DiversityNursing Blog

Source: Nursingideas.ca

In an era in when hospitals compete for patients by boasting the latest clinical technology, the most prestigious physicians and impressive amenities, patient satisfaction is most influenced by human factors, especially superior service-related communication skills between hospital staff and patients, according to the J.D. Power and Associates 2012 National Patient Experience Study released today.

The study measures patient satisfaction across all areas of the inpatient and outpatient hospital experience, including: interactions with healthcare professionals; tests and procedures; admission and discharge; and facility environment. It serves as a benchmark for the J.D. Power and Associates Distinguished Hospital Program. This distinction program acknowledges high levels of performance by a hospital in achieving an “outstanding” inpatient, emergency department, cardiac, maternity or outpatient experience. 

The study finds that recently-hospitalized patients have high levels of overall satisfaction. Overall patient satisfaction with their inpatient hospitalization averages 825 index points on a 1,000-point scale, similar to that of guests at luxury hotels, among whom satisfaction averages 822. In outpatient settings, overall patient satisfaction is higher, averaging 863. However, patient satisfaction dips to 788 for emergency department visits.

“Hospitals may attempt to attract patients and staff by adding equipment or sprucing up their facilities,” says Rick Millard, senior director of the healthcare practice at J.D. Power and Associates. “From the perspective of patients, it might be more worthwhile to invest in finding and keeping staff with superior interpersonal skills.”

Investments in staff can be overlooked, as Millard notes many hospitals have spent a lot of money in recent years to make their facilities look and feel more like hotels. Yet, facility characteristics are more important for hotels than for hospitals.  For upscale hotels, the facility accounts for nearly one-half (48 percent) of guests’ overall satisfaction, while in an inpatient setting the hospital facility represents just 19 percent of patients’ overall satisfaction. 

“Having an appealing hospital facility matters, but an experienced and socially skilled staff has a greater impact on patient satisfaction,” says Millard. “Personal interactions with the staff have a profound impact in both inpatient and outpatient settings.”

Doctors and nurses account for 34 percent of the overall experience ratings for inpatients, and their influence is even higher (43 percent) among patients in emergency settings. Among outpatients, doctors and other healthcare professionals represent 50 percent of their overall experience.

Solid interpersonal skills are especially necessary for handling the types of problems that may arise during hospitalization. When problems do occur, they may jeopardize patient satisfaction. According to the study, staff service and staff attitude are the most common types of problems that patients experience. Patients who say they had any problem with their room or hospital staff rate their overall experience a 5.3 a 10-point scale, compared with 8.7 among patients that did experience any problems.  

“When problems occur, they produce opportunities to demonstrate a genuine interest in the patient’s needs,” says Millard. “Resolving problems is clearly associated with higher ratings by patients. This has become more important as hospital reimbursement is now linked to patient satisfaction as measured by the government through the HCAHPS [Hospital Consumer Assessment of Healthcare Providers and Systems] survey.”

Millard notes that one area where hospitals can learn from hotels is how transitions occur. The admission and discharge process in hospitals is analogous to check-in and check-out in the hotel industry. Among inpatients, 35 percent of the overall patient experience is predicted by the admission and discharge process; yet the impact is much less in emergency and outpatient settings, where it is 19 percent and 12 percent, respectively.

“The first and last impressions are very important for a patient, much like they are for hotel guests,” says Millard. “Getting a patient into a room quickly at the start of their hospital stay, and ensuring a smooth process during discharge, along with a follow-up call once the patient gets home to make sure they’re doing okay, goes a long way toward achieving high satisfaction.”

Nongovernmental, acute-care hospitals throughout the nation are eligible for the J.D. Power and Associates Distinguished Hospital recognition program. Recognition is valid for one year, after which time the hospital may reapply. The service excellence distinction is determined by surveying recently discharged patients regarding their perceptions of their hospital experience and comparing the results to the national benchmarks established in the National Patient Experience Study.

The 2012 National Patient Experience Study is based on responses gathered between December 2011 and March 2012 from more than 10,275 patients who received care in inpatient, emergency or outpatient facilities in the United States.

Source: Infection Control Today

By Carolina Madrid

August 31, 2012

We tend to categorize every ethnic community outside of  Whites as a minority or diverse population group, but there’s a gray area that we’re failing to pay close attention to: the bicultural and multiracial population. It was the fastest-growing youth group in the country in the last decade, increasing almost 50 percent to 4.2 million, according to Census 2010.

As our nation’s population becomes more diverse, the bicultural population will continue growing and the segregated communications approaches that have worked in the past will not work with this audience any longer. Use the guide below as an overview to understanding biculturalism and how you can think about it in an upcoming campaign.

A cultural tug of war

Being bicultural, multicultural or multiracial means that you have ties to different cultures. It can mean that you grew up in the United States with roots in another country or that you have parents from distinct ethnic backgrounds. Either way, there’s usually a sense of being pulled in two different directions while trying to maintain both or assimilate into another.  Why does this matter? Because someone who you thought was a Hispanic, Spanish-speaking person may not be receptive to messaging that speaks solely to Latinos.

Inglés or Spanish?

The language preference of bicultural individuals varies.  Younger populations who went to school in the United States tend to prefer English, while older populations will favor their native language.  There’s also the second-generation population who doesn’t prefer one or the other. The language you use will largely depend on the demographic.

What am I?

The degree to which individuals associate themselves with a given cultural background also varies. Just as there are those who believe in maintaining a sense of heritage, there are those who don’t want to stay in touch with their roots and prefer to assimilate into only one culture. This is why it’s important to stay away from explicit cultural messaging that would isolate or turn off the bicultural or multiracial population.

Univision or CNN?

Just because someone speaks Spanish doesn’t mean he or she watches Univision, the nation’s largest Spanish-language network. In fact, he or she will likely prefer to watch English-language TV. Still, on CNN, there is an opportunity to reach the bicultural population with messaging about the Hispanic or Asian population.

Fusion nation

Fusion cuisine is a perfect example of the adaptation and merging of two different cultures. You appreciate the base flavor of the dish, while adding in contemporary ingredients and spices for a blend that’s the best of both worlds. Don’t be afraid to also use this approach in your communications programs, using a mix of messages.

Contextual decision-making

How you communicate with a bicultural population will also depend on the message that you’re trying to convey. Different scenarios will call for the incorporation of cultural messaging, while other times, this might seem forced. But what is certain is that early awareness and the ability to use it wisely will reap the rewards of a genuine connection.

 

As a resource for Nurses across the country, DiversityNursing.com wants to be sure our community is aware of the following site: The Future of Nursing: Campaign for Action.

The Future of Nursing: Campaign for Action, an initiative to ensure that all Americans have access to high-quality, patient-centered health care, with nurses contributing to the full extent of their capabilities. Action Coalitions work with the campaign to implement the recommendations of the landmark Institute of Medicine (IOM) report, The Future of Nursing: Leading Change, Advancing Health. The coalitions are comprised of nursing, other health care, business, consumer and other leaders across the country. 48 states have Action Coalitions involved in this initiative.
 
The Campaign for Action is a collaborative effort to implement solutions to the challenges facing the nursing profession, and to build upon nurse-based approaches to improving quality and transforming the way Americans receive health care.
 
Action Coalitions are the driving force of the campaign at the local and state levels. These groups capture best practices, determine research needs, track lessons learned and identify replicable models. Examples of accomplishments to date include:

Texas is collaborating with nursing education leaders to adopt a common menu of core required classes across 106 schools in the state.

New Jersey is advancing practice by disseminating best practice models that demonstrate the benefits of staff nurses working to the full extent of their education and training.

Indiana is working within Indiana University to include inter-professional education into the newly designed curriculum to be used by a number of its health profession programs, including the schools of medicine and nursing.

Virginia is advancing nursing leadership by recognizing and mentoring 40 Virginia registered nurses younger than 40 who positively represent and lead their profession.

To get involved and find out more http://www.thefutureofnursing.org/

This is a great video by Global Novations on Defining Diversity and Inclusion

Overall, the National Center for Education Statistics (NCES) expects the Class of 2013 to total 1,744,000 bachelor’s degree graduates. Women will account for approximately 57 percent of bachelor’s degrees. This continues a trend that started in the early 1980s, the last time men earned more bachelor’s degrees than women.

In addition to the gains women are making, most racial/ethnic groups are gaining ground. Hispanic graduates, in particular, are responsible for much of that growth.

Overall, racial/ethnic minorities account for approximately 29 percent of bachelor’s degrees. That’s up from around 25 percent at the end of the 1990s. (See Figure 1.)  

Just as females account for a larger portion of degrees conferred, so too are females driving much of the gains in diversity. For example, the most current data show that African-American females account for 6.5 percent of degrees; their male counterparts, just 3.4 percent. Meanwhile, Hispanic females earned 5.2 percent of bachelor’s degrees, compared to 3.3 percent earned by male Hispanics.

Figure 1: Degrees Conferred by Racial/Ethnic Group, 2009-10 versus 1999-00



Source: 2011 Digest of Education Statistics, Table 300. National Center for Education Statistics. Data are for bachelor’s degree graduates.

by Katrina Gravel

This past month, the George Washington University School of Nursing (GW) received a three-year, $1 million grant from the U.S. Health Resources and Services Administration to fund a program that aims to increase the diversity of nursing professionals, according to a press release from GW. The school’s Success in Nursing Education project focuses not only on drawing in African-American, Asian, Hispanic, and Native American students, but also male students and economically disadvantaged students from Washington, D.C., and rural Virginia. A report released by the U.S. Department of Health and Human Services (HHS) in September 2010 showed that men made up less than 10% of employed RNs licensed between 2000 and 2008, while non-white or Hispanic nurses represented only 16.8% of all registered nurses in 2008. While those percentages may have grown in years since the HHS survey, it is unlikely that the gap has become significantly smaller.

The lack of ethnic minorities, males, and economically disadvantaged nursing students does not reflect the immense diversity of the patients these students will soon be treating. As an article in GW’s student newspaper The GW Hatchet cites the school of nursing’s Dean Jean Johnson as saying, “the nursing workforce should reflect what the population at large looks like.”

GW will use the grant to launch a recruitment campaign to reach disadvantage students, as well as students who are changing careers. The program will offer both undergraduate and graduate degrees in nursing, and will utilize retention tools such as mentoring programs. The grant will also create scholarships and financial aid for some students, according to the GW press release.

Has your organization made efforts to diversify its staff? What are your thoughts on the GW program? Leave a comment and let us know!

by Mareisha Winters
Let’s talk about work.

There is a lot of attention being paid to our increasingly diverse workplace. There are all types of differences including race, gender, generations and thinking styles, just to name a few. LTAW’s focus this month is on some of the key diversity dimensions and how to navigate them for greater productivity and engagement.

The increasingly diverse global workforce has made cultural competence an imperative to sustain and enhance workplace performance and engagement.  What is culture and what is cultural competence?  Culture is the behavioral interpretation of how a group lives out its values in order to survive and thrive; the set of shared attitudes, beliefs, behaviors, values, goals, and practices that characterizes an institution, organization or group.  Cultural competence is the capability to shift cultural perspective and adapt behavior to cultural commonalities and differences.  Ongoing, continued learning is required for cultural competence.

The three largest minority groups in the US workforce today are: Hispanic/Latino (14.7%), Black/African-American (11.6%), and Asian American (4.6%).  The more different cultures work together, the more cultural competence is essential to avoid problems ranging from miscommunication to actual conflict.  These problems can compromise effective worker productivity and performance.

Developing cultural competence results in an ability to understand, communicate with, and effectively interact with people across cultures.  The purpose of this post is to understand the different barriers and hurdles that minority groups tend to face in the workplace.  Managers must understand that their style cannot necessarily be “one size fits all” if they have a multi-cultural team.  Below are some characteristics of the three main minority groups in the workplace.

Hispanics/Latinos

Hispanic culture tends to be risk adverse and more of a “we” vs. “I” culture.  This can negatively impact them in the workplace if it is not understood.  Their risk avoiding nature may not afford them the same chances to show their abilities and skills.  By not self-promoting as much as others, Hispanics may not be rewarded for their contributions.

Cultural competence can help Hispanics reach their full potential in the workplace.  Many employees make sweeping stereotypes about Hispanics.  Some are criticized for their accents, leading to assumptions on their abilities, level of education, and intelligence.  Hispanics tend to speak Spanish with each other because of comfort, but this can be confusing or seen to be exclusionary by others.

Mentoring can make the difference in retaining Hispanics.  Hispanic mentors serve as role models and better understand some of the cultural nuances of being Latino in the workplace.  Hispanic employees need formal and informal ways to connect with each other in order to maintain the relationship bonds they value.

Blacks/African Americans

Studies tell us that there is greater corporate flight amongst minorities, especially among African Americans.  Research conducted by the WP Carey School of Business showed that the predicted quit rate for whites was 3.73%, compared to 4.79% for African Americans.   Discriminatory environments and micro-behaviors are often cited as reasons African Americans leave an organization.  So what can a company do to make these employees feel more engaged? Based on findings from focus groups conducted by the Future Work Institute, the top five characteristics of an organization that retains African American employees include:

    A climate of inclusion
    Supportive interactions with leaders
    Offer of profit and loss responsibilities
    Opportunities for development and advancement at all levels
    Community involvement and social responsibility

As with Hispanics, mentoring is a key factor in the career development and retention of Blacks/African Americans.  Studies have shown that mentoring of African Americans leads to: increased performance, faster promotion rate, early career rate of advancement, greater upward mobility, higher income, job satisfaction and perceptions of great success and influence in an organization.

African Americans place a high value on interpersonal relationships with supervisors and co-workers, which impacts both job satisfaction and employee commitment.  Supportive work environments for African Americans include: collectivist (focus on group rather than individual outcomes) approaches to work, agreeableness and teamwork.

Asian Americans

The same Future Work Institute focus group study revealed the major hurdles for Asian Americans in the workplace.  The primary reasons that Asian Americans feel excluded in the workplace include:

    Lack of mentors with Asian perspective.  Because of the small number of Asian Americans in the US workforce, mentors with Asian perspective are limited.  Similar to Hispanics and African Americans, Asian Americans would benefit greatly from having mentors in the workplace.
    Glass ceiling.  Asian Americans who wish to move up the career ladder feel limited because they do not see Asian representation at the top.
    Lack of transparency.  The need for constructive feedback is essential for career development.
    Life is out of balance.   Often caught between the demands of kids, parents and work, Asian Americans feel their work and life is out of balance.  According to AARP, 73%of Asian Americans believe that children in their families should care for elderly parents, compared with 49%of the general population.
    Cultural differences.  The sentiment from many Asian Americans is that, “Our culture is very different from the _______ culture.”  There is a lack of cultural understanding which is a barrier for them in the workplace.

It is important to note that the data presented above does not apply to every person within that subgroup and that any generalizations should not be viewed as stereotypes.  We offer this information to provide guidance to leaders on how the differences in values and culture might influence workplace behaviors and needs and why cultural competence is such a vital skill for leaders to effectively manage the increasingly diverse workforce.

Value differences! Live inclusively!

By Anna Gorman, Los Angeles Times
August 22, 2012

Black and Latino children were more likely than white children to be obese, witness gun violence and ride in a car without a seat belt, according to a study released Wednesday.

The study, published in the New England Journal of Medicine, found wide ethnic and racial disparities in health behaviors among fifth-graders in Los Angeles, Houston and Birmingham, Ala.

“The disparities were pretty substantial across so many different health indicators,” said lead researcher Mark Schuster, a Harvard Medical School professor and chief of general pediatrics at Boston Children’s Hospital.  “The breadth of the findings was striking to us.”

The researchers examined 16 health behaviors, including cigarette smoking, alcohol use, exercise habits, terrorism fears, bike helmet use and psychological quality of life.

Many of the behaviors carry potential for lifelong health problems, Schuster said. For example, researchers found that obesity rates were twice as high among black and Latino children, placing those children at increased risk for diabetes and heart problems. Black children were also more likely to be bullied, smoke cigarettes and drink alcohol than white and Latino youths.

Parents’ education and income played a critical role in the disparities, according to the study. Researchers also found that schools had a huge influence on children’s behavior, and that there were differences among schools even in the same neighborhoods.

Researchers interviewed more than 5,000 fifth-graders and their parents between 2004 and 2006. Schuster said the team focused on 10- and 11-year-olds because there was already significant research and public awareness about risky behaviors among adolescents.

“Finding disparities this young suggests that we have to start young to try to address them,” he said. “There is a strong likelihood that these disparities will persist unless we intervene to change them.”

From Human Resource Executive Online By Katie Kuehner-Hebert

It's one thing to be bullied by a co-worker or a boss, but simply witnessing the behavior in the workplace can be enough to make a worker call it quits, according to a study of "ambient" bullying.

Researchers at the University of British Columbia in Vancouver, Canada surveyed 357 nurses in 41 hospital units and found a statistically significant link between working in an environment where bullying was occurring and a desire to leave the organization. The study was published last month in the journal Human Relationsby SAGE.

"We underestimate the power of the impact of just being around bullying in the workplace," says Sandra Robinson, a professor at UBC's Sauder School of Business and one of the authors of the study.

"For those seeking to influence problematic behavior, they need to be sensitive [to the fact] that the impact of such behavior transcends the person or the group . . . actually being bullied, and that there may be other victims who are impacted by the harmful behavior, whether it comes from their supervisor or co-workers," Robinson says.

Marianne Jacobbi, senior editor at Ceridian/Lifeworks EAP programs in Boston, says research has shown that ambient bullying, or "indirect bullying" is pervasive -- 70 percent of employees say they have witnessed other people being bullied or mistreated at work.

"Bullying has a negative effect on team relationships, which creates a toxic work environment," Jacobbi says. "When [people] witnesses bulling, they think, 'This could be me next,' particularly if it's their boss."

Indeed, research has also shown that 72 percent of all bullies are bosses, she says.

HR managers should encourage an environment in which people feel safe to discuss bullying they've witnessed, and assessed that their comments will remain confidential whether they come to their boss, the HR department or the organization's employee-assistance program, Jacobbi says.

"The most important thing is creating a climate where people feel they have someplace to go when they feel uncomfortable," she says.

Ken Zuckerberg, director of training at ComPsych Corp. in Chicago, says HR managers not only have to watch out for employees with low morale after witnessing bullying, but also employees who try to appease the bully and make bad business decisions to avoid getting on their bad side.

When dealing with bullying behavior, organizations should treat it as a performance problem first and foremost, Zuckerberg says. A common mistake that HR managers often make in these situations is to take on the role of a counselor and try to figure out what is going on in the bully's life to cause them to act that way.

"One word of caution ? you want to continue to manage performance, but you don't want to be diagnosing mental-health issues," he says. "Most HR managers are not clinicians and they instead, should refer the bully to their EAP for help in uncovering what might be core issues behind bullying."

Seymour Adler, a partner with Aon Hewitt in New York and an organizational psychologist, says some people who witness bullying in the workplace feel they've been put in "a totally untenable situation of whether or not they need to try to be a hero."

"Who knows what the consequences will be if they do something about it, so they end up being passive about it," Alder says. "That can really be very corroding to their self-esteem, to how they view themselves as human beings."

If top-level managers are bullies, HR managers need to risk confronting them for the sake of the rest of the organization, he says.

"[HR managers have] the responsibility for the motivation, effective use and treatment of all of the human capital within their organizations," Adler says. "They need to be true to their value system, even if it ends up costing them their job."