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HTHM801 Health Policy And Decision Making

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HTHM801 Health Policy And Decision Making Question: Case Study: National Standards on Culturally and Linguistically Appropriate Services in Health and Health Care.  Case Summary: In a narrative format, discuss the key facts and critical issues presented in the case. Case Analysis: a. OMH has said the enhancement initiative followed a decade of successful implementation of the 2000 standards, but the news media have reported on implementation problems, and the 2013 standards were released with an implementation manual almost 200 pages long. What do you think might be some barriers to implementation, and what would you suggest to encourage implementation? b. What do the expanded definitions of health and culture say in general about the way government framed health in 2013 as compared to 2010? What might have contributed to the change? c. How do you explain the differences between recommendations, guidelines, and mandates? What are the possible explanations for making all enhanced standards guidelines? Executive Decisions: a. Which are the most important standards in your opinion? Which are the least important? Explain your reasoning. b. What would you change about these standards if you were in charge of the U.S. Department of Health and Human Services? c. Does it seem unusual to you for a government agency to wait more than 10 years to review and revise standards like these? What night be the reasons for waiting? What arguments could be made for more frequent review? Answer: According to Purnell (2013), cultural competence is having the knowledge, skills, and ability to effectively understand a patient’s culture. Concurring and respecting these cultural distinctions is crucial in promoting cultural diversity and reducing health disparities. More so, analyzing standards that help improve culture and language in a healthcare organization is essential (Wynia, Johnson, McCoy, Griffin, & Osborn, 2010). Hospitals need to develop an understanding of their patience cultural diversity, and make improvements across all demographic groups so as to improve their overall performance. For many years, the original National CLAS standards serves as a motive to improve on health equity. In 2000, the definition of health was no implicit, this is because the development and implementation of the standards were not clear. Similarly, the value of the patient outcome is not considered due to lack of emphasizing. Although ethnic disparities in health might have triggered its enhancement, racial diversity is the main factor that promotes its innovation. Information from the National Advisory Committee, public meetings, general comments, and literature review are the development processes that are used to enhance it. The new standards have improved their lucidity to promote assimilation and the ability to understand how to use them in an organization. It has a broader meaning of recipients and how services should be offered in a health center. Moreover, it explains that we no longer refer people as patients but we call them individuals since matters affect them at a personal level. Similarly, it is not about consumer satisfaction rather than how one delivers assistance in order to attain contentment. The revised standards provide a structure for firms seeking to offer services that are responsive to cultural health beliefs and health equity. In this case, health equity can be defined as the achievement of the highest level of health for all people in a given population. They apply to firms that are focused on the prevention of health issues and gaps. The National CLAS 2013 are services that consider and respect the health of an individual. It defines health as being free from diseases (McLaughlin & McLaughlin, 2015). Moreover, it describes culture a series of learning beliefs, social behavior, customs and language (Weech-Maldonado et al., 2012). CLAS ensures that services are offered in a suitable and sensitive manner, in a way that it respects people’s cultural standpoint. The office of monitoring health developed 15 standards that are used in guiding the implementation of culturally and linguistically appropriate services. Principal, Governance, leadership and workforce, communication and language assistance, and engagement, continuous improvement are the categories used in grouping the standards. Leadership and workforce standards help in recruiting and hiring qualified individuals that will be able to adjust in a diverse population. It also outlines the importance of continuing with education and training. It further outlines the importance of employing a culturally diverse staff member into administrative and managerial positions. Such diversity helps them in planning, making policies and decision making in regards to health care issues. Providing mentoring opportunities to support personal growth will also help improve the effectiveness of an organization. Alternatively, engagement, continuous improvement and accountability are crucial in an organization. The standards clearly emphasize that top management of any organization are responsible for the implementation of the CLAS standards. Managers should be able to provide performance feedback of every staff in the organization. It is essential because it helps to outline the shortcomings of an individual and the appropriate training methods that each should receive. When implementing the CLAS standards it is advice able to use the toolkit. It mainly helps healthcare agencies such as hospitals, clinics, and local health departments in Health Care Delivery. Implementation of health promotion programs will also improve the skills of the staffs in an organization. Furthermore, it is essential to develop measures to assess the effectiveness of the programs being implemented in order to improve the areas that have less impact. Evaluation of the program is crucial since it helps to improve the quality of services and healthcare outcomes. Communicating mission, policies and procedures is also crucial in promoting excellent performance by nurses. An assumption can be the worst decision made by managers. Regular supervision and individual career development plans should be done to ensure that every employee is fit to do a particular task and that everyone employed has the right and required skills. The blueprint acts as guidance in advancing and sustaining policies and cultural practices (Ohta, 2015). It also provides strategies for implementation of the standards and a list of resources for additional guidance. The enhancement of the old standards was triggered by the rapid growth in the demographic trends occurring in the United States. Moreover, the rapid growth of upcoming treatments and different ways to reduce gaps promoted change. It also addresses the issue of health literacy, patient satisfaction and safety, and the advancement of technology. To ensure the proper implementation of CLAS Standards, the healthcare organizations need to have knowledge on cultural proficiency and linguistic competence. Language is a method of written and spoken communication. Basically, it often reflects the cultural environment within which a specific group of people lives. There is more to just being a substance of the communication, it defines the differences that exist through various factors such as accent and dialects. Language is what defines the specific culture of a specific group. The use of the new standards helps to promote cultural competence which has emerged as a solution to inequalities. To achieve cultural competence in an organization, training of cross-cultural issues is very important. Creating policies is also crucial in reducing administrative and linguistic barriers to patient’s care. However linguistic competence refers to the capability of an individual or health organization to effectively communicate to a diverse population. Social-cultural barriers, language, attitudes towards health care and beliefs are the major barriers to culture and linguistics. Moreover, establishing policies and procedures that will help assess the competency of a staff is essential. In addition, it was very unusual for the government to wait for 10 years, given that there is a rapid growth in the emergence of new diseases and infections. Unavoidable factors such as resources might have contributed to the delay. The government should set aside finances and request health donators to take part in the innovation process. It should also invest in research which will help in finding new interventions that will help prevent health disparities. According to the original standards document, the recommendation is a proposal for voluntary adoption by healthcare organization which emphasized on the implementation of conflict and grievance resolution processes. However, the mandate includes Federal requirements for those receiving confederate funds. Lastly, the guidelines involve activities required in the implementation and the adoption of mandates (Register, 2013). Standards for Culture and Linguistics promotes responsiveness to diversity in healthcare organizations. In other words, they help place specific policies and cultural practices that act as a guide when offering services (Seeleman, Essink-Bot, Stronks, & Ingleby, 2015). Communication, language assistance, engagement, continuous improvement, and accountability are the most important standards in the healthcare organization. They affect the final outcome of how a health practitioner perform. Despite the fact that leadership and principal standards are important they lack a direct impact on how the service is delivered. However, the enhanced National CLAS Standards encourages a united adoption of all Standards since it is the most effective and efficient approach to achieve quality health care services for all individuals. Good communication helps consumers feel in control, therefore nurses should demonstrate sincerity, kindness, and humility. Effective communication requires an understanding of the patient’s culture and language. It also requires good communication skills that will help the consumer trust and feel valued by health practitioners. Verbal and non-verbal communication understanding should be the main priority of an organization. Medical centers like clinics, which support communication by the use of CLAS standards, have been able to achieve high-quality health care services. Preliminary health research shows that when individuals are able to express themselves without difficulties excellent patient outcome is achieved. In most cases, lack of cultural competence is associated with the continued tolerance of health disparities. This is a result of misperception between the patient’s culture, language and opinion with that of the nurse. It is essential to reduce barriers to communication. The difference in language, cultural distinctions, and health literacy are some of the barriers that may affect how treatment is applied to a patient (Schyve, 2007). Hurried communication should not be encouraged. Taking time to know a consumer is very essential in order to create a friendly environment. Physical factors such as hearing and seeing can also hinder communication (Norouzinia, Aghabarari, Shiri, Karimi, & Samami, 2015). Standards make a great impact on how effective staff will perform in an organization. These benefits include a reduction of how long inpatient will stay, increase in medication adherence, improved patient satisfaction, improved financial outcomes and enhanced services for the growing diverse population. National CLAS standards aim at addressing inequalities and disparities in health care (Barksdale et al., 2016). In spite of the effort of trying to implement them in hospitals, they should be reign forced when a student enrolls in a nursing school. Before practitioners can understand other cultures, they should understand personal and organizational values and beliefs. This will enable them to listen to the patient’s understanding of health, being respectful, and negotiating treatment options. In health organizations, linguistics competence requires interpretation and translation services. The translation of written material will help to provide alternative information based on the needs of the population being served, employing individuals that can translate both verbal and non-verbal communication is necessary. It will enhance the accommodation of all individuals that are in need of treatment. Individuals should be informed of the availability of language assistance programs. Though it might seem to be time-consuming, it will help the organization have an added advantage in the market. Subsequently, the use of technology such as tracking systems is important when implementing in order to improve the quality of services (Beach et al., 2004). For nurses to achieve cultural and linguistic competency they need to be willing to accommodate all kinds of patients. At times, pain can be a major hindrance of communicating. Nurses should make an effort of assuring the patient that he or she has the support from the hospital. In other words, a nurse can give painkillers that will help reduce pain which will allow the patient to explain himself. Another way that nurses can use is the use is explaining health-related jargons this will help to prevent the patient from fearing. Understanding the different roles of women in different society is very important because it helps to create a nurse-patient relationship (Neese, 2016). Lack of cultural diversity awareness and language are the barriers of implementing the standards (Ogbolu, Scrandis, & Fitzpatrick, 2018). Inadequate resources such as time and lack of cultural competence training also act as barriers (Ogbolu & Scrandis, 2017). An intervention that can be used is employing medical interpreters who will help with the interpretation of foreign language (Zuniga, Seol, Dadig, Guion, & Rice, 2013). The use of the internet by nurses is also important because it will place them in a learning environment. The internet tends to improve the performance of an individual since he or she is able to learn from other people globally. It also an added advantage to the organization since they will be able to identify their competitors and learn from them. In conclusion, cultural competence training intervention for health care providers and students is essential for quality health services (Lie, Lee-Rey, Gomez, Bereknyei, & Braddock, 2010). It helps to focus on the patient-provider relationship and helps to promote changes in the clinical environment. Establishing individual responsibility will also help increase the performance of an individual. This is because they will be careful not to make mistakes and also feel trusted by the management. Employee empowerment is very crucial in an organization since they will feel appreciated and respected. References Barksdale, C. L., Rodick, W. H., Hopson, R., Kenyon, J., Green, K., & Jacobs, C. G. (2016, July 21). Literature Review of the National CLAS Standards: Policy and Practical Implications in Reducing Health Disparities. Retrieved from https://www.ncbi.nlm.nih.gov/pubmed/27444488 Beach, M. C., Cooper, L. A., Robinson, K. A., Price, E. G., Gary, T. L., Jenckes, M. W., … Gozu, A. (2004, January). Strategies for Improving Minority Healthcare Quality: Summary. Retrieved from https://www.ncbi.nlm.nih.gov/books/NBK11918/ Lie, D. A., Lee-Rey, E., Gomez, A., Bereknyei, S., & Braddock, C. H. (2010). Does Cultural Competency Training of Health Professionals Improve Patient Outcomes? A Systematic Review and Proposed Algorithm for Future Research. Journal of General Internal Medicine, 26(3), 317-325. doi:10.1007/s11606-010-1529-0 McLaughlin, C. P., & McLaughlin, C. D. (2015). Chapter 4: Where Do We Want to Be? In Health Policy Analysis: An Interdisciplinary Approach (2nd ed., p. 102). Neese, B. (2016, July 22). A Guide to Culturally Competent Nursing Care. Retrieved from https://online.alvernia.edu/culturally-competent-nursing-care/ Norouzinia, R., Aghabarari, M., Shiri, M., Karimi, M., & Samami, E. (2015). Communication Barriers Perceived by Nurses and Patients. Global Journal of Health Science, 8(6), 65-74. doi:10.5539/gjhs.v8n6p65 Ogbolu, Y., & Scrandis, D. A. (2017, April). Barriers and facilitators of care for diverse patients: Nurse leader perspectives and nurse manager implications. Retrieved from https://onlinelibrary.wiley.com/doi/pdf/10.1111/jonm.12498 Ogbolu, Y., Scrandis, D. A., & Fitzpatrick, G. (2018). Barriers and facilitators of care for diverse patients: Nurse leader perspectives and nurse manager implications. Journal of Nursing Management, 26(1), 3-10. Retrieved from https://onlinelibrary.wiley.com/doi/full/10.1111/jonm.12498 Ohta, G. (2015, July). National Standards for Culturally and Linguistically Appropriate Services (CLAS) in Health and Health Care. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4498546/ Purnell, L. D. (2013). Foundations for cultural competence: individual and organisational. In Transcultural Health Care: A Culturally Competent Approach (4th ed., p. 7). Register, F. (2013, September 24). National Standards for Culturally and Linguistically Appropriate Services (CLAS) in Health and Health Care. Retrieved from https://www.federalregister.gov/documents/2013/09/24/2013-23164/national-standards-for-culturally-and-linguistically-appropriate-services-clas-in-health-and-health Schyve, P. M. (2007, October 24). Language Differences as a Barrier to Quality and Safety in Health Care: The Joint Commission Perspective. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2078554/ Seeleman, C., Essink-Bot, M., Stronks, K., & Ingleby, D. (2015, November 16). How should health service organizations respond to diversity? A content analysis of six approaches. Retrieved from https://bmchealthservres.biomedcentral.com/articles/10.1186/s12913-015-1159-7 Weech-Maldonado, R., Dreachslin, J. L., Brown, J., Pradhan, R., Rubin, K. L., Schiller, C., & Hays, R. D. (2012, January). Cultural competency assessment tool for hospitals: Evaluating hospitals adherence to the culturally and linguistically appropriate services standards. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4983191/ Wynia, M. K., Johnson, M., McCoy, T. P., Griffin, L. P., & Osborn, C. Y. (2010). Validation of an Organizational Communication Climate Assessment Toolkit. American Journal of Medical Quality, 25(6), 436-443. doi:10.1177/1062860610368428 Zuniga, G. C., Seol, Y. H., Dadig, B., Guion, W. K., & Rice, V. (2013, April). Progression in understanding and implementing the cultural and linguistic appropriate services standards: five-year follow-up at an academic center. – PubMed – NCBI. Retrieved from https://www.ncbi.nlm.nih.gov/pubmed/23629039

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