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Running head: INTERPROFESSIONAL COLLABORATION 1

Proposal for Interprofessional Leadership in Preston Health Services

Sitara Monnappa

Capella University

Collaboration, Communication, & Case Analysis for Health Care Master’s Learners

Interprofessional Collaboration Preparation

October, 2018

INTERPROFESSIONAL COLLABORATION 2

Executive Summary

This executive report addresses the issue of low patient influx to Preston Health Services

(PHS), a newly opened facility in a culturally diverse neighborhood. After analyzing different

aspects of the facility and conversing with the local residents, it was determined that residents

feel uncomfortable going to the facility because the health care staff is not representative of the

neighborhood. A culturally diverse staff is an effective way to increase patient influx to the new

facility, which is reflected in the following plans for the recruitment of a diverse workforce.

There are many possible factors that may have led to the low influx of patients to the new

facility. The foremost factor may be a language barrier between the health care professionals in

the organization and the local residents who visit the facility. Other factors may include cultural

differences and the preference for traditional home remedies for illnesses. The solution to these

problems involves hiring and retaining a culturally diverse staff in addition to training current

staff to be culturally sensitive and aware. It is essential that the leader and facility employ

policies and practices that promote the recruitment, hiring, and training of a diverse workforce,

including onboarding and culture diversity programming and training on an ongoing basis.

Effective leaders can guide employees to understand and respect the value that diversity brings to

an interprofessional team. Team members can learn about each other’s cultures and values as

well as those related to the community, and work together as an interprofessional team that is

based on mutual respect and trust. This could increase the number of patients visiting the new

PHS facility.

Commented [A1]: Good work in presenting a concise summary, identifying the major issue, the potential contributing factors, and potential solutions.

INTERPROFESSIONAL COLLABORATION 3

I. Introduction

Today’s population is becoming more diverse with shifts in demographic trends,

reflected by immigration, travel, technology and geographic mobility. The need for leadership,

skilled personnel, and well developed programs and policies are critical to meet the needs of

diverse groups in health care.

Some of the factors affecting the patient influx are:

a. Language barriers: Patients with limited English proficiency (LEP) often

encounter language barriers in health care facilities, giving rise to disparity in

health care access. According to the Center for Disease Control and Prevention

(2017), although materials that are translated might help to address the gap or

bridge language barriers, they may not be accurate or complete. Interpreters may

lack skills in literacy, have emotional connections, or have difficulty with

technical terms. There may be confusion, loss of meaning or difficulty in

communicating information (especially traumatic news) that may affect this

process. This discourages many of the residents from using the new PHS facility.

b. Lack of cultural competence: Cultural competence involves culturally appropriate

behaviors and attitudes among employees and patients in health care and long-

term care organizations. Nilson (2017) describes cultural competence as not an

endpoint but a continual process that includes reciprocity and engagement of all

involved.

c. Lack of awareness among residents: Individuals from culturally and linguistically

diverse (CALD) communities tend to be unaware of formal health care services.

Commented [A2]: A good analysis…Is there a predominant language or culture represented in the community? This might be good information to have in planning recruitment and training.

INTERPROFESSIONAL COLLABORATION 4

The following barriers were identified by Wholer and Dantas (2017): Logistical

issues, language and communication, incompatibility between providers and

patients, and knowledge of culturally accepted practices.

The possible implications of the lack of cultural diversity may include the following:

• Some patients may attempt to manage their chronic diseases with traditional self-

medication practices, which might aggravate their diseases further.

• The health care staff members may not understand the culturally diverse residents

of the neighborhood. Miscommunication can occur and patients may not be

accepting or understand the care provided if counter to traditional practices and

cultural norms.

II. Proposed Plan/Solution

a. In order to attract more patients to the new facility, the organization has to hire

and retain a culturally diverse health care staff, which can be achieved by

initiating the following practices:

i. The new PHS facility can provide professional interpreter services, both

on-site and off-site. On-site interpreters can have face-to-face discussions

with patients about treatment options, while off-site interpreters can

communicate with patients through telephone or e-mail (Brach &

Fraserirector, 2016).

ii. The facility can create a more welcoming environment for patients by

hiring and retaining a culturally diverse staff that shares cultural beliefs or

Commented [A3]: Good delineation of these specific problem areas. Good use of the research and literature to support your analysis.

Commented [A4]: Yes, this might be a good temporary solution…What are some of the pros and cons with the use of interpreters? Is there a more permanent solution? How does this relate to hiring and retaining a culturally diverse workforce?

INTERPROFESSIONAL COLLABORATION 5

is at least proficient with a culturally diverse patient population. The

recruitment of a diverse workforce must begin early in the process so that

personnel are available with the needed skills. Opportunities to pursue

careers in health care may be limited by education, finances, location, and

the sociocultural factors that impact many lives. The leaders of the PHS

facility will need to promote diversity policies, using facility resources to

focus on recruitment of diverse groups, including connections with local

schools, fellowship programs, loan forgiveness programs, and use of

community volunteers.

iii. Cultural competency training can increase cultural awareness, knowledge,

and skills, which can improve patient-staff interactions (Brach &

Fraserirector, 2016). Professionals can develop cultural and linguistic

competency training to solve a variety of potential issues (Jackson &

Gracia, 2014). The senior managers should create a set of principles for

respectful treatment of all team members (Brach & Fraserirector) and

patients. One way employees can be trained is by analyzing cross-cultural

scenarios in case studies.

iv. The management of the new PHS facility can engage the community

health workers of the neighborhood in educating the communities about

health care services provided at PHS. Community health workers are

trusted community members who support individuals and address their

problems at the community level. Research has shown that health care

access and outcomes and the quality of life in minority communities are

Commented [A5]: Good ideas. These may also be effective mechanisms to connect with the community, identifying key stakeholders in the process.

INTERPROFESSIONAL COLLABORATION 6

enhanced by the involvement of community members (Jackson & Gracia,

2014).

III. Benefits of Implementing the Plan

The proposed plan is evidence-based and the main points have been taken from research

related to cultural diversity in health care organizations. The benefits that can be expected from

the implementation of the proposed plan are as follows:

a. The plan will help the current health care staff of the new PHS facility address

culturally competency. They will have a better understanding of patients and their

cultures and be able to overcome linguistic and cultural barriers both within the

organization and for service delivery.

b. The plan will help recruit and retain a diverse workforce while building

connections between the health care staff and community members. Research

suggests that community members often have a better understanding of the

perspectives of patients than health care personnel (Jackson & Gracia, 2014).

Involving community members in daily tasks will increase the patient influx at the

new PHS facility. The plan will help the current health care staff become more

connected with one another and the community they serve. Having a diverse

workforce also has broader consequences such as optimizing creativity and

innovation, and reducing health disparities in society, thereby facilitating the

provision of equitable health care to all citizens.

c. Leaders in the new PHS facility can evaluate outcomes for effectiveness by

monitoring the number of patient visits. The scholar-practitioner model can be

Commented [A6]: Good work. The use of community health workers has been supported in the literature as noted. How will these community health workers be recruited and trained? What type of community activities might be used to make connections with the community stakeholders and the community at large?

Commented [A7]: Great points in discussing the importance of a diverse workforce. What types of outreach activities might be utilized? Health fairs? Health screenings? Advisory Boards? What are the mechanisms to accomplish this?

INTERPROFESSIONAL COLLABORATION 7

utilized by researching the evidence in the field related to cultural diversity in

health care organizations, analyzing cultural diversity strategies used by other

leaders, and creating new strategies. They can test these strategies in the PHS

facility and design methods to track effectiveness. Applying the skills of the

practitioner-scholar model will help leaders stay current with trends and best

practices.

Conclusion

The new PHS facility, set up in a culturally diverse neighborhood, has been unable to

attract many patients. Analyses have revealed that this may be due to a lack of health care

personnel from culturally diverse backgrounds. Therefore, it is imperative for PHS to hire and

retain health care staff from diverse cultural backgrounds to encourage patients to visit the

facility. To do so, a plan needs to be implemented to recruit a diverse workforce and to train the

current staff members of the facility to become culturally competent. One or more effective

leaders will have to manage the changes brought about by the recruitment of a culturally diverse

staff so that the current staff do not feel alienated. This will ensure a culturally diverse

workforce, which in turn will increase patient influx to the new PHS facility.

Commented [A8]: Good example of the importance of monitoring and evaluation to assess effectiveness.

Commented [A9]: Well done… A fine proposal to engage the community and maximize effective service.

INTERPROFESSIONAL COLLABORATION 8

References

Brach, C., & Fraserirector, I. (2016). Can cultural competency reduce racial and ethnic health

disparities? A review and conceptual model. Medical Care Research and Review, 57(1),

181–217. Retrieved from https://ncbi.nlm.nih.gov/pmc/articles/PMC5091811/

Center for Disease Control and Prevention (CDC). (2017). Culture and health literacy. Retrieved

from https://www.cdc.gov/healthliteracy/culture.html

Jackson, C. S., & Gracia, J. N. (2014). Addressing health and health-care disparities: The role

of a diverse workforce and the social determinants of health. Public Health Reports,

129(2), 57–61. Retrieved from https://ncbi.nlm.nih.gov/pmc/articles/PMC3863703/

Nilson, C. (2017). A journey toward cultural competence: The role of researcher reflexivity in

indigenous research. Journal of Transcultural Nursing, 28(2), 119-127. doi:

10.1177/1043659616642825

Wholer, Y., & Dantas, J. (2017). Barriers accessing mental health services among culturally and

linguistically diverse (CLAD) immigrant women in Australia: Policy implications.

Journal of Immigrant Minority Health, 19(3), 697-701. doi: 10.1007/s10903-016-0402-6

https://www.ncbi.nlm.nih.gov/pubmed/?term=Brach%20C%5BAuthor%5D&cauthor=true&cauthor_uid=11092163

https://www.ncbi.nlm.nih.gov/pubmed/?term=Fraserirector%20I%5BAuthor%5D&cauthor=true&cauthor_uid=11092163

https://www.ncbi.nlm.nih.gov/pubmed/?term=Jackson%20CS%5BAuthor%5D&cauthor=true&cauthor_uid=24385666

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3863703/