Developing Effective Cross-Cultural Communication Skills In Healthcare

Objectives

Effective cross cultural communication skills are critical towards increasing the provision for culturally sensitive healthcare under community health settings and in hospitals. Two-way communication process between the indigenous and non-indigenous service users and the healthcare professionals helps in proper understanding of the culture of the Aboriginal patients and also helps in improving overall quality of care (Hunt, 2013). Lack of proper communication skills among the health care professionals have been found to be one of the important reason for early hospital discharge or rejection of westernised treatment. It is also recognised as one of the important reason for the medical non-compliance and high rate of mortality among the aboriginal population (Hunt, 2013).

Hence development of communications skills by proper training has been considered as the appropriate strategy.

• Increasing a positive therapeutic relationship between the client and the health care employees.
• Increases the level of confidence among the aboriginal people to clarify their doubts regarding medical jargon or the treatment regimen.
• It further reduces the likelihood of the misunderstandings and the errors and reduces the rate of the medical noncompliance or discharge against the medic al advice.
• Further it also improves the professional skills and improves the level of reputation and respect between the patient and the health practitioners (Long, 2012).
• Increases the profit of the organisation by increasing the number of clients.
• Reduces the rate of medication errors.

Objectives:

NOTE: use SMART objectives

• Specific
• Measurable
• Achievable
• Relevant
• Timely
• To increase effective communication skills among the nurse and health care workers
• To obtain positive feedback from the aboriginal patients regarding the type of care
• To increase the likelihood of aboriginal patient to use westernised treatment than the traditional treatment.
• To ease their access to health care by improving proper communication portals.
• To complete the communication training within 3months. .

Primary care setting of a rural health care organisation present in close proximity to an aboriginal community. Training about increasing the communication skills should be provided to the health care staffs. To include the nurses and health care workers from urban setting to understand the overall perspective of the health care workers.

Deliverables:

• An education program to raise the awareness among the health care workers about cultural safety. The approach undertaken while providing effective communication training among the nursing professionals for cultural competence must be designed in such a way that it addresses patient specific communication and healthcare needs (Renzaho et al., 2013).
• The first part of the strategy towards training cultural competence among the nurses via the use of effective communication skills will initiate with addressing patient communication needs. It will be the role of the nurse to understand the patient’s communication needs via checking the patient’s medical records or via interacting with the family members (Gallagher & Polanin, 2015). Here specific communication needs mainly highlights the use of preferred languages or any use of the sensory or communication impairments. In order to train in this domain the nursing professionals are required to be trained on languages other than English and the use of proper non-verbal communication skills in understanding patient’s communication needs or other health-related needs. Important non-verbal communication skills upon which the nurses will be trained in order to again cultural competence include use of welcoming facial expressions, proper use of the gestures and body language, maintenance of proper eye-contact and responding to every statement with a nod in order to establish connection. Use of touch is also regarded as unique non-verbal communication skills under effective communication (Ben-Nun, 2014). According to Kourkouta and Papathanasiou (2014) the use of non-verbal communication skills helps in the establishment of the therapeutic relationship with the patients and this in turn helps to improve the therapeutic outcomes of the patient care while increasing the patient participation in care process.
• Another approach of the strategy for effective communication training includes the information of the men and women’s business. According to Montagu (2013), it is important that the staffs working with the aboriginal and Torres Strait Islanders people to understand the concept of segregated practices like men and women business in their culture. So the strategy will encompass training of a special approach where the female Aboriginal service uses would be enquired if they would prefer to be greeted and treated by a female healthcare professional. If this option is not feasible then the concerned nursing professional would ask the female service user about their preference regarding presence of their relative or partner during the communication (O’hagan et al., 2012). The same gender appropriateness is applicable for the men as well. In order to understand the gender based required difference, health literacy will be delivered to the nursing professionals. This health literacy will be given under community settings through interactive sessions and power point communications. Providing proper health literacy will help the nursing professionals to increase their knowledge about the cultural and the spiritual values of the Aboriginals and Torres Strait Islanders (Kourkouta & Papathanasiou, 2014).

The success of the training program can be measured by the attendance of the trainees, which can be recorded by maintaining an attendance register. The feedback of the patients, which can be got by the conduction of feedback sessions taken from the patients after a month or two. According Posavac, (2015), interviews and surveys can be helpful in obtaining feedback from the clients, Furthermore the productivity of the organisation at the end of the year can also be measured (Sachin Jain, 2013)

Resources:

What are the resources required?

Training program to be held in community care settings or the primary care settings in rural areas.

A trainer (Four registered nurses having experience in treating aboriginal patients), a social care worker working with the aboriginal community, two aboriginal health care workers (Aboriginal health care workers can also be taken in to consideration for a better understanding of the aboriginal issues)

Tools: PowerPoint presentations, flyers and leaflets.

Linkages:

Key performance Indicators like the number of hospital admissions, number of medical errors and near misses and number of hospital readmissions.

IMPLEMENTATION

Assumptions Constraints

• Changes may give rise to conflicts among the health care stakeholders.
• The aim of this training program might not be acceptable to some health care workers.

What are the actions required to mitigate the risk based on assumptions?

• The trainees will be informed about the aims of the project beforehand and feedback will be obtained from the trainees to understand their mindset.

What challenges might arise?

• Conflict among the aboriginal and the non- aboriginal health care workers regarding concepts of cultural safety and privileges given to the aboriginal people.
• Funding crisis. Since it is a rural care setting, hence funding crisis might regarding the provision of basic technologies like computers. Scope: Change legislation relevant to the project, change can be implemented in any one of rural clinic and hence the problem cannot be addressed in the other clinics placed in more rural areas.

Cost: high cost for the continuation of the training program for 4 months

Schedule: Once in a week, for three months.

This strategy will include:

Quality: Dependent on availability of resources and skill

Time Frame & Milestones:

Computer based strategies and trainings once in a week for 3 months including fieldwork to aboriginal communities.

Engagement Strategy

Stakeholders

What are their information needs How & when will we provide them information about the initiative

Clinical staff, Organisational management, funders, consumers, etc Registered nurses, Health care workers, aboriginal health care workers. Exact number of aboriginal population, percentage of the health care workers per aboriginal patients. Newsletter, staff meeting, executive briefings, Emails.

Team roles

Clinical Leaders:

List the Leaders/Champions & summarise role of each Registered nurses

• Train the trainee nurses
• To abide by the nursing codes of professional standards and the related legislation while the conduction of a training procedure.

Social care workers

• Provide education to the trainee nurses about the health care requirements and the grievances of the aboriginal patients (Truong, Paradies, & Priest, 2014).

Aboriginal nurses

• Share information about their culture
• The probable methods of communication acceptable in aboriginal culture.

Team  Coordinator: One of the management member

• Will look after the funding
• The KPIs
• The effectiveness of the program
• The deadlines

Team Members:

Clinical staff, Organisational management, funders, consumers

Community partnership and the interpersonal collaboration among the different members in a health care organisation.

Review Process:

Insert details of meeting schedules and review processes Meeting schedules: One day in a week. The training session will be taking place for 3 hours in a week.

References

Ben-Nun, L. (2014). Non-Verbal Communication Skills. BN Publication House. Israel.

Clifford, A., McCalman, J., Bainbridge, R., & Tsey, K. (2015). Interventions to improve cultural competency in health care for Indigenous peoples of Australia, New Zealand, Canada and the USA: a systematic review. International Journal for Quality in Health Care, 27(2), 89-98.

Gallagher, R. W., & Polanin, J. R. (2015). A meta-analysis of educational interventions designed to enhance cultural competence in professional nurses and nursing students. Nurse Education Today, 35(2), 333-340.

Hunt, J. (2013). Engaging with Indigenous Australia-exploring the conditions for effective relationships with Aboriginal and Torres Strait Islander communities.

Kourkouta, L., & Papathanasiou, I. V. (2014). Communication in nursing practice. Materia socio-medica, 26(1), 65.

Long, T. B. (2012). Overview of teaching strategies for cultural competence in nursing students. Journal of cultural diversity, 19(3).

Montagu, A. (2013). Coming into being among the Australian Aborigines: The procreative beliefs of the Australian Aborigines. Routledge.

O’hagan, S., Manias, E., Elder, C., Pill, J., Woodward?Kron, R., McNamara, T., … & McColl, G. (2014). What counts as effective communication in nursing? Evidence from nurse educators’ and clinicians’ feedback on nurse interactions with simulated patients. Journal of advanced nursing, 70(6), 1344-1355.

Papadopoulos, I., Shea, S., Taylor, G., Pezzella, A., & Foley, L. (2016). Developing tools to promote culturally competent compassion, courage, and intercultural communication in healthcare. Journal of Compassionate Health Care, 3(1), 2.

Posavac, E. J. (2015). Program evaluation: Methods and case studies. Routledge.

Renzaho, A. M. N., Romios, P., Crock, C., & Sønderlund, A. L. (2013). The effectiveness of cultural competence programs in ethnic minority patient-centered health care—a systematic review of the literature. International Journal for Quality in Health Care, 25(3), 261-269.

Sachin Jain, P. H. D. (2013). Experiential training for enhancing intercultural sensitivity. Journal of cultural diversity, 20(1), 15.

Truong, M., Paradies, Y., & Priest, N. (2014). Interventions to improve cultural competency in healthcare: a systematic review of reviews. BMC health services research, 14(1), 99.

Truong, M., Paradies, Y., & Priest, N. (2014). Interventions to improve cultural competency in healthcare: a systematic review of reviews. BMC health services research, 14(1), 99.