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Developing an Action Plan for a Linguistically Competent Organization: Lessons from the Field

Developing an Action Plan for a Linguistically Competent Organization: Lessons from the Field. Presented by: Virginia S. Tong, LMSW Vice President, Cultural Competence NYS Conference on Increasing Language Access to Healthcare: Toward Effective State and National Policies

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Developing an Action Plan for a Linguistically Competent Organization: Lessons from the Field

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  1. Developing an Action Plan for a Linguistically Competent Organization: Lessons from the Field Presented by: Virginia S. Tong, LMSW Vice President, Cultural Competence NYS Conference on Increasing Language Access to Healthcare: Toward Effective State and National Policies University at Albany April 25, 2007

  2. LutheranHealthCare • Established in 1886 • Located in Sunset Park, Brooklyn • System includes: • 476 bed teaching hospital and Level 1 Trauma Center • Ambulatory care system (600,000 visits) • Nursing home • 3 senior housing developments • Managed care company (Health Plus) • Community services division (ESL, GED, daycare, meals on wheels, …)

  3. Lutheran HealthCare’s Mission and Vision Statement Lutheran HealthCare has no reason for being of its own; it exists only to serve the needs of its neighbors … Lutheran HealthCare understands a hospital is not a collection of buildings, machines and beds, but a staff of talented, creative and committed people who serve the community as they are needed... Lutheran HealthCare works in partnership with its neighbors, each relying on the other as friends who care about and assist each other… (Adopted by the Lutheran Medical Center Board of Trustees, October 24, 1990 and reaffirmed annually since.)

  4. Neighborhood Profile • Located in Sunset Park, Brooklyn, along the waterfront • 1880’s: LMC est. in 1880’s – Norwegian immigrants • 1960’s: Predominantly Scandinavian and Puerto Rican residents • 1980’s: Chinese immigrants • 1990’s: Arabic, Russian, Dominican and Mexican immigrants, expansion to include Caribbean population • Annual documented need for 40+ languages and dialects • Institution-wide average number of annual patient visits that require an interpreter close to 200,000 (excluding part-time clinics)

  5. Our Demographics

  6. Governance • Community members are members of the Health Council for Lutheran Family Health Center and the Board of Trustees of LHC • VP Cultural Competence reports to CEO • Cultural Access Task Force • Composed of senior management of hospital, nursing home and ambulatory network, interdisciplinary staff, providers, administrators, representatives of major ethnic communities in Southwest Brooklyn • Committees include: Dietary, Language Bank, Education, Telecommunications, HR, Signage, Translation, and Spiritual Care (Holiday committee no longer meets)

  7. Governance • Advisory Groups • Provide community and staff input to cultural and spiritual initiatives • Arab Initiatives Committee • Latino Advisory Board • Chinese Advisory Board • LGBT Advisory Board • ADA Subcommittee • Senior Initiatives • Tanenbaum Center Project • AdHoc- Chinese Unit Advisory Board, Mosque Advisory Board, various focus groups (ie Russian)

  8. History of Cultural Competence at Lutheran Healthcare • 1990- Asian Initiative w/ Chinatown Health Clinic • 1995- Cultural Access Task Force • 1996- Partnerships with Russian providers • 1997- Open Park Ridge HC (w/ mosque), Hire Cultural Initiatives Coordinator • 1998- Open Caribbean Health Center • 2000- Mexican Health Project • 2002- Open Chinese Health Center • 2004- Korean Initiative • 2004- Appoint Vice President for Cultural Competence • Responsible for all matters related to cultural competence and working with all staff on the planning and implementation of cultural competence initiatives in operations and program planning

  9. Accomplishments • Multilingual signage (5 languages- FHC, 6 language- LMC); • Most major forms translated in 4 languages • IT changes- added interpreter, language and ethnicity fields • All staff attended mandatory cultural competence training in 2004 • Nearly 200 staff trained in medical interpreter training in Spanish, Cantonese, Mandarin, Russian and Arabic- including intermediate Spanish • Celebration of over 30 ethnic and religious holidays • Latino, Chinese, Kosher and Halal menus

  10. Translated Documents and Signage

  11. Accomplishments • Foreign and sign language assistance services managed by Patient Relations and the Cultural Initiatives Coordinator: Language Bank, interpreter telephones, video conferencing, bilingual and bicultural Patient Relations agency and freelance interpreters • Eight representatives and advocate, who speak LHC’s four key languages • Centralized written translation service system -professional resources and in-house reviewers, sometimes community base organizations

  12. Accomplishments • Immigration policies and information distributed to all HR staff • Inclusion ofcultural competence measures inannual employee evaluation • Amended job descriptions include a cultural competency statement and bilingual skills needs (required vs. preferred) • Uniform language policy and procedure • Numerous cultural trainings and incorporation of cultural competence into all trainings including: customer service, telephone techniques, conflict resolution, sexual harassment, patient safety etc…

  13. Demographics

  14. Accomplishments • Recruitment of bilingual/bicultural employees as dual role interpreters through active HR efforts: 58% of approx. 3,500 staff members self identify as bilingual - major employer in the community • Language proficiency screening of job seekers’ language skills in collaboration with HR • Computerized reports of language capabilities of staffmembers by department

  15. Keys to Success • Organization’s Mission and Vision • Support from Board and Key Leadership • Dedicated staff – VP for Cultural Competence, Cultural Initiatives Coordinator • Dedicated Budget • Involvement in Strategic Planning • Support from organized labor • Collaboration, and communication with critical departments- Human Resources, Organizational Learning, Pastoral Care, Food Service, Nursing, Medicine, External Affairs, Finance, Social Services, Facilities, IT, etc… • Partnerships with community organizations

  16. Challenges • Resistance to change • Allegations of racism, reverse discrimina tion • Lack of resources- staff, marketing, translation, training, screening • Lack of pool of bilingual professional staff • Lack of “best practices” • Length of time to fill position • Job requirements vs. language requirements • Need to develop alternate strategies • Issues with dual role interpreters and volunteers (linguistic competency, confidentiality, union issues) • Lack of interpreter training and screening standards

  17. Thank You! • Should you have any questions or comments, please contact: • Virginia S. Tong Vice President, Cultural Competence Lutheran HealthCare 5121 2nd Avenue Brooklyn, N. Y. 11232 718-630-7236 / vtong@lmcmc.com

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