Janice Hidalgo Director Everyone with Diabetes Counts, New York Consumer Healthcare Engagement Programs IPRO

Transcription

1 Janice Hidalgo Director Everyone with Diabetes Counts, New York Consumer Healthcare Engagement Programs IPRO ANNUAL MEETING IPRO ESRD Network of New York May 23, 2017 Garden City Hotel

2 Atlantic Quality Innovation Network (AQIN) The federally funded Medicare Quality Innovation Network Quality Improvement Organization (QIN-QIO) for New York State, the District of Columbia, and South Carolina. Led by IPRO. Partners include Delmarva Foundation in the District of Columbia and The Carolinas Center for Medical Excellence in South Carolina. One of 14 QIN-QIOs operating across the U.S. 2

3 Everyone with Diabetes Counts: CMS funded initiative to provide diabetes-self management education to Medicare beneficiaries, with a special focus on disparate populations. Next year marks our program s 10 year anniversary 8,000 program graduates A goal of 10,000 graduates by Statistically significant improvement in patient behavior & compliance, reduction in weight and A1c. 3

4 EDC / ESRD New York Network Connection: 2015 Data Out of the 29,039 patients on dialysis in New York State, 12,131 (41.8%) also live with diabetes. Data source: 4

5 Everyone with Diabetes Counts: Our diabetes self-management workshops incorporate many elements we will discuss today: Cultural Competency Clear Communication Patient Engagement and Empowerment Self-Management Self-Awareness Linguistic Diversity Theory of Change 5

6 What you already know Numerous studies have indicated that when compared to Non-Hispanic Whites, racial and ethnic minorities have lower life expectancy, fewer years of health life, Increased death from preventable diseases and overall poorer indicators of health (2). The causes of health disparities are complex and multi-level. Health/healthcare disparities are also shown to improve when socioeconomic and level of education status are adequate, but other factors play a major role as well. Increasing Awareness of Cultural Stereotypes - DeGannes CN, Woodson-Coke K, Henderson T, Sanders-Phillips K. 6

7 What you already know Evidence suggests that conscious and unconscious stereotypes, biases and assumptions play a significant role in the decreased referral rates for specialized care." Increasing Awareness of Cultural Stereotypes - DeGannes CN, Woodson-Coke K, Henderson T, Sanders-Phillips K. 7

8 What you already know Culture The integrated patterns of human behavior that include language, thoughts, actions, customs, beliefs, values and institutions that unite a group of people. Cultural Competence The capability of effectively dealing with people from different cultures. Adapted from 8

9 Culturally and Linguistically Appropriate Services (CLAS) Standards - DOHHS 9

10 GOAL for TODAY To increase your awareness of racial and ethnic disparities, The presence of unconscious and conscious personal stereotypes, biases, assumptions and the impact of such on healthcare delivery. We hope to accomplish this by sharing personal stories of IPRO s DSME graduates and EDC staff. 10

11 Linguistic Diversity Trivia Considering that New York City is one of the most diverse places on the planet, it s not surprising that just?? percent of New Yorkers speak only English at home, according to the most recent data provided by Census Bureau s American Community Survey.? A%2F%2Fwww.ef.com%2Fblog%2Flanguage%2Fnew-york-infographic%2F&bvm=bv ,d.amc&psig=AFQjCNHKfnfaG0- fmk5efnoa1gmljqwhbg&ust=

12 Linguistic Diversity Trivia 51% of New Yorkers speak only English at home, followed by 25% who speak Spanish at home. 800 total languages spoken in NYC. A%2F%2Fwww.ef.com%2Fblog%2Flanguage%2Fnew-york-infographic%2F&bvm=bv ,d.amc&psig=AFQjCNHKfnfaG0- fmk5efnoa1gmljqwhbg&ust=

13 Linguistic Diversity Challenge Every table should have a paper with the word HELLO and lines numbered 1-10 Select a scribe for your table As a group, list as many ways as possible to say HELLO in different languages. You have 1 minute! 13

14 Scribe, please share how many languages your group came up with? 14

15 Good to Know 15

16 Good to Know 20 million Americans speak poor English 10 million speak none More than 300 languages are spoken in the United States. 16

17 CULTURAL COMPETENCY KEY WORDS Diversity Culture Difference Knowledge Understanding Belief Sensitivity Language Assumption Stereotype Race Competency Equality Disparity Minority Awareness Ethnicity Behavior Religion Food Bias Sexual Preference Empathy 17

18 CULTURAL COMPETENCY KEY WORDS Diversity Culture Difference Knowledge Understanding Belief Sensitivity Language Assumption Stereotype Race Competency Equality Disparity Minority Awareness Ethnicity Behavior Religion Food Bias Sexual Preference Empathy 18

19 Theory of Change 19

20 Theory of Change 20

21 The challenge 21

22 Let s do a Stress Release Exercise! Yes No Maybe 22

23 What does fear FEEL like? How does it relate to CHANGE? 23

24 CULTURAL COMPETENCY KEY WORDS Diversity Culture Difference Knowledge Understanding Belief Sensitivity Language Assumption Stereotype Race Competency Equality Disparity Minority Awareness Fear of Change Ethnicity Behavior Religion Food Politics Bias Sexual Preference Empathy 24

25 CULTURAL COMPETENCY KEY WORDS Diversity Culture Difference Knowledge Understanding Belief Sensitivity Language Assumption Stereotype Race Competency Equality Disparity Minority Awareness Fear of Change Ethnicity Behavior Religion Food Politics Bias Sexual Preference Empathy 25

26 Stereotype & Assumptions = Cultural Assumptions Stereotype: any commonly known public belief about a certain social group or a type of individual. Stereotypes are often confused with prejudices, because, like prejudices, a stereotype is based on a prior assumption. Stereotypes are often created about people of specific cultures or races. 26

27 Pig! Cow! We are too quick to assume; most of the time we think the worst and that creates recurrent defensive behaviors. 27

28 How can I be BETTER at practicing Cultural Competency? Become an ACTIVE Critical Thinker, CHALLENGE Assumptions and Recognize Your Level of Cultural Awareness FYI: It takes lots of practice! 28

29 Recognizing Levels of Awareness 1. My way or the highway 2. I know their way, but my way is better 3. My way and their way 4. Our Way Everyone is the product of his/her culture There is no recipe to follow Thousands of presentations / trainings Recognizing is the first step Learn not to fear it 29

30 Recognizing diversity and learning not to fear it. 1. Admit you don t know 2. Suspend judgments 3. Empathy 4. Self-assessment: check your assumptions 30

31 Steps to Improving Sensitivity 1. Make contact 2. Show respect 3. Pronounce names clearly 4. Speak slowly and clearly 5. Be yourself 6. Take time to listen 7. Be careful with promises 8. Stay away from criticizing other cultures 31

32 Lessons from the Field I forgot my glasses because I am ashamed to admit I don t read very well. I don t know what to ask, and I am hesitant to ask you I am blinking a lot so you can ask me about my eyes. 32

33 Lessons from the Field I thought my ear infection medication was to put in my ear and not my mouth. I get confused about percentages and ratios. My English is ok only when I am comfortable, stress doesn t allow me to focus. If I look surprised, I don t understand you. 33

34 Lessons from the Field I blinked the other day a lot, but you didn t notice anything wrong, so I must be fine I am more comfortable with a female/male doctor. I use home remedies, but I won t tell you I misunderstood the dosage on the Instructions and took eleven pills and was ill for days. 34

35 At the end of the day: Clear Communication

36 Homework Summary To practice Hello, Good-bye and Thank You in different languages: Self-Assessment: Enhanced CLAS Standards:

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38 For more information Janice Hidalgo Director Consumer Health Engagement Programs Everyone with Diabetes Counts, New York (516) IPRO CORPORATE HEADQUARTERS 1979 Marcus Avenue Lake Success, NY IPRO REGIONAL OFFICE 20 Corporate Woods Boulevard Albany, NY

39 This material was prepared by the Atlantic Quality Innovation Network (AQIN), the Medicare Quality Innovation Network - Quality Improvement Organization for New York State, South Carolina, and the District of Columbia, under contract with the Centers for Medicare & Medicaid Services (CMS), an agency of the U.S. Department of Health and Human Services. The contents do not necessarily reflect CMS policy.11sow-aqinny-b