Accommodating different cultures, languages and faiths
There’s a hospital in New Jersey that offers seaweed on its menu, since many women of Korean descent are taught that’s what they should eat after giving birth; another is designing modesty gowns for Muslim women. In the past five decades, about 59 million immigrants have come to the U.S., and that’s one reason “it’s in everyone’s best interest to develop and promote culturally diverse patient services,” says Marisol Romany, manager of language services and cultural development at Orlando Health, which runs six acute care hospitals in Florida and is affiliated with two other facilities. Here are 11 strategies hospitals are using to serve a diverse clientele:
If your strongest language is Chinese, Korean or Japanese, checking into a U.S. hospital could be daunting. Holy Name Medical Center in Teaneck, New Jersey, provides patient navigators for Asian patients — many of them first-generation immigrants — to guide them through registration, help schedule their tests, take them to their appointments and explain every step in the patient’s native language. These bilingual navigators help relieve the anxiety felt by many Asian patients, who have no experience with U.S. hospitals, says Kyung Hee Choi, vice president of Asian health services for the hospital. Annually, the hospital has about 50,000 visits from Asian patients, between 7 and 10 percent of all visits.
To serve its sizable community of Chaldeans — Catholics who are primarily from Iraq, Syria, Turkey and Iran — the Henry Ford West Bloomfield Hospital in West Bloomfield Township, Michigan, is partnering with a local radio station to launch programming on health subjects in Aramaic, the language many Chaldeans prefer, says Lynn Torossian, president and CEO of the facility. The show will focus on topics such as digestive health, exercise tips and the importance of preventative wellness appointments, Torossian says. There have also been segments on how to modify Middle Eastern recipes to make them healthier, she says.
The location and number of a hospital room can be important to people of certain cultures. Orlando Health has an online cultural toolkit for its staff members that, among other things, advises that Muslim Arabs who are hospitalized with a terminal condition prefer to be in rooms facing east, toward their holy city of Mecca. At Holy Name Medical Center, staff members have been trained that Asian patients shouldn’t be assigned to room number 4, 44 or 444, because when spoken in Chinese, Korean and Japanese, it sounds similar to the word for death, Choi says.
Barbershop blood pressure readings
For many African-American men, the local barbershop is a popular gathering place. To reach this group, doctors are training barbers in 88 barbershops in the Los Angeles area to take customers’ blood pressure. More than 40 percent of African-American men and women suffer from hypertension, or high blood pressure, according to the American Heart Association, and it can lead to strokes and heart attacks and heighten the risk of dementia and kidney problems. The barbershop effort is part of research funded by an $8.5 million grant from the National Institutes of Health’s National Heart, Lung, and Blood Institute to the Cedars-Sinai Heart Institute.
Dressing modestly is important for many observant Muslim women, who wear burqas that cover almost all of their body. To accommodate this religious tenet, Orlando Health is working with a vendor to develop a modesty gown for observant Muslim women patients, Romany says. The goal is to develop a gown that allows the patient to follow her religious beliefs while allowing physicians to treat her by, for example, starting an IV line.
Most patients raised in a Western culture are comfortable making eye contact with other people, including doctors. That’s not necessarily true of people raised in other cultures, Romany says. For example, some Filipinos may avoid eye contact or look away much of the time to signal respect to an authority figure, according to the Stanford School of Medicine. If a patient is looking down instead of into the eyes of a clinician, the doctor or nurse should not bend down to try to force eye contact, which could be viewed as disrespectful, Romany says.
Many Korean women are taught by their mothers that eating seaweed soup for three months after they’ve given birth is healthy, Choi says, adding that her mother taught her this. To accommodate new mothers of Korean descent who want to follow this advice, Holy Name Medical Center offers an Asian menu that includes seaweed soup, Choi says.
Kosher and halal-certified meals
The diverse community the Henry Ford West Bloomfield Hospital serves includes a large number of Jewish and Muslim people. To accommodate the dietary preferences of both groups, the hospital provides kosher meals prepared by a caterer, Torossian says, as well as halal-certified meals for Muslim patients, which have been prepared in accordance with Islamic law and are free of pork products and contain no alcohol.
Some hospitals provide space to accommodate a variety of religious practices. The Henry Ford West Bloomfield Hospital has a non-denominational interfaith sanctuary available to people of all faiths, Torossian says. The hospital provides prayer mats to Muslim worshippers and has a variety of holy books available, including the Bible, the Quran and the Torah, which is used in Jewish religious services.
Many first-generation immigrants from non-Western countries aren’t familiar with U.S. medical practices, says Wendy Jerde, a spokeswoman for CentraCare Health, which runs six hospitals in central Minnesota. To help address this need, a CentraCare community health worker conducts home visits with 50 primarily Spanish-speaking Latino diabetes patients, checking their glucose levels and making sure they follow medication protocols, Jerde says. In St. Cloud, Minnesota, four CentraCare community health workers help Somali women who enter the hospital to deliver their baby, Jerde says. They also work with families with children who need pediatric care.
No red ink
Holy Name Medical Center staffers are trained not to use pens with red ink to write down the name of patients of Korean descent in charts and reports, Choi says. In Korean culture, “when you write someone’s name in red ink, it means that person has died,” she says. In South Korea, red is used to record the names of people who have died in family registers, Choi says.
U.S.News & World Report, Ruben Castaneda