It seems that the term "cultural competence" is one that I have been hearing very often lately: when interviewing candidates for the Diversity and Cultural Competence Council, at New Employee Orientation when I present on this topic, and most recently at our practice managers' round table meetings. When I talk about cultural competence, I use the following definition from The Joint Commission:
[Cultural competence is] the ability of health care providers and health care organizations to understand and respond effectively to the cultural and language need brought by the patient to the health care encounter.
I'm excited to share a real story that happened at RMH! It's about how a team of employees in various departments worked together and demonstrated cultural competence at its best, all with the goal to provide high quality care to the patient.
The story begins with a call from an orthopedic scheduler at RMH Orthopedics and Sports Medicine. She had a patient who was one of Jehovah's Witnesses. The physician had ordered Procrit (a medication that stimulates your bone marrow to make more red blood cells) to be administered prior to total knee replacement surgery.
(For those of you who may not know, Jehovah's Witnesses do not accept blood transfusions. Instead, they request a multimodality approach to non-blood medical treatment. Because of this, Procrit was ordered to decrease the need for a blood transfusion since it is often prescribed to treat anemia caused by chronic kidney failure, chemotherapy, etc. It can also be used to prevent a blood transfusion in an anemic patient during surgery.)
So, one person was in charge of figuring out how to get the Procrit and how to get it administered to the patient in time for his surgery date. The medication has to be administered three times before surgery and again the day of surgery. Many steps had to be completed in order to get this medication approved, ordered, delivered and administered, including:
- Working with the insurance company to get authorization
- Making arrangements with the RMH Treatment Center to administer medication
- Getting authorization from insurance to obtain medication from their pharmacy
- Getting RMH Pharmacy involved with the order
- RMH Pharmacy working with other health care organizations to get medication
- Making arrangements for the delivery of the medication
- Communicating with patient about when medication would be ready and the co-payment
- Arranging appointments with patient to administer medication
By the time this was all said and done . . . .
- approximately 15 tasks had been completed
- at least 10 phone calls had been made
- at least 10 people, 4 departments, and 2 outside organizations had been involved, and hundreds of minutes spent to figure it all out.
In such a complicated scenario, it would have been easy for an RMH team member to question the necessity of these steps. But this did not happen because every single person involved had in mind the patient's interest and personal beliefs. Every person involved was focused on doing their part to ensure the patient was ready for their surgery. No one questioned, criticized or judged the patient for their beliefs; instead our staff pulled together and worked as a team to make sure the patient received the best possible care while ensuring their wishes were respected.
As the Cultural Diversity Coordinator, it makes me proud to know that at RMH we have such a wonderful group of people working together to meet our patients' healthcare needs while taking into consideration and respecting their cultural needs.
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