Organizational DiversityEmployee Engagement and Cultural

Competence

Housekeeping

• What will today look like?• Breaks and Lunch• VCU DoG and DSS• Certificates of Attendance/CEU’s• CEGL/VCU Continuing Education

Learning ObjectivesAt the end of this training, participants will be able to:

• Understand the importance of diversity, cultural competence and person centered care.

• Use the concepts of diversity, cultural competence and person centered care to create an inclusive culture in assisted living and adult day settings.

• Understand and apply best practices for hiring, training and retaining healthcare professionals in a diverse workforce.

• Understand and apply best practices for team building in a diverse workforce.

• Understand and apply best practices for marketing culturally competent, person-centered care and diversity.

Why does it matter?

Defining diversity

• noun \də-ˈvər-sə-tē, dī-\ : the quality or state of having many different forms, types, ideas, etc.

• the state of having people who are different races or who have different cultures in a group or organization. (Merriam-Webster, 2014)

Getting to know you

What is diversity?

• What are some of the most common – and obvious – ways people are different?

• What are some of the other – and less obvious – ways people are different?

Different elements of diversity

Gwele NS. Diversity management in the workplace: Beyond compliance. Curationis, 2009;32:4-10.

The New Face of Diversity

The benefits of diversityValuing Diversity

Legal & Regulatory

Team

Personal

Organizational Productivity

Federal diversity laws

• Title VII of the Civil Rights Act 1964• The Equal Pay Act 1963 (EPA)• The Age Discrimination in Employment Act 1967 (ADEA)• Titles I & V of the Americans with Disabilities Act

1990 (ADA)

State diversity lawsVa. Code § 32.1-14- The State Board of Health must report annually on the health status and conditions of minority populations.

• Va. Code § 32.1-122.7. The Virginia Health Workforce Development Authority (VHWDA) must develop a statewide health professions pipeline of diverse, geographically distributed and culturally competent healthcare workers (see http://www.vhwda.org/ for job openings and career fairs).

Regulatory compliance with diversity

Medicaid providers must render culturally and linguistically appropriate services (CLAS).

Regulatory compliance with diversity

Visit the US DHHS Office of Minority Health website “Think Cultural Health” www.thinkculturalhealth.hhs.gov/Content/clas.asp for resources to help organizations meet the standard of “culturally and linguistically appropriate” services (CLAS).

Regulatory compliance with diversity

Assisted living facilities are required to “support the principles of individuality, personal dignity, freedom of choice” although there are no specific requirements to provide culturally or linguistically appropriate services. 22 VAC 40-72-440 Individualized service plans

The team benefits of diversity

Harrison S. Equality for gay staff can only be good for the workforce as a whole. Nurs Stand. 2009;22:12-13

Increased productivity

Achieve group goals more

readily

Seek win-win outcomes

Greater authenticity

The personal benefits of diversity

Beheri WH. Diversity within nursing: Effects on nurse-nurse interaction, job satisfaction, and turnover. Nurs Adm Q. 2009;33:216-226.Wolfson N, Kraiger K, Finkelstein L. The relationship between diversity climate perceptions and workplace attitudes. The Psychol-Manage J. 2011;14:161-176.

More trusting relationships

Job Satisfaction

Empowerment

Personal Growth

Case study

Diversity quiz

The best way to value diversity in the workplace is to:a) Assume everyone is the same.b) Appreciate the differences among people.c) Create in-groups and out-groups.d) Believe the differences always lead to

conflict.

Diversity quiz

The Civil Rights Act of 1964 protects against discrimination on the basis of:a) Race, sex, religion.b) Color, race, national origin.c) Race, color, national origin, sex, religion.d) All the above in answer “c”, plus age.

Cultural competence

What is culture?• noun \ˈkəl-chər\ : the

beliefs, customs, arts, etc., of a particular society, group, place, or time

• a particular society that has its own beliefs, ways of life, art, etc.

• a way of thinking, behaving, or working that exists in a place or organization (such as a business) Merriam-Webster, 2014

What are the elements of culture?

Defining cultural competence

Culturally Competent Care

Behaviors

Values Beliefs

A closer look at values and beliefs

Beliefs Staff need to understand

these

Values

AttitudesClients/residents have these

Behaviors

Practices

Levels of cultural competence

Beyond competence to humility

Legal and regulatory compliance

• Title IV of the Civil Rights Act 1964- Federally funded health/social service organizations must provide language assistance to any client with limited English proficiency (LEP)

• CLAS Standards - Culturally representative staffing- Staff education and training- Language assistance service and materials- Cross cultural conflict and grievance procedures

U.S. Dept of Health and Human Services Office of Minority Health (2014)

Why we need a culturally competent workforce

A culturally competent workforce can deliver the highest quality of care to every person, regardless of race, ethnicity, cultural

background, or English language proficiency.

U.S. Dept of Health and Human Services Office of Minority Health (2014)

A case study

What cultural competence is…and isn’t

Cultural competence is: Cultural competence is NOT:

Willingness to learn about others

Making assumptions about others

Effective communication with others

Relying on stereotypes of others

A person centered approach Bias in delivering services

Hiring in a diverse environment

Legal requirementsTitle VII Civil

Rights Act 1964

Age Discrimination in Employment

Act 1967

Americans with Disabilities Act

1991

US Rehabilitation Act 1973

Equal Pay Act 1963

Regulations for Assisted Living Facilities

22 VAC 40-72-170. Staff general qualifications. A. All staff shall: 1. Be of good character and reputation; 2. Be physically and mentally capable of carrying out assigned responsibilities; 3. Be considerate and respectful of the rights, dignity and sensitivities of aged and disabled persons; 4. Be clean and well-groomed; and 5. Meet the requirements specified in the Regulation for Background Checks for Assisted Living Facilities and Adult Day Care Centers (22 VAC 40-90).

Regulations for Adult Day Centers

22 VAC 40-60-200. General qualifications. A. All staff members, including the administrator, shall: 1. Be of good character and reputation; 2. Be competent, qualified and capable of carrying out assigned responsibilities; 3. Be willing and able to accept training and supervision; 4. Be considerate, understanding and respectful of aged and disabled persons; 5. Be clean and well groomed; and 6. Meet the requirements specified in the Regulation for Background Checks for Assisted Living Facilities and Adult Day Care Centers (22VAC40-90).

Hiring for diversity and cultural competence

1. Ask behaviorally based questions – past performance predicts future behavior.

2. Do not ask illegal questions.3. Seek out people who value

diversity and who will collaborate respectfully with others.

4. Provide all interviewers with training.

5. Be aware of your tendency to stereotype and your own biases.

Hiring for diversity and cultural competence

6. Don’t make assumptions about the interviewee.7. Don’t hire in your own image.8. Focus on job related criteria in the interview.9. Don’t rely on your gut.10. Do share your commitment to diversity with interviewees.

And don’t forget

• Reference check• Criminal background check• Driving record• The more you know about the individual, the better hiring selection you and your team will make.

Once the ideal candidate is hired…

The first day• Welcome them and make them feel at home• Assign a mentor• Give them a tour of the

community/residence• Introduce them to colleagues and clients/residents• Review all mandatory activities, rules and regulations• Make a personal connection with

them!

Training and retaining a diverse and culturally competent team

How do you want it to be?

X Culture• High turnover• New staff expected to just

“jump in”• “That’s not my job.”• Staff are blamed for things

beyond their control• Persistent call outs• Managers hide• Blame and hostility

Culture• Stability and longevity• New staff are mentored and

“acclimatized”• “We work as one team!”• Staff are involved in making

improvements• Schedule flexibility• Managers walk around• Communication and

collaboration

An inclusive culture starts with leaders

• Talk about your mission and values

• Model the culture• Recognize and encourage staff• Support cultural competence• Learn to communicate in a

diverse world

Talk about your mission and values

• Post your mission statement in a visible location(s)• Bring your mission to life by incorporating it into day-to- day conversations• Encourage staff to learn its

meaning…not just the words

Model the culture

Fun ways to recognize and encourage your staff

• How many fun ways can you think of to show your staff that they are valuable and unique individuals and that

what they do matters?

Ways to recognize and encourage all staff

• Display photos of your staff with information about their family, favorite foods or hobbies.• Have a thank you card bulletin board on display.• Submit press releases to the local paper celebrating staff

anniversaries and longevity awards• Plan an awards ceremony with your staff as the guests of

honor.

Ways to recognize and value staff diversity

• Learn about the holidays and traditions of your staff so you can highlight or celebrate these.• Hold pot-luck suppers with favorite foods from around the world.• Hold a multi-cultural fashion show using your staff as the models.• Consider the “Snap Cup” Exercise

Support cultural competence

• Learn about the diversity of your local community• Teach staff about the local cultures of your community• Provide language interpretation services• Review your policies and procedures for cultural competence

Learn to communicate in a diverse world

Cultural patterns of communication

• Different communication styles• Different attitudes towards conflict• Different approaches to completing tasks• Different decision making styles• Different attitudes towards disclosure• Different approaches to “knowing”

Different communication styles

Different attitudes towards conflict

• It can be seen as positive or negative

• Openly dealing with it can be seen as acceptable or unacceptable

Different approaches to completing tasks

• The way people view team work in completing a task may vary from culture to culture• Some may focus first on completing the task• Others may focus first on developing relationships

Different decision making styles

• Decision making roles and expectations about roles vary from culture to culture

Different attitudes towards disclosure

• Frankness about emotions varies from culture to culture

• So does frankness about personal information

Different approaches to “knowing”

• People seek knowledge in different ways…

Putting it all together

• Don’t assume there is one right way to do anything, including communication• Listen actively and with empathy and be prepared to get outside your comfort zone• Avoid generalization and bias – we are all individuals

even within our national cultures

Marketing diversity

Marketing diversity

• Learn about your customers and their needs• Adapt your products and services to meet their

unique needs• Find appropriate channels to communicate• Attract staff by showing you understand and can meet their needs• Brand your organization as diversity-friendly

Celebrating Diversity• Strengthens employee retention• Builds census• Enhances quality of life• Provides person-centered care• Is the right thing to do

Questions?

Thank you for coming today!

Authors:

Jay White, MS (Gerontology) and Director of Professional and Community Development, VCU Department of Gerontology

Jenny Inker, MS (Gerontology) and Research Associate, VCU Department of Gerontology