Penn Bridges Disparities Through Diversity and Cultural Competence in the Midst of Health-care Reform

( Health-care reform and cultural competence in health-care delivery are hot topics.  Research has shown that cultural competence is a key strategy for bridging health and health-care disparities.

Penn Presbyterian Medical Center will host its annual conference on Friday, Oct. 26, from 7 a.m. to 4 p.m. in Room 106 of thePhiladelphia Heart Institute, 51 N. 39th St.

“Health Care Reform: Reshaping Access and Delivery of Care to Vulnerable Populations” is the topic this year.

The keynote speaker, Rita K. Adeniran, the director of diversity and inclusion and global nurse ambassador for the Hospital of the University of Pennsylvania, will speak about “Bridging the Disparity Chasm: The Role of Health-care Leaders and Providers.”

“The Cultural Diversity Committee at Penn Presbyterian designed the 2012 conferencewith the goal of providing attendees with advanced knowledge and skills that will help them deliver culturally competent health-care services to every patient,” Adeniran says.

“Taking steps to achieving cultural competence,” she says, “includes encouraging health-care providers to acquire the knowledge and skills needed to holistically assess an individual patient’s illness through his or her own lens.  Understanding the way a patient views his or her illness is central to care planning.

“When there exists a disconnect between health-care provider and patient, or when a patient’s values and beliefs are not taken into consideration, there is an increased risk of a preventable readmission, poor outcome and additional health-care costs,” she says.

Other leaders in culturally competent healthcare concur.

“We are seeing an increasing number of ethnic-minority patients from different cultures in our health-care system, which necessitates culturally competent approaches to treatment,” says Eun-Ok Im, a professor in the University of Pennsylvania School of Nursing.

“For example, Asians tend to be stoic to pain and rarely complain about their pain or symptoms.  Furthermore, they consider health-care providers to be authority figures whom they should not challenge,” explains Im, whose research harnesses the power of technology and anonymity to study how Asians culturally approach cancer pain, menopause and other mid-life women’s health issues.

“Thus, when a health-care provider assesses the pain or symptoms of Asian patients, he or she may not be able to adequately or appropriately assess the patients’ pain and symptoms because the patients may not report pain and symptoms,” she says. “The provider may not understand the non-verbal cues from patients.  As a result, Asian patients may not have adequate pain and symptom management that could be easily achieved.”

Another example of sensitivities to be aware of include when a patient attributes a disease to external or supernatural forces.  Others believe symptoms are caused by powerful emotions like anger or jealousy.  But, under Western standards of medical care, these same conditions and symptoms would be attributed to psychological, physiological or scientific causes.

If a patient experiences palpitations, restless sleep and muscle twitching, he or she may be diagnosed with having a seizure disorder.  But, in Latin America, these symptoms may be diagnosed as “susto,” a condition caused by a separation of the body and soul, when an individual is frightened.

“In this case,” Adeniran says, “to be an effective health-care provider while still adhering to standards of treatment, providers must be supportive and tolerant of the patient’s beliefs and incorporate these values into treatment.”

Other issues to will be addressed include the politics and ethics of health-care reform, older adults, opportunities and challenges under health-care reform and the uninsured, the under-insured and charitable care.

While the conference is open to anyone, its primary audience is nurses, nurse managers, social workers and allied health professionals.

The cost is $5 each for Penn employees and students, including undergraduates.  It is also $5 each for students from other universities.  For people who work in other organizations and hospitals around the region, the fee is $20 each.