University of Illinois Hospital and Health Sciences System
CULTURAL COMPETENCY AND DIVERSITY PLAN
5 East Rehabilitation Unit
May 2013
Prepared by KeirRingquist and Victor Agoo
A Cultural Competency and Diversity Plan was developed for the Comprehensive Integrated Inpatient Rehabilitation Program to demonstrate how University of Illinois Hospital and Health Sciences (UI Health) will respond to the diversity of our stakeholders, including patients, employees and outside vendors. We want to enable staff to work effectively cross culturally with each other, as well as, the patients and families we serve by understanding, appreciating and respecting differences and similarities in beliefs, values and practices within and between cultures.
UI Health maintains a policy of nondiscrimination with all employees and applicants for employment. It is the policy of UI Health to offer equal employment and advancement opportunities to qualified individuals on the basis of merit, competence and qualifications and without regard to race, color sex, religion, ancestry, national origin, age, veteran status, marital status, disability or genetic information. Rehabilitation staff receive cultural diversity training at the time of hire and as needed thereafter.
This Cultural Competency and Diversity Plan addresses the following areas: culture, age, gender, sexual orientation, spiritual beliefs, socioeconomic status and language. Cultural competency and diversity is part of staff orientation. The Cultural Competency and Diversity Plan is reviewed annually for relevance and updated as needed by the Rehabilitation Unit Leadership Team. The information in this document is shared with staff and available to patients and other stakeholders on our website.
CULTURE
Our patient demographics vary from year to year. Last year, our patient population was 17% Caucasian, 61% African American, 17%Hispanic/Latino, and 5% Asian. Chicago has a large presence of African American and Hispanic/Latinos in its population. Chicago demographics from 2010 indicate that 31% of the population is Caucasian, 32% African American, 14% Hispanic/Latino, 5% Asian and 3% other. Our current staff is 23% Caucasian, 23% African American, 2%Hispanic/Latino, 52% Asian.
An example of meeting the cultural needs of our patients is the awareness of the Hispanic/Latino culture for our patients, with the organization hiring staff who are bilingual in Spanish wherever possible. In our rehab department, we make every effort to match our Spanish-speaking patients with Spanish-speaking staff who are able to build rapport through language, cultural values and beliefs. Cultural requests related to diet are considered unless the dietician indicates otherwise. Staff and patients celebrate Cinco de Mayo and other Hispanic events every year. Much of our written materials are available in Spanish, and other worksheets and therapeutic tasks are utilized that contain culturally enriching information. Additionally, interpreters are available to assist in translation.
Our rehabilitation social worker and discharge planner work regularly with external stakeholders such as nursing homes, home health agencies and DME vendors to ensure that patients with different cultural and language needs upon discharge are matched with the most appropriate facility to provide continued services.
As noted in the introduction to this plan UI Health as an employer does not discriminate in hiring or advancement based on race, color, national origin or ancestry.
AGE
Our patient ages were as follows for the last year: 16% in the 18—44 range, 58% in the 45-64 range, and 26% in the 65+ range. Our rehab unit tends to have younger patients compared to national benchmarks for inpatient medical rehabilitation units but is in alignment with having a younger population in the surrounding area. As a result, we provide more focus on return to work and child care tasks during the rehabilitation process.
The city of Chicago demographics indicate that 44.6% of the population falls in the 18-44 age range, 18.9% are between 45-64 years of age, while26.2% are under the age of 18 and 10.3% are over the age of 65. Our rehab unit does not accept patients under the age of 18. Because our patients are of a working age, we focus on return to work and child care tasks during the rehabilitation process as appropriate.
In addition to cultural and language awareness when working on discharge needs, our social worker and discharge planner are sensitive to a patients need for placement and services based on age as well. The rehab unit recently had a patient with a spinal cord injury who was 27 years old and in need of nursing home placement. The social worker spent additional time finding a facility that had younger patients for this patient to be able to have people of her age to identify with.
Our staff have to be 18 years of age. The largest demographic for our staff falls in the 18-40 range, which allows for better understanding for the majority of clients we serve who are of a similar age. We have not had an issue with an elderly patient having concerns with having a younger staff member but should that arise, we would switch them to an older staff member if possible.
GENDER
Our patient demographics last year indicated 49% were male and 51% were female. We traditionally have always had an evenly split population as it relates to gender. Our staff demographics, however, indicated that we have a higher number of female staff at 89% compared to 11% male staff.
Care is taken to accommodate the request if a male patient prefers a male staff member to assist with toileting, etc. We do occasionally have sexually inappropriate male patients, and care must be taken with our female staff. However, this behavior is due primarily to their brain injury, and this is certainly discussed with staff and is addressed with training. If patients are sexually inappropriate, staff areencouraged to follow the patients’ behavior plan and report the behavior. In extreme cases, female staff may be given another assignment.
As noted in the introduction to this plan we do not discriminate in hiring or advancement based on gender.
SEXUAL ORIENTATION
We respect patients of all sexual orientation. When we have patients with a need for additional support or concern regarding sexual orientation, this can be addressed through the psychology department and/or we will locate community resources to address this. There is a largeGay, Lesbian, Bisexual and Transgender organization in our county that can further assist with social, educational and advocacy services.
Sexual orientation is not a demographic that is tracked for patients or staff due to privacy issues.
SPIRITUAL BELIEFS
We respect patients’ spiritual beliefs and admit patients with a variety of spiritual beliefs and many with no particular spiritual belief. We have chaplaincy services available for consultation for every patient and a spirituality group is held every Sunday on the Rehab Unit for patients who wish to partake in these activities. Family can attend as well. It patients have certain spiritual holidays, we will respect that as well even changing therapy to weekends if the holidays fall during weekdays.
If we have patients who need to have special food related to their spiritual beliefs we will accommodate that request as much as possible through our dietary department and/or let the family members bring in foods that fit the spiritual beliefs of the patient if it is cleared medically by the physician.
Concerning employees, we have occasionally had a request for a religious accommodation relating to dress, and as long as it’s not a safety issue, we will accommodate the request (i.e. wearing culottes rather than pants, or a head scarf). Staff have made special requests to work or not work certain days of the week and/or holidays based on religious beliefs and rehab leadership makes every effort to accommodate these requests.
As an employer, we cannot discriminate based on the spiritual beliefs or religion of our staff. Again due to privacy issues this is not a demographic that is tracked for patients or staff.
SOCIOECONOMIC STATUS
Patients receive services regardless of their or their family’s socioeconomic status. Services are typically funded through Medicaid (28% of UI Health Rehab Patients), Medicare (32% of UI Health Rehab Patients), or Commercial Insurance (26.4% of UI Health Rehab Patients). This past year, 11% of the patients admitted to the Rehab Unit were unfunded. With a large percentage of patients who are uninsured or underinsured, the Rehab Unit works diligently to make sure the needs are the patient are met after discharging from the program back to the community. When a patient is discharged from the program, if socioeconomic status is an issue, the case managers will assist the patient and family with accessing social services such as disability access, social security, etc.
As an employer, we cannot discriminate in hiring or advancement since decisions must be based on merit, not socioeconomic status. Again this is a demographic we do not track in our patients or staff due to privacy issues.
LANGUAGE
On occasion, we have a patient who is a non-English speaker. Being part of a large metropolitan area, there are numerous languages spoken and we need to be prepared to provide care to everyone equally regardless of their primary language. The main non-English language spoke is Spanishand we are able to accommodate that issue by providing bilingual staff, having onsite interpreters, and language lines including video interpreters. We also have requests for other languages other that Spanish to be interpreted and in these instances if we do not have staff who can provide the direct language interpretation, we use the language line and or video interpreters. Many documents have been translated into Spanish for our patients and families to utilize. Additionally, at discharge, our social work and discharge planner make efforts to find outside vendors who speak the language of the patient whenever possible.
Regarding employees, staff must be able to speak, read and write English. We have some bilingual staff.