Kayla Yun

3/2/21
Scenario 3

Goal 1: Create an environment and mechanisms that promote high quality care.

Change Concept 1a: This scenario I feel accurately, and to the best of their ability given the
circumstances accurately assessed the organizational understanding of culturally and
linguistically effective care. They provided the child and this mother with an interpreter/cultural
mediated that then followed up with them at their own home upon leaving the facility.
Knowing that the surgery needed to be performed for the best interest of the child, the
healthcare providers did everything they could to make sure that the child was cared for.
Although, there are always room for improvements. A suggestion I have to would be to
continuously facilitate national standards for Culturally and Linguistically Appropriate Services
(CLAS) and population health.

Change Concept 1b: In this scenario the boy had been seen at the Hmong community center by
a shaman prior to seeing the physician. The child’s surgery was permitted after the shaman,
community leader, mother, interpreter and physician all came together. I suggest that the clinic
involve many different community centers in a plan of action such as the one in this scenario.
There should be some knowledge, and a mutual understanding, of a strategic healthcare plan
for circumstances such as this one. Having many different areas of community expertise on the
same page could allow for planning, implementing, and evaluating services and policies. This as
a result would allow for an easier and more comfortable experience for the patients of diverse
backgrounds.

Change Concept 1c: This scenario provided the patient and his mother an interpreter who also
acted as a cultural mediator. My suggestion for this circumstance would be to potentially hire a
more ethnically diverse staff, as this would allow for linguistically effective care at all points of
contact. There would also be no need to hire a translator, and the clinic could focus solely on
having a cultural mediator on staff to properly handle religious beliefs and practices when it
comes to a healthcare standpoint.

Goal 2: Support families to manage the health care of their children.

Change Concept 2a: In this scenario a shaman had advised against any type of surgery as it
could not be touched until the boy’s injury was healed. This spiritual ritual was a part of a
religious practice unknown to the health care providers. They were not educated on this
matter; therefore, they could not fully understand the circumstances behind the mother’s
reluctancy for surgery on her son. In order to incorporate relevant healing traditions and beliefs
into patient care and communication, cultural awareness training should be provided for all
staff. This training would allow for better understanding of religious practices and methods to
prevent negative patient/provider experiences such as this scenario from happening.
Change Concept 2b: Language barrier was a hindrance during this scenario. Without the
interpreter there would have not been a way for the patient and his mother to communicate
with the healthcare providers. In order for families to be engaged and educated in their child’s
care they must be able to understand the information being expressed to them. I would suggest
a pamphlet be constructed for a wide range of diverse backgrounds explaining ways in which
they can stay connected with providers to ensure their child’s health is being cared for. This
pamphlet of course will be written in a language in which they can properly understand and
allow them to retain important knowledge about their child’s care.

Goal 3: Promote clinical care that is consistent with scientific evidence and family
preferences.

Change Concept 3a: In this scenario it seems that the boy’s mother took her son to the Hmong
community center first, before taking him to the pediatric outpatient clinic. This is most likely
due to the fact that she felt more comfortable speaking to healthcare providers who speak the
same language and share the same beliefs. In order to ensure they provide evidence-based
guidelines into daily practice and share information with families to encourage participation in
care, the clinic must choose the right recommendations for each clinical situation. Physicians
must ensure they're focused on the latest up-to-date medical studies as each patient has a
different socioeconomic status and racial background. This requires persistence and the
promotion of continuous learning for all healthcare providers alike.

Change Concept 3b: This scenario provides a look into the Hmong community and some of their
religious practices and beliefs. Beyond this scenario, there is a large population of people,
especially in the United States, who belong to a variety of religions and hold a variety of beliefs.
With that being said, clinicians should be provided a “hub” for access to reliable resources
about the most prominent of cultural groups in their community. The government and its
health resources should provide all healthcare providers the option to learn about the melting
pot of individuals who receive care at their health care facilities at the tips of their fingers. This
can either be provided by a tablet or desktop computers within the office where the clinic lies.
This would provide an option if, and when, providers have questions regarding a specific patient
and their ability to provide care to these individuals. Not only just questions, but the
opportunity to learn and further knowledge on a specific religion and their cultural beliefs.

Goal 4: Assure the delivery of effective, efficient, patient-centered care.

Change Concept 4a: Given the current scenario, they did use an interpreter/cultural mediator
who was able to efficiently communicate how serious the boy’s injury was and the need for
surgery. My only other suggestion here for another form of communication would be the ability
for the mother to write out in physical form, on a piece of paper, any concern or other
necessary points of communication. This way there is another way for the boy’s mother to
explain the reasoning behind not wanting her son to have surgery. This certainly provides them
with effective and respectful care compatible with their Hmong cultural beliefs.
Change Concept 4b: My suggestion to create an effective and efficient system to define roles
and responsibilities regarding culturally effective care and distribute tasks among members
consists of list of essential tasks. In order to create a symbiotic environment for all healthcare
professionals in this current scenario, they must all first know how important their own role is
in regard to their patients’ health and safety. All physicians, nurses, interpreters, and cultural
mediators should have a checklist of responsibility that must be regularly studied/practiced
ensuring efficient care and boundaries. This way each healthcare provider issues efficient and
quality care without overstepping boundaries with other providers.