Sixth National Conference on Quality Health Care for Culturally Diverse Populations: Peer-to-Peer Practice Advancement Sessions Moving the Mission : From Strategy to Action

A-4 Organizational journeys to CLAS, Part I: Readiness to engage

Moving the Mission : From Strategy to Action
Monday, September 22, 2008: 10:45 AM-12:15 PM, Minn Marriott, 6th Floor - St. Croix I
Although care givers at the bedside are frequently most aware of gaps in a hospital’s services to diverse patients, they often feel least able to affect systems change that would improve services in a meaningful way. At Barnes-Jewish Hospital in St. Louis, expertise in the implementation of some of the CLAS standards (particularly in the area of access to interpreters) wasn’t translating to a coordinated effort to achieve all the relevant standards. For many years, efforts were championed by just a few people, not embraced by senior administration and could not gain traction to pull in other key players such as physician staff from our affiliated Washington University School of Medicine or key educational institutions on our campus such as our schools of pharmacy, nursing, radiology, etc.. With a new hospital president came new energy and the creation of our Center for Diversity and Cultural Competence, a tangible commitment to doing “whatever it takes” to reduce health disparities. A strategic plan was developed that focuses leadership energy on improving all aspects of our cultural competence from staff recruitment/training/retention to minority contracting to and to the deliverly of culturally congruent bedside care. This presentation focuses on replicable actions at the bedside that mesh with our strategic plan.  It describes our training of trainers program of educators already embedded in nursing divisions and in critical departments such as Security, Housekeeping, Nutritional Services, Patient Safety, Social Work and others, a program developed in conjunction with the International Institute of St. Louis, one of our local Refugee Resettlement Agencies. It spells out crucial changes in utilization of interpreters and cross-cultural consults, new standards for documentation in the patient record and measurable expectations for clinical and service managers that are reflected in annual performance reviews.  It also addresses preparation for certification and regulatory activities such as Magnet and JCAHO.

Presentation Information:

Program: Peer-to-Peer Practice Advancement Sessions
Primary Category: Culturally Competent Care
Subtopics: Clinical interactions, Patient education, Curricula development, Continuing education/on-the-job learning, Training trainers, Ancillary staff programs, Leadership development/training, Assessing learning/performance on cultural competence/disparity reduction, Disparity reduction, Racism, sexism, discrimination, Implementing the CLAS standards or other cultural competence frameworks, Implementing disparity reduction programs, Organizational assessments, Organizational plans, policies, management strategies, Data collection (on individuals and communities), Workforce diversity, Quality improvement, Risk management, Patient safety, Partnerships with community organizations, Interpreter services—development and management, Interpreter practice—skills, day-to-day issues, Health literacy, Organizational internal policies, Standards (performance, organizational), Accreditation requirements, Magnet, Program/intervention evaluations

Region Addressed by Presentation: National
Organization: Health Care System
Population/Demographic: racial/ethnic minorities etc.
Keywords: staff education, patient care, nursing documentation, training of trainers, effective use of interpreter resources


Barbara Bogomolov, RN, BSN, MS(r) , Center for Diversity and Cultural Competence, Barnes-Jewish Hospital at Washington University Medical Center, St. Louis, MO
    Manager, Refugee Health and Interpreter Services
    Barnes-Jewish Hospital at Washington University Medical Center
    Center for Diversity and Cultural Competence
    4905 Forest Park
    St. Louis MO, USA 63110

    Phone: 314-747-5683
    Fax: 314-747-5778
    Email Address:

    Biographical Sketch:
    Barbara Bogomolov, RN, has extensive experience in the delivery of cross-cultural care and teaches utilizing a world view model for medical, nursing and ancillary professionals both domestically and internationally. She is responsible for an interpreter team that delivered nearly 36000 encounters in 75 languages in 2007. She has developed and is presently testing an acculturation model that can be used by bedside care givers to adjust care to the patient/family's level of acculturation.