Cultural Competence in Health Services | The Jerusalem Intercultural Center

Cultural Competency in Healthcare Organizations – with Israeli Forum for Diversity in Employment

“Never say ‘Diversity’ without the word ‘Inclusion’ immediately following; that is the only way employees from diverse communities can be integral parts of the organization – members of the ‘family’ and not just ‘guests’.”

Continuing to improve employment diversity

That is how our first session in a series of cultural competency workshops, which was held in partnership with the Israeli Forum for Employment Diversity, started, on October 25. It was the first of a series.

A few principles of employment diversity in healthcare organizations

The first workshops dealt with cultural competency in healthcare organizations, which was facilitated by our own Dr. Rachely Ashwal. The first part of the workshop was led by special guest Malki Rotner, Director of the Israeli Forum for Employment Diversity.

Stay tuned for more.

Here’s the original Facebook post in Hebrew:

Naomi Roff2021-12-21T07:28:04+00:00November 1st, 2021|Blog, Cultural Competence, Cultural Competence in Health Services, Cultural Competence in the Workplace|

Simplifying Language – A Principle of Cultural Competency

A main principle of Cultural Competency is making services accessible to all. This includes adapting language to increase understanding. This could mean translation into different languages used – or simplifying the language used.

Keeping calm – and keeping it simple

On July 29, the JICC’s Cultural Competency Desk held a Language Simplification workshop online for cultural competency coordinators from healthcare and welfare institutions.

Dr. MIchal Schuster, on simplifying language

Dr. Michal Schuster led the fascinating meeting, which practiced with the participants important basics of simplifying language during meetings between therapists and patients from different identity groups.

Here’s a Facebook post from Cultural Competency desk’s Dr. Rachely Ashwal:

Many thanks to the Jerusalem Foundation for its ongoing support of cultural competency in Jerusalem.

Naomi Roff2021-09-24T14:34:56+00:00August 15th, 2021|Blog, Cultural Competence, Cultural Competence in Government Institutions, Cultural Competence in Health Services|

Training the Trainers for the Man and Medicine Course

For the past several years the Hadassah – Hebrew University School of Medicine (located at Hadassah Hospital at Ein Kerem) operates a course called “Man and Medicine,” which seeks to give medical students tools and awareness about the meeting with the person behind the sickness, and to help the future doctor look not at the sickness to be treated, but at the person as well. Members of the JICC’s Cultural Competency desk have been lecturing in the course almost since its beginning. We lectured, operated simulations and played movies to help impart the principles of cultural competence. After a few years, the course structure was changed, and we trained the course instructors how to use our training videos and teach the principles themselves.

Talking about Stereotype

On March 10, 2021, an orientation meeting was held for 30 course teachers (each one works with 12 – 13 students), most of them senior physicians at Hadassah Hospital. We were asked to give them tools to guide the students they mentor. This included: reviewing cultural competency and its principles, reminding how to use the training videos, as well as tips of how to do this via Zoom, since most of the course is currently being held remotely. The training was led by Orna Shani Golan, Director of the JICC’s Cultural Competency Desk.

The two-hour training included how to deal with generalizations about different groups, such as: “Muslim women don’t get epidural shots,” or “Ethiopians don’t look you in the eyes,” or “Vegans are anti-vaxxers,” and more. The participants discussed the communication gaps that arise when there are cultural gaps. Overall, they understood how to teach their students how to have an inter-cultural dialogue understanding the patients’ point of view from a cultural standpoint.

Many thanks to the Jerusalem Foundation for its support of cultural competency in Jerusalem since its inception, and to the Hebrew University Faculty of Medicine – Hadassah Medical Center, for their long-time partnership.

orna2021-03-20T08:21:43+00:00March 17th, 2021|Blog, Cultural Competence, Cultural Competence in Health Services|

New Arabic-language Digital Tools to Fight Covid

We’ve been on the front lines helping to fight the spread of Covid in East Jerusalem for the past year, the first NGO ever invited to join a public command center that was set up together with the Jerusalem Municipality, the Ministry of Health, and the IDF’s Home Front Command, among others. At the same time, we actively set up and coordinated a Forum to Fight Covid in East Jerusalem, network of 150 Arab Palestinian civil society actors in East Jerusalem, representing some 80 organizations.

The new web site lists the updated numbers of cases in East Jerusalem

As a result of this work, an idea was raised to create a go-to web site that included all the possible information about Covid – healthcare information, where to go for testing, information vaccinations, information to counter fake news, and more.

This web site draws from official sources and authorities to ensure accuracy of information. Also critically important – the web site is considered an independent initiative. Official Israeli channels are often regarded with suspicion in East Jerusalem, so the fact that it is independent adds to the website’s legitimacy.

Updated testing information also listed

You can view the website here.

And the Facebook page here:

For example, here’s a post about vaccinations in the Shuafat Refugee Camp:

And another, a video by Jerusalemite doctors about the importance of the vaccine:

Many thanks to the Jerusalem Foundation, the Russell Berrie Foundation, and the Leichtag Foundation for their emergency support of our efforts to stop the spread of Covid in East Jerusalem.

Naomi Roff2021-03-30T16:08:09+00:00March 14th, 2021|Blog, Cultural Competence in Health Services, Effective Activism, Palestinians/Arabs|

Cultural Competency with the Jerusalem Mental Health Center

Cultural Competency – the ability of systems and individuals to effectively and positively adapt themselves to relevant identities, cultures, ethnic groups, etc. – is an ongoing personal and organizational process. We were thrilled by the opportunity to continue working with the center, having held workshops on cultural competence in mental health, and training bilingual staff in interpreting techniques. Almost a decade ago, when we started working with them, one of the organization’s legendary administrative directors, Shneor Havkin, told us: “We know the basics of cultural competence, we get along. But that’s not enough.” He explained that culturally competent health care, especially mental health care, is so complex, need more advanced and nuanced training is needed to make sure that patients receive the best care possible.

Hagai always takes a good picture

What does this actually mean? The Jerusalem Mental Health Center, including its hospitals and outpatient clinics, are diverse organizations. Because of their location in Jerusalem – the employees as well as the patients – come from diverse groups as well as the patients. Employees must adopt culturally competent skills in order to treat patients in a way that takes into account their perceptions, preferences and limitations. Culturally adapted treatment is particularly challenging in the context of mental health, where it is not always clear whether a person’s particular behavior is the result of his personality, the society in which he lives, or the mental illness he is dealing with.

A snapshot of the workshop

A culturally competent organization must also look inward – and examine how it manages the diversity among employees in the best way possible. Diversity is the ability to manage employees from diverse human backgrounds. Inclusion, another related term, refers to the individual’s feeling as part of a group, the employee’s ability to express himself while maintaining his uniqueness, without the organization’s even slightest demand to downplay his identity or assimilate it into the organization altogether (from the Israeli Forum for Employment Diversity website).

The interest and investment in issues of diversity and inclusion has increased greatly in recent years, and has also received backing and government support through sets of guidelines, standards and training. We recently completed a course on diversity management and cultural competence for employees from the human resources and welfare, and heads of nursing departments at the Jerusalem Mental Health Center. In the 4-session course, participants learned about the benefits of diversity, the challenges of managing diversity and inclusion, and areas where existing knowledge and resources can be utilized to improve diversity management. For example, we spoke about Employee Resource Groups (ERGs), which are voluntary, employee-led groups that foster a diverse, inclusive workplace aligned with organizational mission, values, goals, business practices, and objectives. Examples of ERG’s can be promoting the discussion of LGBT workers’ rights, marking holidays and celebrations for members of different cultures, organizing culturally competent training days and more. We also learned about how to correctly manage conflicts, tools for effective intercultural communication, and even some techniques to simplify complex information for employees with different levels of literacy.

Managing diversity is important to the organization, employees and the community, but it is a challenging matter that sometimes causes dilemmas. For example, employees shared with us dilemmas on how to properly manage situations such as evaluating employees’ work and efficiency, firing employees, or managing crises that included a cultural element. There is not always a right solution to the issue, but even the opportunity to look at such situations from an intercultural standpoint can give the manager a new perspective, and enables them to choose the most professional solution and still give the employee the feeling that their cultural needs have been seen and heard.

We are pleased to continue to accompany the Jerusalem Mental Health Center in the process, which will continue with projects initiated by the participants on the subject of diversity and inclusion. Such mini-activism in the organization is important to continued engagement of the employees.

Dr. Michal Schuster, who led the training at the Jerusalem Mental Health Center, described the workshop in this Facebook post (Hebrew)

Many thanks to the Jerusalem Foundation for their continued support of cultural competency in Jerusalem since its inception in 2008.

Naomi Roff2020-11-28T12:36:01+00:00November 23rd, 2020|Blog, Cultural Competence, Cultural Competence in Health Services|

Cultural Competency Lectures at Hadassah, despite and because of COVID-19

Over the past few months, especially since the beginning of the COVID-19 crisis, workshops to improve cultural competency, especially in the healthcare field, have been more important then ever. You can read about our activities here, here and here.

Coming to Hadassah for cultural competency workshops

Many of these activities have been remote meetings, via Zoom.

But at Hadassah Hospitals (both Ein Kerem and Mount Scopus), the need was for in-person meetings, especially since professionals came off shifts from the Hospitals’ different departments, including the COVID-19 wards. Our lectures focused on issues of intercultural encounters with patients and their families in cultural competency workshops for coordinators in charge of improving patient experience.

Meetings according to Ministry of Health guidelines

The lectures were of course held in accordance with Ministry of Health regulations. We were able to give them tools and knowledge that would help them get through their shifts more easily.

There is no need talk about the medical staff’s commitment and dedication. For a variety of reasons, they do not always receive cooperation from patients and their families, and / or they do not always fully understand the complexities of the different Israeli identities and their approach to medical care.

Cultural competency an important part of healthcare, In the midst of hospital shifts

We were happy to come, and honored to be part of the effort to make Israeli healthcare more culturally competent, especially during the COVID-19 crisis.

Here’s a Facebook post that lecturer Dr. Rachely Ashwel wrote after the workshops:

Many thanks to the Jerusalem Foundation for their continued support of cultural competency in Jerusalem since its inception in 2008.

Naomi Roff2020-11-20T14:07:15+00:00November 15th, 2020|Blog, Cultural Competence, Cultural Competence in Health Services|

Intercultural Communication in Mental Health Care during the COVID-19 Pandemic

We wrote here about our first Zoom-based meeting for cultural competency coordinators in health care during the coronavirus crisis. The second meeting, held on June 24, focused on mental health.

Ofra, Director of Special Programs in Mental Health, Ministry of Health, opens the online session

The meeting included 25 professionals, most of them cultural competency coordinators and coordinators for patient experience in psychiatry, for hospital-based as well as community-based care.

It was important and helpful to pause for a moment during these exceptional times, and reflect upon the changes in interpersonal and intercultural communication that characterize the recent period. We saw that many of the challenges stemmed from the restrictions that prevent family or other visitors from being able to mediate or be extra support systems for the patients.

Sometimes solutions have been found. In psychotherapy, for example, the challenges of not being able to see facial expressions while wearing a mask has been solved by wearing plastic shields, or by remote therapy. However, technological barriers often prevent the transition to online therapy, including lack of physical access to computers and a lack of access to treatment in the appropriate language, especially among the older population. Many therapists and treatment centers are trying to provide treatment in different ways to protect the health of the patients, without sacrificing quality and cultural competence. At the same time, they fear for their own health and safety.

It was very exciting to hear about the solutions taken in the various organizations:

An effort to provide solutions for speakers of lesser-used languages through organizations and representatives from consulates in the Sharon area;
Tablets and training for patients in Acco;
Translation of explanatory pages on the isolation unit in various languages at Hadassah Ein Kerem;
Use of recorded and culturally adapted tutorials by phone or video at a hospital in Be’er Sheva, and more.

At the end of the session, all felt that they had learned a great deal. The warm and positive responses that were sent afterward definitely reinforced this feeling.

rachelly2020-10-09T11:46:47+00:00August 25th, 2020|Blog, Cultural Competence in Health Services|

Culturally Competent Health Care for the Haredi Community in the Age of COVID-19: A Discussion with Rabbi Zvi Porat

We recently held a Zoom event that focused on caring for the ultra-Orthodox community during the COVID-19 outbreak in Israel. It was one of the most significant and exciting events – which is part of a series of Zoom meetings for cultural competence coordinators in healthcare organizations and in general – that we’ve had thus far.

Invitation to the online event

It is no secret that the ultra-Orthodox community is sensitive about being labeled, especially if it affects their healthcare, for better or for worse. For the better, this labeling sometimes helps to provide tailored and improved care, such as making sure that patients receive meals in accordance with their specific dietary (kashrut) regulations, or the best/ most culturally sensitive ways of communicating with them or those who accompany them. For the worse, for the ultra-Orthodox community, being labled also means that they’re being singled out, and they feel that they are being discriminated against based on stereotypes of the ultra-Orthodox population. This creates an especially sensitive situation since the community has been particularly hard hit during this pandemic, and causes feelings of inferiority and discrimination – and resentment – even when there is no such intention on the part of the caregivers.

About the complexity of inter-identity relations during health care

In addition, the heated public discourse fans the flames of an already sensitive situation. With the outbreak of the coronavirus, the media often portrayed the ultra-Orthodox community as disobeying safety regulations and crowding together in huge events despite social isolation guidelines that were set in order to protect the public. At the same time, positive aspects of the community’s behavior – from cooperation with and generosity to the police and the Home Front Command who were patrolling the neighborhoods during the lockdown – also extraordinary events – were barely noticed.

Inter-identity and intercultural questions that concern healthcare practitioners

Given this complexity, and in light of our familiarity with the diversity of communities within the different ultra-Orthodox populations in Israel, coupled with the necessity to engage all populations in working to both follow the current health guidelines and treat patients in the best way possible, we initiated a meeting specifically on the subject of Healthcare for Ultra-Orthodox Communities in the Shadow of COVID-19. In the meeting, which took place via Zoom on July 15, 2020, Rabbi Zvi Porat, an expert on delivering culturally competent healthcare to the ultra-Orthodox community, spoke about the complexities and experiences experienced by members of the ultra-Orthodox community in various healthcare settings. He also presented different examples of how to respond to different challenges in an appropriate manner that meets the needs of the ultra-Orthodox and does not create a feeling of being stygmatized.

Discussing the complexities of the intercultural encounter in healthcare

Dr. Michal Schuster presented the culturally competent perspective in treating ultra-Orthodox patients, as well as recommendations based on proven experience and veteran initiatives that have already provided successful responses, alongside the complexity of the ever-changing guidelines, especially for those who do not receive regular updates from television or social media.

Dr. Racheli Ashwell presented the transformative model for managing tension-filled events and inter-identity conflicts and the recommended way to avoid such events and manage them in a positive and empowering way.

One of the things that was exciting about this meeting was the number of participants: 48 people devoted their time in the middle of the day to an hour and a half session. Feedback was very positive, and the productive and constructive discussions that took place during the meeting demonstrated the importance and the need for such training during this complex period.

rachelly2020-09-11T05:01:28+00:00August 7th, 2020|Blog, Cultural Competence in Health Services, Ultra-Orthodox Jews|

Santé Israël on Olim and Migrant Communities during the Coronavirus Webinar

Santé Israël is known as a leader in caring for olim communities during the coronavirus crisis. Project Coordinator Marie Avigad was invited to speak at a Zoom webinar on Olim and Migrant Communities in the Corona Period, organized by the Institute for Immigration and Social Integration at the Ruppin Academic Center, which took place on May 13, 2020. Some 75 people attended the webinar.

Flyer from the webinar

She joined others from the French-speaking community in Israel, who spoke about the French-speaking community in Israel, about how they’re dealing with the coronavirus crisis here (both as patients and has medical personnel), about different initiatives launched by and for the French-speaking community.

Marie was asked specifically about problems that French-speakers encounter. She spoke about:

Language issues and access (or lack of access) to information – regarding Ministry of Health guidelines, regarding their rights (such as if they’ve been placed on furlough)
Coping with the Unexpected Situation: She experience two types of problems – French people with health issues who came to visit in Israel and were not able to return to France; or Israelis of French origin who were used to going back and forth to France for treatment. In both cases these people were left with an insufficient amount of medicine – what could they do? What were the local names of the medication? How could they obtain them? Or, if they needed treatment or lab test here to monitor their illnesses – what were they to do? Or, what were they to do if they’d recently made aliyah and were not yet able to register at an HMO or National Insurance Institute (NII – Bituach Leumi)?
Other questions she’s answered included: how to get medication without leaving home: dealing with problems of violence or fear of domestic violence during quarantine …

Marie spoke about the different activities that Santé Israël has done since the beginning of the coronavirus crisis, which included (and which we’ve written about here, here, and here):

Creating pages on the site that include translation of the Ministry of Health guidelines with regular updates, rights information, how to obtain medicines, etc.
Regular updates on Santé Israël’s Facebook page
Answering inquiries related to all these problems in email, Facebook, phone, and WhatsApp
Creating a WhatsApp group of French-speaking professionals, which facilitates information sharing

Many thanks to the Pharmadom Foundation for their continued support of Santé Israël over the years.

Naomi Roff2020-07-10T07:31:27+00:00May 31st, 2020|Blog, Cultural Competence, Cultural Competence in Health Services, Santé Israël - French internet platform on the Israeli healthcare system|

Culturally Competent Health Care during the Coronavirus Crisis

Since the beginning of the coronavirus crisis, we at the JICC’s Cultural Competency Desk are thinking about the multitude of communications challenges that require drastic changes in the way we utilize health services.

Cultural Competency Coordinators share experiences during coronavirus crisis

It’s not obvious that everyone can use health services via phone or Zoom. It’s not obvious that everyone knows and understands the health guidelines, even though they’re all over the media. It’s not obvious that someone who needs urgent medical care (especially not related to COVID-19) will seek it at this time. It’s not obvious that a hospitalized person will fully recover, if he doesn’t have extended family to support him. So much new uncertainty that has been added to the general state of uncertainty, which challenges the cross-cultural meeting even more.

On May 5, 2020 we held a professional development meeting (via Zoom, of course), led by our Dr. Michal Schuster, to try to explore these questions and issues, and to examine opportunities and existing responses that will help us overcome these challenges.

There were 30 healthcare professionals from all disciplines and all areas of the healthcare system, as well as those from professional schools for health care. They spoke about the challenges, as well as creative solutions that they’ve used. They shared their insights and original initiatives and noted the importance of cultural competency and adapting the medical response to diverse populations in a situation where the absurd has become the new normal.

One initiative was a “Zoom kiosk” for the ultra-Orthodox who didn’t want to use the Internet at home but needed to receive guidance or participate in different medical committees through Zoom; explanatory videos for populations who have difficulty reading technical documents; a voicemail-based service that made guidelines accessible for those without digital devices; and even purchasing tablets and providing training to connect patients relatives who are unable to visit due to strict guidelines.

This was all so amazing and exciting work, which already shows that while this is an extremely challenging era, it also offers opportunities for innovation and creative thinking, and many of the initiatives should remain with us to provide the best possible response, even after we return to routine. In the end, communication is communication, and caring professionals will find new ways to provide care and services.

We summed up the meeting with a range of practical and conceptual tips and recommendations, and invited all to consult with us further.

One participant noted, “Thank you for allowing me to participate in this amazing meeting, very exciting work.”

Here’s the Facebook post by Racheli Ashwal:

Here’s a Facebook post by our Michal Schuster:

Many thanks to the Jerusalem Foundation for their strategic support of Cultural Competency over the past decade.

Naomi Roff2020-05-31T15:26:53+00:00May 12th, 2020|Blog, Cultural Competence, Cultural Competence in Health Services|