deadline dates will follow
Workshop Goals • Identify what you and your organization need to begin a cultural competency initiative. • Resources and Connections • Goals • Champion / team of champions • A plan • Identify the steps of a process to move your organization towards obtaining cultural competence. • Identify strategies to overcome potential challenges or pitfalls.
More Strategies to overcome pitfalls • Conflict Management • Requesting fears and concerns of workgroup members • Soliciting information about fears and concerns of the rest of the staff in the organization • Brainstorm ways to address the fears as part of the project plan. This is different than other projects • Communication • Avoid overuse of terminology / jargon • Know your audience as you present your project plan to build buy-in across the organization • Lost 6 months worth of productive project time.
More Strategies to overcome pitfalls • Connections • Develop a list of resources that will be available to staff throughout the development phase of the initiative. • Seek out formal and informal partnerships • External partners • Internal partners
Workshop Goals • Identify what you and your organization need to begin a cultural competency initiative. • Resources and Connections • Goals • Champion / team of champions • A plan • Identify the steps of a process to move your organization towards obtaining cultural competence. • Identify strategies to overcome potential challenges or pitfalls.
Overview of the Plan Research Work group preparation Assessments Process planning and program(s) development Process and program implementations Re-assessment and plan revisions
PROCESS AND PROGRAM IMPLEMENTATION RE-ASSESSMENT PROCESS AND PROGRAM PLANNING ASSESSMENTS PROJECT PROGRESSION WORK GROUP PREPARATION RESEARCH PROJECT PROGRESSION Project Progression and Visibility to the Organization Visible NotVisible
Overview of the Plan Research Work group preparation Assessments Process planning and program(s) development Process and program implementations Re-assessment and plan revisions
Research • Research Cultural Competence • Definitions • Culture • Cultural Competence • Cultural Competence in different healthcare disciplines • Organizations • In college health organizations • Other health care organizations • Our organization and attempts to address the topic • Research Consultants and Trainers • Organizational consultants • Trainers (for all staff) • Counselors to have available for staff during the process
Research 8 months Original Date: January – August 2007 Revised Dates: July 2007 – February 2008
Overview of the Plan Research Work group preparation Assessments Process planning and program(s) development Process and program implementations Re-assessment and plan revisions
Work Group Preparation • Education about tools and principles in the field of cultural competence • Avanti retreat / training • Work group retreat / training • Sensitivity training • Individually process reactions to the trainings
Work Group Preparation(cont’d) • Work Group team building • Share our experiences with each other • Share any initial concerns or reservations about launching the project plan • Establish communication mechanism(s) between Avanti and the Work Group
Work Group Preparation 3 months Original Dates: April – July 2007 Revised Dates: February - April 2008
Overview of the Plan Research Work group preparation Assessments Process planning and program(s) development Process and program implementations Re-assessment and plan revisions
Assessments • Use Assessment Tools • Conduct organizational assessments • Offer individual assessments • Focus Groups • Of Clients to learn their experiences • Of Staff to learn their experiences • Benchmark our organizational assessment outcomes against similar organizations • Assess organizational readiness for change
Assessments 12 months Original Dates: Summer 2007 – Summer 2008 Revised Dates: May 2008 – May 2009