Reference no: EM133398237

Question: Discuss which elements of the CLAS the healthcare service meets this report. Evaluate and suggest additional ways in which the chosen case study's service could be improved to meet the CLAS standards.

Case: White Memorial Medical Center Family Practice Residency Program, Los Angeles, CA Support provided by the California Endowment to the White Memorial Medical Center Family Practice Residency Program enabled several faculty members, including a director of behavioral sciences, a manager of cross-cultural training, and a director of research and evaluation, to devote time specifically to cultural competence training. A medical fellowship position was also established with part-time clinical and supervisory responsibilities to provide a practical, clinical emphasis to the curriculum. The curriculum, which is required, begins with a month-long orientation to introduce family medicine residents to the community. The doctors spend nearly 30 hours on issues related to cultural competence, during which time they learn about traditional healers and community-oriented primary care and hold small group discussions, readings, and self-reflective exercises. Throughout the year, issues related to cultural competence are integrated into the standard teaching curriculum and codified in a manual. Residents present clinical cases to faculty regularly, with particular emphasis on the sociocultural perspective. In addition, a yearly faculty development retreat helps to integrate cultural competence into all of the teaching at White Memorial. The hospital is currently assessing the outcomes of these interventions.

White Memorial Medical Center Family Practice Residency Program, Los Angeles, CA The family practice residency program at White Memorial Medical Center began in 1988 with an explicit mission to serve the local community. The program also wanted to establish partnerships with local high schools and colleges to develop a pipeline for training students who could eventually serve the health needs of their own communities. The area served by the facility is predominantly Mexican American, and half the population speaks mostly Spanish. About half the residents are insured through Medicaid, while the rest are either uninsured or have private insurance. Since the program's inception, White Memorial has emphasized the importance of cultural issues both outside and inside the medical encounter, but the formalization of the cross-cultural curriculum began in the late 1990s. Support from the California Endowment made it possible for several faculty members, including a director of behavioral sciences, a manager of cross-cultural training, and a director of research and evaluation, to devote time specifically to cultural competence training. A medical fellowship position was also established with part-time clinical and supervisory responsibilities to provide a practical, clinical emphasis to the curriculum. The curriculum, which is required, begins with a month-long orientation to introduce family medicine residents to the community. The doctors spend nearly 30 hours on issues related to cultural competence, during which time they learn about traditional healers and community-oriented primary care and hold small-group discussions, readings, and self-reflective exercises. Throughout the year, issues related to cultural competence are integrated into the standard teaching curriculum and codified in a manual. Residents present clinical cases to faculty regularly, with particular emphasis on the sociocultural perspective. In addition, a yearly faculty development retreat helps to integrate cultural competence into all of the teaching at White Memorial. The hospital is currently assessing the outcomes of these interventions. 8 Key Lessons Learned • Conduct a needs assessment of residents before curriculum development, make a multidisciplinary teaching team, and carve out time for faculty development. Include both minority and nonminority staff as faculty. • Develop awareness and emphasize cross-cultural issues during orientation to help set the tone for the entire program. • Integrate components of cultural competence into many different aspects of the educational curriculum-seminars, lectures, workshops-so the effort is not viewed as an added burden to an already busy resident schedule. Integrating cultural competence with clinical/biomedical education also prepares physicians on all levels. • Evaluate the program at multiple levels, including cultural awareness, knowledge, and skills assessment. • Determine means of gaining consensus for this type of curriculum, such as modifying hospital culture to keep up with the changing demographics of the community, performing public relations, securing federal funding and foundation grants, and fulfilling regulatory requirements. • Secure faculty time, teaching time, and funding for cultural competence curriculum.