How to respect cultural differences in patient care

Nurse Leader Insider, November 5, 2003

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Your facility must comply with the fifth requirement in standard HR.2.10-that organizations include cultural diversity and sensitivity training as part of employee orientation. But besides being a mandate from the Joint Commission on Accreditation of Healthcare Organizations, educating staff to respect patients' cultural differences can also significantly improve patient satisfaction and help you provide better patient care. For staff at BryanLGH Medical Center in Lincoln, NE, thinking about cultural diversity is a way of life. The following are some tips from staff at BryanLGH for teaching staff members how to comply with this requirement.

Make forms available in more languages
A key issue is the need to communicate basic information to patients who don't speak English. To do that, find someone to translate forms, which are traditionally available only in English. These include informed consent forms, patient rights brochures, and any paperwork that requires a patient signature. Finding a reliable translator is important because incorrect words or phrases could alter the original meaning.

The medical center also has its Health Insurance Portability and Accountability Act of 1996 notice of privacy practices printed in two languages, as well as signs telling patients to ask for an interpreter if necessary.

Cultural competency requires ongoing training
New employees review the medical center's diversity initiative during the first day of orientation. Any new managers, supervisors, or directors meet with a diversity coordinator in their first six months for a more detailed explanation of the diversity council and its goals.

Different cultures lead to different expectations
The medical center teaches staff that people from different cultures or religious backgrounds will have different expectations from health care professionals. For example, most hospitals have policies prohibiting family members from watching surgeries. However, according to some religions, family members must be present during surgery. In some cases, religious beliefs should hold a higher value than following a policy.

Make it easy to learn about different cultures
Through the medical center's intranet, staff have access to "culturegrams" that provide detailed information about a culture, such as the primary language, common foods, history, and political system. Staff can also refer to culturegram binders when they work with patients from different cultures to get a better understanding of how to treat them.

Get involved in the community
The center has done significant work with other businesses and people in the community, such as hosting discussions about different diversity issues.

Staff members from the center also serve on a multi-agency task force that tries to address the various needs of immigrants new to the United States. The discussion topics have included recognizing and respecting religious diversity and the experience of immigrants moving to Lincoln. These discussions are open to the community, as well as to staff.

Adapted from: Briefings on JCAHO,

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