Relationship between social determinants and health outcomes

How To The Improve Integration Coordination Of Services?

In my role as healthcare service manager I often have to work across multicultural and multilingual setups where I have to interact with people coming from different countries across different races. In my role as a healthcare service manager I need to emphasis upon cultural competency where I need to ensure that all the patient visiting the hospital unit are provided with equal support and care services.  The language and cultural differences often makes it a problem. However, my professional enables me to travel across different geographical locations and boundaries intermixing with people of different culture.  This also allows me the scope of learning different languages. This further allows me to identify their individual cultural faiths and beliefs, which is crucial for being culturally sensitive.

Therefore, working across diverse cultures would help me absorb the aspects of cultural liaison well. It covers two basic aspects such as – cultural humility and linguistic competency. It also takes into consideration confidentiality and safety concerns while the delivery of treatment and care within a hospital setup. As mentioned by McNab, Paterson, Fernyhough & Hughes (2016), cultural liaison helps in the provision of holistic care approaches. It helps in bridging of the communication gaps which allows for the establishment of a global healthcare.

There are a number of factors which plays a crucial role in determining the health outcomes. Some o these are social determinants, human rights and cultural competence. In this respect, the social determinants of health mean the economy and living conditions of the people.  As mentioned by Weller, Boyd & Cumin (2014), poor socio-economic conditions often serves a hindrance in the path of availing appropriate healthcare services.  As argued by Garg, Toy, Tripodis, Silverstein & Freeman (2015), the people living within the rural areas often improper or poor healthcare services as much of the health professionals do not want to move towards the interior. The cultural competence helps effective implementation of the human rights as it  helps one develop  sensitivity to others social and cultural beliefs.

Therefore, learning about some of these aspects would help me in removing the health and support care services biases. It would help me promote the healthcare needs of the poor and the marginalized people. In order to ensure that equitable distribution of support and care services are provided I could personalised visit the rural and the marginalized area with a healthcare team where free health checkups and vaccinations could be provided as a basic healthcare objective. Some of these have been supported through NSW healthy living programmes which   aim towards promoting cultural competency in healthcare by improving community health through healthy eating active living programs.

Enact five key constructs of cultural competency within the NSW

The five key constructs of cultural competency are as follows – cultural desire, cultural awareness, cultural Knowledge, cultural skill and cultural economics. The cultural desire is the motivation of individual and organizations to engage in the process of being culturally competent. As mentioned by Sallis, Owen & Fisher (2015), cultural desire helps one to be open to others and accept difference or similarities. This will me be in being more patient in my interaction with others. The cultural awareness on the other hand helps in removing the biases possessed by one towards different cultures. The cultural knowledge will help in understanding the world views which help me in implementing a culturally sensitive practice. The cultural skills will help me in the collection of client data pertaining to the patient health history. It helps one in performing cultural sensitive assessment. Therefore, I could use these skills within my actual clinical setup where I have to encounter patients from across different races and cultures. An effective cultural encounter would help me in breaking the stereotype while addressing the patients and engage with them in a friendly manner. Some of these aspects are very important with respect to health service management as it helps in the establishment of a culturally competent practice.

The cultural safety could be associated with a number of nursing and health service principles, which forms the basis for health management as well. Some of these are critical thinking and analysis, practise of therapeutic relationships, maintaining the capability for practice, comprehensive conduct of health assessments, development of a plan for patient centred practise, provision of responsive quality services, and evaluation of outcomes (Pauly, McCall, Browne, Parker & Mollison, 2015).

The policies places sufficient importance upon the therapeutic relationships which forms the backbone of healthcare practices as it helps in bridging the gap between different race and cultures (Waring, Allen, Braithwaite & Sandall, 2016). The provision of responsive support and care services also help in reducing the heath inequalities faced by the marginalised and the poor people (Weller, Boyd & Cumin, 2014). The policies also places sufficient importance upon the evaluation methods and practices. These help in monitoring the progress ion health within the present society.  In my opinion, one of the most important parameters in implanting a safe cultural practice is through effective therapeutic communication approaches. These when applied within my clinical setup would help me in the settlement of disputes. Additionally, it will help in providing a person centred care by supporting policies such as informed decision making where the support users will be informed by the health service management before making any crucial changes within their plan of care.

Relationship of healthcare policy to cultural safety

According to Hart and Mareno (2014), healthcare professionals are challenged under the healthcare environment in order to provide culturally competent care to a diverse group of population. In order to provide culturally competent care, the healthcare staffs are required to deliver person and family centred care via acknowledging the culturally difference among the families of different patient’s group while incorporating patients and their family members in the decision making process. However, the healthcare professionals experience certain barriers towards comprehensive implementation of the culturally competent care (Hart & Mareno, 2014). The main barriers include diversity among the patient population, lack of adequate resources to deliver culturally competent care along with biasness and prejudices towards sudden cultural values and beliefs (Hart & Mareno, 2014). The main barriers of patient in obtaining the culturally competent care include linguistic barriers. The Australian aboriginals come from a linguistically diverse background in comparison to the healthcare providers and this creates a barrier towards enjoying optimal culturally competent care (Komaric, Bedford & van Driel, 2012). The main facilitators of the culturally competent care model include proper cultural awareness among the healthcare practitioners and other health care staffs. This help in the establishment of efforts along with the provision for proper therapy based on the psychological and physiological requirement of the patient.  Moreover, cultural awareness among the service providers also helps in proper understanding about the health-related goals of the patient. In case of patient also, the main facilitator of the culturally competent care is the cultural awareness (Grandpierre et al., 2018). Proper cultural awareness among the patient population helps in improved communication among the patient and the caregivers. This helps in proper understanding of the patient’s complications and drafting the care plan accordingly (Grandpierre et al., 2018).

As health service management professional, I think proper understanding about the concept of the cultural competence helps in the proper management of the social determinant of health among the aboriginals and Torres Strait Islanders residing in Australia. For example for understanding of the cultural competence, helps in the proper understanding the main barrier towards the socio-economic status among the Australian aboriginals and the Torres Strait Islanders. Poor socio-economic background is the main social determinants of health. I think the main barriers towards the poor socio-economic status of aboriginal population is their lack of proper exposure towards education, health awareness, poor society background and lack of employment. This lack of proper education and health awareness make them more susceptible towards developing fatal diseases. Moreover, poor social-economic status lead to the generation of behavioural risk factors, which further increases the chance of disease development (Australian Institute of Healthcare and Welfare, 2016). As professional health service management professional, I would promote awareness in the domain of maintaining healthy behavioural habits in order to promote quality health and well being. In the grounds of human rights, I feel that the proper awareness of cultural competency among the health service management professionals help in considering the individuals a unique patient with unique needs. This will help in the reduction of the prejudices and other barriers towards implementing proper care plan (Australian Institute of Health and Welfare, 2016)

References

Australian Institute of Health and Welfare. (2016). Social determinants of Indigenous health. Access date: 26^th May 2018. Retrieved from: https://www.aihw.gov.au/getmedia/d115fe0f-9452-4475-b31e-bf6e7d099693/ah16-4-2-social-determinants-indigenous-health.pdf.aspx

Garg, A., Toy, S., Tripodis, Y., Silverstein, M., & Freeman, E. (2015). Addressing social determinants of health at well child care visits: a cluster RCT. Pediatrics, 135(2), e296-e304. operations : https://pediatrics.aappublications.org/content/135/2/e296.short

Grandpierre, V., Milloy, V., Sikora, L., Fitzpatrick, E., Thomas, R., & Potter, B. (2018). Barriers and facilitators to cultural competence in rehabilitation services: a scoping review. BMC health services research, 18(1), 23.  doi:  10.1186/s12913-017-2811-1

Hart, P. L., & Mareno, N. (2014). Cultural challenges and barriers through the voices of nurses. Journal of clinical nursing, 23(15-16), 2223-2233. doi: 10.1111/jocn.12500

Holland, K. (2017). Cultural awareness in nursing and health care: an introductory text. CRC Press. Retrieved from : https://books.google.co.in/books?hl=en&lr=&id=MwMvDwAAQBAJ&oi=fnd&pg=PT10&dq=Holland,+K.+(2017).+Cultural+awareness+in+nursing+and+health+care:+an+introductory+text.+CRC+Press.&ots=KDII4eOMyb&sig=hHzFWTBxPVvqmpYkJxz7thrwpaU&redir_esc=y#v=onepage&q&f=false

Komaric, N., Bedford, S., & van Driel, M. L. (2012). Two sides of the coin: patient and provider perceptions of health care delivery to patients from culturally and linguistically diverse backgrounds. BMC health services research, 12(1), 322. https://doi.org/10.1186/1472-6963-12-322

McNab, J., Paterson, J., Fernyhough, J., & Hughes, R. (2016). Role of the GP liaison nurse in a community health program to improve integration and coordination of services for the chronically ill. Australian journal of primary health, 22(2), 123-127. Retrieved from : https://www.publish.csiro.au/py/PY14089

Pauly, B. B., McCall, J., Browne, A. J., Parker, J., & Mollison, A. (2015). Toward cultural safety: nurse and patient perceptions of illicit substance use in a hospitalized setting. Advances in nursing science, 38(2), 121-135. doi: 10.1097/ANS.0000000000000070

Sallis, J. F., Owen, N., & Fisher, E. (2015). Ecological models of health behavior. Health behavior: Theory, research, and practice, 5, 43-64. Retrieved from : https://books.google.co.in/books?hl=en&lr=&id=0j4LCgAAQBAJ&oi=fnd&pg=PA43&dq=Sallis,+J.+F.,+Owen,+N.,+%26+Fisher,+E.+(2015).+Ecological+models+of+health+behavior.+Health+behavior:+Theory,+research,+and+practice,+5,+43-64.&ots=w20tdnqAll&sig=XaJNlb-xRXY9-N4dOLGUB0C7OCM&redir_esc=y#v=onepage&q&f=false

Waring, J., Allen, D., Braithwaite, J., & Sandall, J. (2016). Healthcare quality and safety: a review of policy, practice and research. Sociology of financial & illness, 38(2), 198-215. Retrieved from : https://doi.org/10.1111/1467-9566.12391

Weller, J., Boyd, M., & Cumin, D. (2014). Teams, tribes and patient safety: overcoming barriers to effective teamwork in healthcare. Postgraduate medical journal, postgradmedj-2012. Retrieved from : https://pmj.bmj.com/content/early/2014/01/07/postgradmedj-2012-131168.short