CLAS - week 5

Question 1

Created by The Office of Minority Health in 2000

Guidelines, recommendations, and mandates (a total of 14) with a goal of creating a more consistent way of looking at culture across the country

They address inequities related to culture and linguistics, and seek to reduce disparities

Answer 1

CLAS standards

Question 2

Common understanding/key definitions – so everyone is on the same page

Practical framework for implementation of services

Organized into three categories*

• Culturally competent care (1-3)
• Language access services (4-7)
• Organizational supports for cultural competence (8-14)

Answer 2

key features of CLAS

Question 3

Current federal requirements

4, 5, & 6

Answer 3

mandates

Question 4

This is something that the OMH thinks should be mandated by federal, state, and accrediting agencies
1-13

Answer 4

guidelines

Question 5

Suggestion for voluntary implementation by hospitals/organizations (14)

Answer 5

recommendations

Question 6

Includes care that is respectful, understandable, and effective

• Respectful includes consideration of values, preferences and expressed needs of the patient
• Understandable means communicating in the patient’s preferred language and making sure they understand the information
• Effective means- satisfaction, appropriate diagnosis and treatment, adherence, improved health status

Answer 6

Standard 1

Question 7

Form the basis for all other standards
concerns not only patient-facing staff members but also the entire range of managers, policies, and systems that underlie any clinical encounter

Provides an environment where patients feel comfortable discussing their needs and choices

Having knowledge of and integrating
-Knowledge also means having the resources you need available

Answer 7

Standard 1 (2)

Question 8

staff members from population groups similar to those being served makes for better understanding of the needs of those groups, as well as helps patients feel more comfortable and welcome in the facility

• Cultivate a staff that is bilingual and bicultural
• Include diversity from staff members to senior leadership
• Work on internal staff development and retention

Answer 8

standard 2

Question 9

• Provide internships, residencies, rotations that focus on serving culturally diverse populations to recruit
• Establishing incentive programs, such as bonuses or salary differentials to bilingual staff members or those who attain certification in cultural competence or interpretation
• Becoming involved with programs like the National Health Service Corps, which provides incentives to primary care physicians who practice in underserved communities
• Provide training so that staff works to grow into community advior roles or do community outreach
• Avoid burnout by not asking too much of linguistically skilled employees or ask them to do things they are not trained to do.
• Promote diverse staff that utilize cultural skills
  Don’t penalize for those who are working on cultural competence

Answer 9

standard 2 (2)

Question 10

• Training may represent the most important element in ensuring competence
  - Continuing education provides ongoing education on the significance of cultural attitudes on the effectiveness of health care.
  - Can create their own in house training or contract out

-Staff includes not only personnel by subcontracted and affiliated personnel

Answer 10

standard 3

Question 11

• Services need to be provided regardless of the size of that person’s language group in the community
• Preferred hierarchy of language services
• Qualified Language Assistance Services (mandate)
• This is part of the civil rights act of 1964
• Bilingual staff, trained interpreters, language line- Adherence to care is higher when language access is provided

Answer 11

Standard 4

Question 12

• Having language services does not guarantee they will be used when needed.
• Facilities must distribute written notices and post translated signage with this information.
• Facilities must ask and record a patient’s preferred language on their patient record.

Answer 12

Standard 5

Question 13

Notices to Patients/Consumers of the Right to Language Assistance Services (mandate)

Create wall signs at all major points of entry and discharge. Places they are likely to interact with staff, pharmacy, labratories, billing

Wall sign with tear off cards
Automatically assigning interpreters
Bilingual wallet cards

Answer 13

Standard 5 (2)

Question 14

• Providers must assess and ensure the competency of individuals providing language services.
  - Ensuring Qualified Bilingual and Interpreter Services

-Family members should not act as interpreters

Answer 14

Standard 6

Question 15

• Written material reinforce key messages
• Key documents need translation (applications, consent forms, letters concerning participation in a program, notification about denial or termination of benefits)
• Also, documents that allow patients to make educated decisions about their healthcare.
• need to have consent for anything being translated

Answer 15

standard 7

Question 16

• Plan strategically! Develop policies, set goal, define and structure activities.
  
  • Service activities, time lines, and milestones
  • Identification of responsible individuals (using detailed organizational charts)
  • Development and implementation of standards and performance requirements
  • Performance monitoring
  • Protocols for scheduling and coordinating activities

-Ensure accountability- have the support of top management/board of directors

Answer 16

Standard 8

Question 17

• Look for strengths, capacities, shortcomings, and challenges
  - The point is to define service needs, identify opportunities for improvement, develop action plans, and design programs and activities
• Assessing the efficacy of CLAS requires data on patient race and ethnicity
  - data should not be aggregated only on the basis of last names—a common practice in efforts to compile ethnicity statistics (overlaps between sub-populations, immigrants often change the spelling of their last names, and marriage related changes)

Answer 17

Standard 9

Question 18

• Tracks performance of the plan
• May need additional identifiers outside of race/ethnicity socioeconomic status, cultural background, country of origin)
• Confidentiality and security concerns

Answer 18

Standard 10

Question 19

Address these concerns (with HIPPA)

• Worries among undocumented individuals about drawing the attention of the Department of Homeland Security
• Fears of receiving inadequate medical services as a result of answering such questions
• Concerns about being asked to pay higher insurance premiums based on race or ethnicity.

Answer 19

Standard 10 (2)

Question 20

• The goal is to make sure that healthcare organizations obtain baseline data and update that data regularly on the makeup of their communities
• Community mapping
• Collection of Data on communities

Answer 20

Standard 11

Question 21

• Patients are more likely to use services that are developed with attention to community needs and wishes, thereby leading to more effective care and healthier communities.
• Work to find ways to involve the communities (community forums, churches, employees, patient questionnaires)

Answer 21

Standard 12

Question 22

• Patients with are more vulnerable than others to experiencing disrespect from a healthcare institution or its staff.
• An absence of complaints does not mean that issues of discrimination are not taking place.

Answer 22

Standard 13

Question 23

• The intent is to make public the healthcare organization’s efforts to implement CLAS standards.
• The focus is accountability

Answer 23

Standard 14