Caring for a Diverse Community

Caring for Patients from Diverse Backgrounds

The 2010 Census documented what we at BIDMC have observed for more than 15 years – we are becoming an increasingly diverse populace, requiring changes in all aspects of the health care delivery system from how we educate individuals about accessing healthcare in the U.S., to enrolling residents in insurance products and registering them in health centers and hospitals.

Health care providers are rethinking a myriad of workforce-related issues from provider competencies, staff diversity and educational training to support services that facilitate optimum care of patients from so many different cultural and linguistic backgrounds.

BIDMC has always emphasized the importance of cultural considerations in providing appropriate care to patients. We know that cultural influences determine cognitive constructs, including how patients' define health, illness, and well-being, even dictating when and if an individual seeks medical care. Certainly understanding one's cultural background provides guidance for developing health promotion strategies as well as influencing the design of treatment interventions and patients' adherence to medical protocols.

With an intentional focus on these issues, BIDMC developed a set of tools and approaches to ensure delivery of culturally-responsive care. From intake assessment forms to multilingual patient satisfaction questionnaires, we have tried to apply "culture eyeglasses" to facilitate communication with, and understanding of, the patients' orientation and experience. BIDMC was one of Boston's first hospitals with an Interpreter Services department, expanding capacity and resources every year to accommodate the growing numbers of Limited English Proficient (LEP) patients. We have tailored services to facilitate specialty care for patients of diverse backgrounds such as our Latina and Chinese Cancer Patient Navigators. And, we are engaged in research specifically targeting diseases that disproportionately affect health outcomes like our programs for African Americans with chronic kidney disease.

A Diverse and Culturally Responsive Workforce

As an academic medical center, BIDMC's mission includes a strong commitment to workforce development programs that enhance the skills of our diverse employees and provide career advancement opportunities. In FY10, BIDMC offered incumbent employees four "pipeline" programs to train for the following professions: Nurse, Patient Care Technician, Research Administrator, and Medical Laboratory Technician. We also executed a targeted growth opportunity for employees of the central processing department (CPD) that resulted in 14 attaining CPD certification and promotions into new roles in CPD. The Employee Career Initiative (ECI) provides career and academic counseling, on-site academic assessment, on-site pre-college and college-level science courses and GED preparation to employees at no charge. Tuition reimbursement and competitive scholarships as well as ESOL and citizenship classes are additional offerings.

BIDMC is committed to making employment opportunities available to qualified community residents through training internships conducted in partnership with community agencies. Working with other groups, including The Work Place, Fenway CDC and Jamaica Plain NDC we interview qualified community residents who have applied for jobs at BIDMC. Recognizing our commitment to the Boston area's student population, the medical center provides summer jobs and mid-year internships to introduce high school students and out-of-school youth to careers in the medical field. In partnership with the Boston Private Industry Council, we host Boston Public High School students in the annual Job Shadow Day with additional student groups touring our skills lab.

Senior leaders are active in advocating on behalf of educational and job opportunities. Lisa Zankman, Senior VP of Human Resources, is a member of the Commonwealth's Workforce Investment Board. Joanne Pokaski, Director of Workforce Development, is on the Boston Private Industry Council's Workforce Development Committee and chairs the PIC's Boston Health Care Careers Consortium. She is also on the State Workforce Investment Board Subcommittee focused on the Healthcare Sector. In FY10, BIDMC received the Associated Industries of Massachusetts' John Gould award for Education and Workforce Development. BIDMC was one of three employers honored statewide by the Massachusetts Workforce Solutions Group as a Workforce Champion.

Multicultural Cancer Task Force

The Multicultural Cancer Task Force (MCTF) was established a decade ago to improve care offered to our diverse cancer patients, to enhance the cultural competence of providers/staff, and to educate the broader community to the disproportionate burden of cancer in communities of color. One of its most significant achievements was the creation and sponsorship of BIDMC's Cancer Patient Navigation program, which now includes Latina and Chinese Navigators.

Cancer Patient Navigators

The diagnosis of cancer can be a frightening and paralyzing experience. For patients unfamiliar with the U.S. health care system or with Limited English Proficiency (LEP), the sense of helplessness and being alone is exacerbated. Beth Israel Deaconess Medical Center was one of the first hospitals in Boston to hire Cancer Patient Navigators to guide patients through the complex maze of diagnostic and treatment services.

Plain Language - Health Literacy Initiatives

To truly engage patients as partners in their care, more than a decade ago, BIDMC launched a health literacy campaign. Our goal is to ensure that all patient education, information and consent forms are written in Plain Language and at the appropriate level.

Under the auspices of the Human Subjects Protection Office, BIDMC developed and piloted a new program titled, Consenting Adults: How to Obtain a Truly Informed Consent. Using a case-study format, experts presented information on the consent process (ethical, legal and clinical requirements), writing plain language consents, and the overlay of culture and language in obtaining an informed consent. Resources to help researchers and clinicians improve their competencies are distributed, and consultation, including live observation, available to help hone staff's skills in this area.