Contemporary Problem in Health Management - Case Study Example

Case Study Name: University: Date: Critical examination of a contemporary problem in health management Introduction The health constructs of Aboriginal and Torres Strait Islander is not only concerned with the individual physical wellbeing, but also the emotional, social, as well as cultural wellbeing of the whole community. However, this concept as observed by Markwick, Ansari, Sullivan, Parsons, and McNeil (2014) a concept that is normally overlooked by mainstream health services. For this reason, gaining the trust of the indigenous population in Australia has become so challenging considering that their mental and physical wellbeing is associated with cultural and historical context. Evidently, Aboriginal Australians are experientially, linguistically and culturally diverse population and masking their health determinants is somewhat challenging. Evidently, there are inequalities in health between non-Aboriginal and Aboriginal Australians, in terms of social capital and psychosocial risk factors. The inequality and poverty that they experience is a modern reflection of how they were treated in the past and the health status inequality that they experience for decades is associated with systemic discrimination. Communication according to Shahid, Finn, and Thompson (2009) may be affected adversely by people’s cultural, historical and socioeconomic backgrounds. Culture is undeniably a multifaceted phenomenon that encompasses language, myth, knowledge, customs, rules, lifestyles, habits, beliefs, attitudes, and rituals that offer a common identity to certain population. Communication concerns between health professionals and Indigenous patients have been identified where health practitioners have been found delivering less supportive discourse and less information to patients from indigenous populations. The case study addresses the strategic management and organisational development required to optimize cultural safety in a health organization. Part One – Reflection In view of Cox (2013) study I have realised that cultural safety in addition to the process undertaken by nurses so as to realize cultural safety are dominant transformative factors within the health system. I concur with Cox and Taua (2013)that the cultural safety cornerstone is that end users must be treated in line with their differences and unique needs and the majority of people consider this idea challenging when equality ideas are ingrained as sameness. My understanding of cultural safety may have been influenced by Brascoupé and Waters (2009) study, who indicates that cultural safety is manifestly the most progressive based on practical relevance in the designing as well as delivery of institutional and government policy. According to Brascoupé and Waters (2009), cultural safety is the reversal of cultural peril or danger, where communities as well as individuals can be in danger or in crisis. DeSouza (2008) has enabled me to clearly understand that the concept of cultural safety entails not only the understanding that differences in culture matter in delivery of health and social policy, but as well the need of making an actual difference in delivery methods as well as the eventual efficiency of the policies. That is to say, cultural safety is not only a process of enhancing program delivery, but it is as well part of the outcome. Since learning about cultural safety in this unit my understanding has changed to a large extent since have been able to realize that cultural safety goes beyond recounting other ethnic groups’ practices, since as a strategy may result in a checklist mentality where group members are prioritized. I have noted that culturally safe health practitioners concentrate on self-understanding as well as the focus are on what values and attitudes health practitioners bring to their practice (Cox & Taua, 2013). There are a number of strategies implemented so as to optimize cultural safety in a health organization, especially a diverse cultural environment. First, books and artworks are displayed so as to reflect the different cultural identities and languages within the workplace. Considering that health information leaflets as well as posters depicting different languages and ethnic groups make persons feel more at ease in recognizing cultural identity. Besides that, a space offering privacy has been made accessible for health counseling. In order to provide a culturally safe health care, various communication strategies have been espoused considering that communication difficulties may lead to negative health outcomes. In this case, ideal communication takes place between persons of the same cultural and linguistic background. To achieve this, the organization has hired cultural liaison workers so as to realize this and for safe care, other health professionals have been trained in interpersonal cultural communication with the goal of maintaining effective communication (Skellett, 2012). Essentially, the obligation for change is normally placed on the culture that is not dominant, but power distance may often prevent people from speaking their mind. As mentioned by Esteban, Kalia, and Lim (2015), change is a necessary component that makes the process of performance improvement in organization successful. Therefore, the organization ensures health professionals have flattened the hierarchy so as to generate understanding and make it feel secure to participate and speak one’s mind. Part Two – Issues on Cultural Safety A number of peer-reviewed studies according to Halligan and Zecevic (2010) have demonstrated the significance of cultural safety in healthcare environment, but the attention turned on the development of common set of measures, dimensions and definitions is very little. Basically, the cultural safety concept evolved as the term was adopted by organizations and Aboriginal people to describe new approaches to community healing as well as healthcare. Scores of studies as observed by Halligan and Zecevic (2010) have confirmed that cultural safety definition must consist of an intensely practical and strategic plan so as to alter the way healthcare is delivered to different ethnic groups. The concept is particularly utilized in expressing a healthcare approach that identifies the current conditions of different ethnic groups which stem from their post-contact history. The cultural safety health movement was initiated during the 1980s in in New Zealand when Irihapeti Ramsden, a Maori nurse student raised a concern about the hospital policy with regard to the standard nursing practices claiming that many health institutions are concerned with ethical safety, legal safety, as well as clinical practices safety, but lacked cultural safety. Undoubtedly, cultural safety was disregarded in the nursing program; therefore, Irihapeti Ramsden concerns resulted in cultural safety movement and the Treaty of Waitangi that acknowledged the Maori as first New Zealanders (Richardson & MacGibbon, 2010). However, in the nursing fraternity, Maori nurses realised that the Treaty was merely an official procedure that was yet to be honored. This is in view of the fact that, Maori patients as well as nurses were viewed as second-class citizens and therefore, were being isolated from the normal nursing practices due to their cultural dissimilarities (van den Berg, 2010). Maori patients as well as nurses started questioning why they had to practice nursing that was against their own cultural customs and beliefs; thus, leading to the introduction of cultural safety. In Australia, the cultural safety concepts, which include cultural competence as well as cultural awareness, have been introduced into the nursing system through the institutions of higher education. Regrettably, the change process is taking long due to the colonial attitude as well as inborn discriminatory attitudes towards Indigenous people. van den Berg (2010) posits that Australia has two centuries of exile and invisibility to overcome before the indigenous population can realize the ideal equality status. Prior to the referendum in 1967, indigenous populations were state governments’ wards and did not have rights over their lives. Instead, they were bound by policies and laws where their movements were monitored by state governments and were legally disallowed to make their own decisions. Indigenous people were a subjugated population, but these attitudes changed thanks to the United Nations policy on indigenous rights (van den Berg, 2010). In a health care organization, minority ethnic culture should be a source of confidence, resilience, strength, identity and happiness rather than discrimination. Considering that all such factors are indistinguishably associated with health as well as wellbeing; therefore, in a healthcare environment, protecting and promoting indigenous and minorities culture is vital for progressing health of people from these cultures. Without a doubt, quality health care for minority ethnic patients must be responsive to effects of racism and cultural differences. Acknowledging impacts on interactions and environments, as well as the application of this awareness to practice help exhibit healthcare that is culturally safe (Richardson & MacGibbon, 2010). There are a number changes needed with regard to how staff approach diversity. A number of open-minded Australians desire to improve the health of the indigenous population as well as the hospital system by means of cultural safety introduction. Realizing cultural safety is not easy because staff must first appreciate diversity in order to advance improved health practices as well as increase statistics of positive health through accepting indigenous people for their dissimilarities from other Australians. As mentioned by Salisbury and Byrd (2006), labor force cultures that value diversity and are inclusive, in comparison with homogeneous ones, improve innovation as well as productivity. Part Three – Processes of Change to Address and Optimize Cultural Safety In health services, creating a cultural safety environment so as to ensure responsive as well as culturally suitable care should be the core business of all health organization. Based on the processes of change so as to address and optimize cultural safety, the first step is introducing a cultural safety education that concentrates on the understanding and knowledge of the individual health professionals, instead of education that makes one learn characteristics of different groups. A health professional can comprehend his/her own culture as well as the power relations theory may be culturally safe in any setting. Health practitioners work with people’s social realities, the majority of whom lack their own cultural information. For this reason, skills and knowledge are needed so as to work with behaviour that stem from different cultured personal and social events. This should be in consideration of cultural safety that needs every person to get nursing services that make allowances for everything that makes them feel unique. In this case, the manager should work from a wholistic standpoint so as to ensure that the employees understand that the needs of individuals (spiritual, social, mental, physical and emotional) are attached and are inclusive of their community and family relationships network. It is imperative to comprehend the role of oppression, racism, and colonization in the advent of social and health determinants as well as Indigenous peoples’ present health conditions. Managers in the health workplace should also consider culture as healing by incorporating traditional practice and knowledge like the use of ceremonies. Basically, traditional knowledge holders such as elders are crucial for the design and enactment of any program that is culturally based. The manager should be the bearer of culture, and therefore, should take into account both the culture of the employees and of the patients. As stated by Downer and Fernando (2015), it is the responsibility of the manager to manage risk and patient safety and set out safety as well as quality procedures and policies. The health practitioner should respect the patient’s culture, nationality, gender, or religion by working in a way that acknowledged the existence of differences. The next step is to diversify the workplace; in view of the fact that indigenous culture is different and observance to customary practices as well as connection to understanding of the traditional language, spiritual beliefs and culture is different and should not be presumed universal. Besides that, programs that are culturally safe are flexible and normally involve practices of different countries, relying on context or location, and westernized activities in order to provide a full modalities’ continuum for end users. The next step is empowerment such that the practitioner and the program acknowledge individual challenges and strengths and recognizes Indigenous people are not all the same. Cultural safety includes cultural sensitivity as well as cultural awareness and is strengthened by effective communication, acknowledgment of diverse views between ethnic groups. For this reason, the manager should espouse cultural respect framework that includes; knowledge and awareness; behaviour and skilled practice; strong relationships; and equity of outcomes. Imperatively, the cultural respect framework will offer the health organization a basis of attaining changed awareness and knowledge, resulting in changes in behaviour and practice, which consequently offers guarantee that cultural safety and practices of healing are legitimized. Essentially, it is imperative when working in a health environment to be aware of cultural diversity and safety, and their impact on services offered to clients (Singer & Tucker, 2006). Importantly, all patients have a right to receive equitable and fair services, which must be of high quality. Managers should understand that they are offering care to persons from cultures where their experiences as well as beliefs are different from their own. The way health practitioners address their patients and clients are very crucial. In this case, understanding the multicultural issues in addition to language services is very crucial in a health care environment. Part Four - Key Messages The first key message is that Cultural safety moves afar the cultural awareness as well as the recognition difference and it exceeds cultural sensitivity, which acknowledges the essence of respecting the difference in culture. As indicated in part one, cultural safety enables us to comprehend the confines of cultural competence, which concentrates on the knowledge, skills as well as attitudes of practitioners. The second key message is that the number of seminars as well as workshops teaching cultural awareness has been increasing steadily, but the majority of practitioners are yet to consider cultural safety as a form of health practice. The third key message is that culture is more than values, practices, and beliefs. Normally, culture has been described as the lifestyle, worldview, shared values and beliefs amongst people, which are passed down from one generation to another. Conclusion In conclusion it has been argued that cultural safety associates with the experience of the nursing service recipient and goes afar cultural sensitivity as well as cultural awareness. As mentioned above, it offers end users the power to take part in realizing positive health experiences and outcomes and also to comment on practices. Besides that, cultural safety allows health professionals to take part in altering any negatively experienced or perceived service. Imperatively, cultural safety is needed so as to address issues prejudice and of attitude formation on end users considering that they have an enormous power in the form of resources and knowledge. For this reason, nurses must understand the process of cultural safety and improve their interpretation skills to overcome the distrust experienced by aboriginal population when communicating with a care giver from a different culture. As mentioned in the paper, Indigenous and minority population experience an inconsistent burden of social disadvantage as well as illness than non-Indigenous, and due to this inequity in health and power status, the indigenous patients are normally treated differently as compared to non-Indigenous patients who are treated impartially. Cultural Safety is meant to improve the development of beliefs as well as attitudes toward aboriginal peoples. Basically, the concepts of cultural safety, including cultural competence as well as cultural awareness as mentioned in the paper have been introduced into the healthcare system through the institutions of higher education. Unfortunately, the process of change has taken long because of the colonial attitude as well as inborn bigoted attitudes towards Aboriginal people. References Brascoupé, S., & Waters, C. (2009). Cultural Safety Exploring the Applicability of the Concept of Cultural Safety to Aboriginal Health and Community Wellness. Journal of Aboriginal Health, 6-41. Cox, L. (2013). Cultural Safety. Cox, L., & Taua, C. (2013). Socio-cultural considerations and nursing practice. In J. Crisp, C. Taylor, C. Douglas, & G. Rebeiro, Fundamentals of nursing (4th ed.). Sydney: Elsevier. DeSouza, R. (2008). Wellness for all: the possibilities of cultural safety and cultural competence in New Zealand. Journal of Research in Nursing, 13(2), 125–135. Downer, T.-r., & Fernando, C. (2015). Clinical governance. Esteban, L., Kalia, M., & Lim, V. (2015). KEY PROCESS INVOLVED IN CHANGE MANAGEMENT. Halligan, M., & Zecevic, A. (2010). Safety Culture in Healthcare: A review of concepts, dimensions, measures and progress. The University of Western Ontario, London, ON. Markwick, A., Ansari, Z., Sullivan, M., Parsons, L., & McNeil, J. (2014). Inequalities in the social determinants of health of Aboriginal and Torres Strait Islander People: a cross-sectional population-based study in the Australian state of Victoria. International Journal for Equity in Health, 13, 91-102. NACCHO. (2011). Creating the NACCHO Cultural Safety Training Standards and Assessment Process. Malbourne: NACCHO Cultural Safety Training Standards. Richardson, F., & MacGibbon, L. (2010). Cultural safety: Nurses’ accounts of negotiating the order of things. Women’s Studies Journal, 24(2), 54-65. Salisbury, J., & Byrd, S. (2006). Why Diversity Matters in Health Care. CSA Bulletin, 90-93. Shahid, S., Finn, L. D., & Thompson, S. C. (2009). Barriers to participation of Aboriginal people in cancer care: communication in the hospital setting. MJA, 190(10), 574-579. Singer, S. J., & Tucker, A. L. (2006). Creating a Culture of Safety in Hospitals. Cambridge, MA: Harvard University. Skellett, L. (2012). Cultural awareness and cultural safety. Australian Pharmacist, 382-384. van den Berg, R. (2010). Cultural safety in health for Aboriginal people: will it work in Australia? MJA, 193(3), 136-137. Read More