Culturally Effective Management

• Religion

• Social determinants of health 

• Lifestyle choices & ideas

• Life experiences

• Class & SES

• Sexual orientation

• Ability

• Age

• Gender & identity

• Cultural, racial, & ethnic

• Politics

• Practitioners must provide "culturally relevant" screening, evaluation, referrals, & interventions to align with being a culturally relevant practice

• Cultural sensitivity: ability to recognize, but not judge differences & similarities

• Cultural safety: clients' belief that their healthcare provider communicates in a respectful, inclusive, & empowering way that recognizes that all people are different

• Human rights: universal rights that belong to every person regardless of race, sex, nationality, ethnicity, language, religion, etc.

• Occupational justice

Cultural Humility

• lifelong process of critical self-reflection & self-critique addressing power imbalances in the client-provider dynamic

• developing mutually beneficial partnerships with communities on behalf of individuals & populations

• advocating for & maintaining institutional accountability

Cultural Competency v. Cultural Humility

• Competency

  • mastery/endpoint

  • structured/rigid

  • hierarchical

  • linear

  • status quo

• Humility

  • learner

  • fluid & evolving

  • cyclical & reflective

  • partnership with communities & populations

  • pathway to equity

Implicit Bias

• unconscious beliefs, feelings, & attitudes that influence our behavior, decisions, & actions

Affinity Bias

• tendency or preference for people like ourselves

• place value on info shared from people like ourselves

• info that confirms (rather than challenges) our beliefs

*Bias often comes from a lack of knowledge about other cultures & lack of critical self-reflection

• OT Managers must understand the inherent power dynamics in healthcare

• Power comes from:

  • independence

  • wealth

  • knowledge

  • status

  • privilege

  • ability to set values & norms

• Asking:

  • Do OT practitioners "look" like our clients?

  • What do we know about our population of OTs?

  • How are we different/same? Able-bodied, "expert", etc.

  • How do we train/support employees to understand & practice "culturally relevant" OT?

Management Functions - how can managers do this?

• *Ongoing education, analysis, & reflection

• Planning

  • mission & vision statements that promote diversity

  • signage, forms, communications, etc. in multiple languages

• Organizing & staffing

  • cultural self-awareness activities with staff

  • hiring divrse staff & leadership

• Directing

  • training & mentoring on cultural humility & culturally relevant practices

  • ongoing reflection related to specific cases

• Controlling

  • QI

  • developing & using performance measures

Vision 2025

• Specifies that OT provides culturally responsive & customized services

• Managers need to run departments that are culturally humble, client-centered, & focused on reducing health & healthcare disparities