Cultural Competence Series: Communication Across Differences ©2012 The University of Texas MD Anderson Cancer Center HR Talent Development: Diversity Programs

©2012 The University of Texas MD Anderson Cancer Center 22 Objectives Communication Across Differences The Communication Across Differences workshop will encourage participants to practice effective cross cultural communication skills in the healthcare environment and workplace by: Understanding how culture influences communication between patients and employees and between team members. Increasing self awareness of your cultural communication style. Identifying effective strategies to build trust and respect when communicating across cultures with patients and employees.

Trust and Respect MD Anderson Cancer Center The MD Anderson Cancer Center provides culturally appropriate patient care and a culturally competent work environment. As an institution, MD Anderson strives to understand and respect the cultural beliefs, customs, and lifestyles of globally diverse individuals and groups. These efforts will enable our institution to bridge cultural differences, build trust and respect, to provide quality care, and to be the employer of choice. Joint Commission The Joint Commission views the delivery of services in a culturally and linguistically appropriate manner as an important healthcare safety and quality issue. For general information on standards related to cultural competency, please visit or contact hlc- ©2012 The University of Texas MD Anderson Cancer Center 3

4 Cultural Identity

Communication Across Cultures sharing Communication is the process of sharing an idea or information. Being able to communicate across cultural differences is important to our patients and employees. essential Successful cross cultural communication is essential for individual and organizational success. ©2012 The University of Texas MD Anderson Cancer Center 5

6 Communication Matrix Communication Levels: Organizational Leader Employee Employee Employee Patient Disclosure Levels: Intimate (Full Disclosure & Trust) Interpersonal (Some Trust) Casual (Minor Trust) MESSAGEMESSAGE COMMUNICATION INFLUENTIAL FACTORS CULTURAL INFLUENTIAL FACTORS

Why Our Actions Count best of our intentions can be negatively impacted Keep in mind, that the best of our intentions can be negatively impacted by how our words or actions are perceived. Several influencers are listed below. ©2012 The University of Texas MD Anderson Cancer Center 7

8 Communication

Positive Relationship trust respect Positive Relationship The relationship between a patient and their healthcare providers is based upon trust and respect. Negative Relationship decrease Negative Relationship The effects of disrespect and derogatory conduct towards a healthcare provider can cause the decrease in morale, staff retention, and the quality of care. ©2012 The University of Texas MD Anderson Cancer Center 9 Relationships

The Truth of the Situation Source: Dont Judge too Quickly series. Ameriquest Mortgage Company. © ©2012 The University of Texas MD Anderson Cancer Center 10

©2012 The University of Texas MD Anderson Cancer Center 11 Patient Communication Points AdmissionAdmission AssessmentAssessment TreatmentTreatment End of Life Discharge and Transfer Influencers: Cultural Cultural Communication Communication Trust Trust

Admission Identify and address patient communication needs. Language Assistance provides interpretation and translation services at no cost to the patient. Interpreters can facilitate cross- cultural communication between patients and healthcare personnel who do not speak the same language. The hospital provides information to communicate with the patient who has vision, speech, hearing, or cognitive impairments in a manner that meets the patients needs. As an example, Sign Language Interpreters can be used to assist hearing-impaired patients. 12 ©2012 The University of Texas MD Anderson Cancer Center

Assessment Always check the accuracy of the patient's name to the patient's record. Greet the patient by their last name and then introduce yourself. Identify and address patient communication needs. When possible, the hospital accommodates the patients cultural, religious, or ethnic food and nutrition preferences, unless otherwise instructed. Ask the patient to identify a support person. Ask the patient and their family members what they prefer regarding their cultural and/or spiritual beliefs. Communicate information about unique patient needs to the care team. 13 ©2012 The University of Texas MD Anderson Cancer Center

Treatment Address the communication needs of a patient that may have sensory and/or communication impairments. Provide information to communicate with the patient who has vision, speech, hearing, or cognitive impairments in a manner that meets the patients needs. Identify and accommodate a patient's cultural, religious, or spiritual beliefs and practices that may influence care. Determine any cultural or alternative healing medications or practices that the patient may be integrating into their treatment plan. Confirm any individuals which are outside of the institution that the patient considers as a member of their treatment and support team. Incorporate cultural competence and patient/family-centered care concepts into care delivery. Communicate information about unique patient needs to the care team. 14 ©2012 The University of Texas MD Anderson Cancer Center

End of Life Address patient communication needs during end-of-life care. Monitor changes in the patients communication status during end-of-life care. Involve the patients surrogate decision-maker and family in end-of- life care. Address patient mobility needs during end-of-life care. Identify patient cultural, religious, or spiritual beliefs and practices at the end of life. Make sure the patient has access to his or her chosen support person. 15 ©2012 The University of Texas MD Anderson Cancer Center

Discharge and Transfer Access patient communication needs. Engage patients, loved ones, and care-givers in the discharge and transfer planning and instruction. Provide discharge instruction that meets the patient's needs. Identify follow-up providers that can meet the patients' unique needs. 16 ©2012 The University of Texas MD Anderson Cancer Center

17 Patient Resources

Language Assistance Language Assistance provides the following interpretation and translation services at no cost to our patients: Interpreters are available on site for the following languages: Arabic, French, German, Italian, Mandarin, Portuguese, Spanish, Turkish, Vietnamese 24 hour notice is required to acquire interpreters for additional languages. Telephone interpreter service is available 24 hours a day. Interpreters are also available to assist our hearing impaired patients. For more information or to request interpretation services, please call the Language Assistance department at (713) ©2012 The University of Texas MD Anderson Cancer Center 18 Source: Language Assistance at:

Additional Patient Resources Anderson Network: Anderson Network: Is a unique global cancer support group of more than 1,800 current and former patients. and-cancer-information/guide-to-md-anderson/patient-and-family- support/anderson-network/index.htmlhttp:// and-cancer-information/guide-to-md-anderson/patient-and-family- support/anderson-network/index.html Chaplaincy: Chaplaincy: To guide our patients on their spiritual journey. programs-and-labs/departments-and-divisions/chaplaincy/index.html programs-and-labs/departments-and-divisions/chaplaincy/index.html International Center: International Center: Welcomes our international patients and assists them with their transition into MD Anderson. ©2012 The University of Texas MD Anderson Cancer Center 19

Additional Patient Resources – continued. Patient Advocacy: Patient Advocacy: Provides patients and families with a central department in which to register complaints or concerns. anderson/patient-and-family-support/patient-advocacy.html anderson/patient-and-family-support/patient-advocacy.html Social Work: Social Work: To help patients and their families cope with the diagnosis of cancer and to eliminate through outstanding integrated programs in patient care, research, education and prevention. ©2012 The University of Texas MD Anderson Cancer Center 20

©2012 The University of Texas MD Anderson Cancer Center 21 Communication

©2012 The University of Texas MD Anderson Cancer Center 22 What do you really mean? Source: If Delivery People Ran the World. Sprint.com/nextel. ©

Are you Talking the Talk? T t T – Convey mutual respect by reducing power barriers, pausing to give everyone t ime to speak, and be aware of non-verbal communication. A Aa a A – A cknowledge the individual(s) and their contributions, a sk questions, and be a ccountable. L l L – Identify the problem and create an atmosphere of equality and trust through l istening. K Kk K – K eep to the point and k eep the conversation at an understandable level. I ii I – Maintain a non-emotional i nteraction and refrain from i nterrupting. N nn N – Clarify the n eed of the communication or n egotiation. G g G – Examine possible solutions, identify the g oal(s) of the resolution, follow up, move on, and motivate. ©2012 The University of Texas MD Anderson Cancer Center 23

©2012 The University of Texas MD Anderson Cancer Center 24 Whats your Communication Style? 1.Read each question in each category. 2.If the question applies to you then answerYES by shading the indicator. You may shade more than oneYES per row. 3.If the question DOES NOT apply to you then proceed to the next question. 4.Each shaded box is worth ONE point. Add the score for each style column. 5.Write the total score for each style. 6.Circle the highest score which indicates your most dominate communication style preference. 7.Compare your results.

©2012 The University of Texas MD Anderson Cancer Center 25 Communicator Styles

©2012 The University of Texas MD Anderson Cancer Center 26 Self Check: Are you practicing the 5 Main Building Blocks of Trust? 1.Communication 1.Communication Are you clear and concise in your communications or are you sending vague hidden messages? 2.Patience 2.Patience Do you pause within a conversation to give the other person time to process the message, organize their thoughts, and to respond back to you? 3.Respect 3.Respect Do you demonstrate respect through your words, body language, and actions when interacting with another individual? 4.Cultural Consideration 4.Cultural Consideration Do you express openness and consideration towards another individuals perspective? 5.Honesty/Acknowledgement 5.Honesty/Acknowledgement Do you acknowledge other individuals contributions and ideas?

©2012 The University of Texas MD Anderson Cancer Center 27 Reminder You will receive an containing a link to complete an online evaluation. Your input and suggestions are very important to our team because we value your feedback to improve our educational programs. Let us know if there is a diversity topic or topics that you would like to learn more about.

How do I print my certificate? 1.Log into the Education Center at: MANAGE MY LEARNING 2.Click the MANAGE MY LEARNING Tab. MY TRANSCRIPT 3.Select MY TRANSCRIPT from the Left Navigational Menu. STARTEND 4.Confirm the START and END date range. TITLE 5.Locate the applicable course TITLE. PRINT CERTIFICATE OF COMPLETION 6.Click the PRINT CERTIFICATE OF COMPLETION link. 7.Print the certificate. 8.Log out. ©2012 The University of Texas MD Anderson Cancer Center 28

©2012 The University of Texas MD Anderson Cancer Center 29 Questions