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Inclusion Institute here aims to reduce disparities in health care for minorities

This article first appeared in the St. Louis Beacon, July 14, 2009 - Denise DeCou knows the danger when health-care providers fail to communicate effectively with their patients. DeCou, executive director of the National Conference for Community and Justice in St. Louis, tells of a licensed practical nurse serving in a Hispanic community here who spoke a bit of Spanish. She wasn't fluent, but she thought she knew enough to explain the dosage requirements for a medication. But instead of saying "take once a day," she said take "once (11, in spanish) times a day."

The mistake was caught and was corrected without harm to the patient. The clinic where the nurse worked took steps to ensure that workers wouldn't use foreign languages to give prescription information unless they were fluent. And it hired professional translators and interpreters.

DeCou says that the small mistake illustrates a larger problem in the medical community here. Health-care providers need to address both language and cultural barriers as their communities become more diverse. A new program sponsored by the group aims to do just that. The Inclusion Institute for Healthcare will be held three times in 2010. Health-care providers will attend a five-day long retreat in seminars, dialogues and hands-on activities to improve their cultural competency and communication skills.

DeCou hopes the program will help health-care providers here connect with patients who have a hard time because of their language skills or a poor education.

The need is apparent. According to an Inclusion Institute fact sheet, the Institute of Medicine says that "minorities tend to receive lower-quality health care than whites do, even when insurance status, income, age and severity of conditions are comparable." (The Institute of Medicine provides science-based advice on matters of medicine and health to policy makers, professionals and the public.)

"We're looking to find ways to communicate in a broader sense across St. Louis regardless of language or economic level," DeCou said.

Participants in the program will learn basic skills and subtle cues to improve interactions with patients. For instance, instructors will show how body language can play a role in delivering bad -- and good -- news. Providers will also learn how to work with translators to make patients feel more comfortable and to translate medical jargon into language easier for patients to understand.

Currently the Inclusion Institute is recruiting advisory panel members. The members will help determine topics for discussion, recruit members for the institute's sessions and evaluate the project after the 2010 retreats. The panel already has 17 members from a variety of professions in health care.

The institute began as a pilot program at Barnes Jewish Hospital in 2007. Instructors trained the hospital's senior management, and in February 2008, the program was extended to middle management. Shortly after, a grant application to broaden the program's reach was submitted to the Missouri Foundation for Health. The grant was approved, and the two-year, $300,000 grant will cover costs associated with the program.

Between 30 and 35 people will participate in each session. Health-care providers who would like to participate or want more information can contact David J. Martineau, program manager, at david@nccjstl.org or at 314-865-3042, ext. 112. 

Sarah Scully, an intern at the Beacon, is a student at the University of Missouri, Columbia.