1. Shifting Organizational Culture
12/10/2019

2. Note to the Reviewer
Shifting Organizational Culture is a component of a Sex Positive Workshop in Arizona done in collaboration with the Pacific AIDS Education Training Center. In this portion of the workshop, we provide capacity of key variables that facilitate organizational change; cultural humility, organizational culture and shared decision-making. This curriculum, participants were provided with a foundation to consider internal strategies and structural interventions for long-term institutional change.
12/10/2019

3. Cultural Humility Principles
Lifelong learning and Critical Self-Reflection
Recognize and Challenge Power Imbalances for Respectful Relationships
Institutional Accountability
The starting point for such an approach is not an examination of the client’s belief system, but rather having health care/service providers give careful consideration to their assumptions and beliefs that are embedded in their own understandings and goals of their encounter with the client.Lifelong learning and critical reflection: Three factors guide a sojourner toward cultural humility. The first aspect is a lifelong commitment to self-evaluation and self-critique (Tervalon & Murray-Garcia, 1998). Underlying this piece is the knowledge that we are never finished — we never arrive at a point where we are done learning. Therefore, we must be humble and flexible, bold enough to look at ourselves critically and desire to learn more. When we do not know something, are we able to say that we do not know? Willingness to act on the acknowledgement that we have not and will not arrive at a finish line is integral to this aspect of cultural humility as well. Understanding is only as powerful as the action that follows
The second feature of cultural humility is a desire to fix power imbalances where none ought to exist (Tervalon & Murray-Garcia, 1998). Recognizing that each person brings something different to the proverbial table of life helps us see the value of each person. When practitioners interview clients, the client is the expert on his or her own life, symptoms and strengths. The practitioner holds a body of knowledge that the client does not; however, the client also has understanding outside the scope of the practitioner. Both people must collaborate and learn from each other for the best outcomes. One holds power in scientific knowledge, the other holds power in personal history and preferences
Finally, cultural humility includes aspiring to develop partnerships with people and groups who advocate for others (Tervalon & Murray-Garcia, 1998). Though individuals can create positive change, communities and groups can also have a profound impact on systems. We cannot individually commit to self-evaluation and fixing power imbalances without advocating within the larger organizations in which we participate. Cultural humility, by definition, is larger than our individual selves — we must advocate for it systemically. 
12/10/2019

4. Converging Cultural Perspectives
Organizational Culture
Client Culture
Professional Culture
Next 3 are Deborah’s
Discussion Question:
How does culture influence boundaries in a healthcare setting?
Discuss each and then how they can influence each climate
Professional culture: consist of: Dress, language, values, philosophy
Organizational culture: Agency vision, mission, behaviors, policies
Client culture: The client will come with his own culture and the three perspectives will converge!!!!!!!!!!!!!!!!
12/10/2019

5. Shifting Organizational Culture
Organizational Leadership
Stakeholders buy-in to this paradigm shift
Evaluate organizational values, policy & procedures that support lexicon and conduct for sexual inclusivity
Assess Program Staff/ Diversity
Shared Decision Making
When
12/10/2019

6. Shared Decision Making (SDM)
Occurs when patients and clinicians work together to reach care decisions that are both medically sound and responsive to patients preferences and values.
Patients are engaged in decision making.
Impacts continuity and coordination.
Patients have more efficient visits/less likely to switch providers.
Combines expectations and culture into day to day processes as part of standard care.
12/10/2019