Americans do it; Europeans do it; even some South Africans do it. But how do Israelis do it? How do Israelis make their health care organizations culturally competent?
We’ve been training health care staff in cultural competency since 2008, and the Ministry of Health has more recently begun training, in light of the Ministry’s 2011 Directive on Cultural Competency. But what’s been missing has been a guide that spells everything out, which coordinators can refer to once they’ve finished the training courses. One that provides the internationally-tested standards of cultural competency, adapted to the unique makeup of Israeli society and everyday Israeli reality.
We are now in the final stages of such a handbook, our Manual for Integrating Cultural competence in Health Care Organizations. This manual is not only the first of its kind in Israel to deal with cultural competency for health care, it is the first of its kind in Israel to deal with cultural competency in any discipline. It is one of our dreams to bring culturally competency approaches to other areas of life in Jerusalem and throughout Israel – from local and national government offices to the police to other public agencies.
As part of the development process for the handbook, on 22 April 2013 we held a day-long seminar for 30 cultural competency coordinators from major health institutions, as well as others who work and research the field, around the country. Our goal for the day was to improve the handbook and to learn from the many people who are already working in the field in Israel.
We were pleased by the diverse turnout. Some had taken our training course, some had taken that of the Ministry of Health, and others had taken neither. The variety of institutions represented was also rather wide: Sheba-Tel Hashomer and Tel Aviv Sourasky (Ichilov, where the seminar was held) hospitals in Tel Aviv, Rambam in Haifa, both Hadassah hospitals in Jerusalem, as well as hospitals in Tiberias and Sefad; four of the eight mental health facilities in Israel; Ministry of Health; Israeli HMO’s; and independent consultants.
Throughout the morning, we got down to work. We utilized the ‘world café’ deliberation method, with one moderator at each table, each table focusing on a different subject from the handbook: from language accessibility, evaluation and making the workplace accessible, training, and definition of the role of the cultural competency coordinator, to the first 10 steps of cultural competency. The groups discussed each area, commented, made suggestions, and brought up new ideas regarding this part. After some time, participants chose another topic, but the moderators stayed in place. In all, we made such 3 rounds, and we discussed the main suggestions and understandings in the summary session.
All told, we came away from the seminar rich in knowledge that will help us to update the handbook. And the participants were quite enthusiastic about the meeting as well, as a number expressed their desire to continue these professional encounters. “This encounter was very important,” said Maya Tzaban, from Poriyah Hospital near Tiberias. “Now I see that we are not alone, added Varda Stenger from Sheba – Tel Hashomer, “that we are a network, and can work together.”
Indeed, although we’ve held encounters with coordinators who’ve taken our courses, and the Ministry of Health has held encounters for graduates of their courses, this is the first time that all cultural competency coordinators have come together for peer discussion, learning and action as a professional network. In light of the feedback, preliminary plans are underway for follow-up meetings.
Additional take-away suggestions included:
- Forming smaller, more focused groups that could discuss their common challenges and situations – such as mental health hospitals, HMO’s, etc.
- Adapt the manual slightly for the different types of institutions that use it – general hospitals, psychiatric hospitals, HMO’s, primary clinics, etc.
Feedback on the manual in general was also very positive. Participants commented that that it helps to give a full picture of cultural competency and initial steps of implementation. They were also eager to provide feedback to refine the document. “I have the time and I’d love to give my input,” said Anat Revach, from the Jerusalem Center for Mental Health. “I want to be part of this process.”
