Patient safety initiative at a hospital

Case 1 Authors: Sharon B. Buchbinder and Dale Buchbinder
Case 1: A new Latina graduate of an MHSA program is hired to be in charge of a quality improvement and
patient safety initiative at a hospital in Washington, DC. On her first morning at work, she asks her
administrative assistant, an older African-American woman, to schedule one-on-one appointments for her key
employees involved in the new program. She wants to see them starting on the next day, so she asks her
assistant to start making the appointments as soon as possible. The administrative assistant nods, says
nothing and returns to her computer work. At the end of the day, the administrative assistant has made no
appointments for her new boss.
Case 2 Author: Understanding Cultural Diversity in Healthcare
Case 2: A Vietnamese Death. Dr. Needleman was invited to do a presentation on cultural competence to the
hospice staff at a large successful, and very white hospital. As part of his preparation, he visited the inpatient
hospice one afternoon. At the end of his visit, he sat with the nurses as they debriefed the shift. One, a leader
of some sort, said that she was pleased Dr. Needleman would talk to them since she needed to know more.
She then said why. She had been rushing around for a few hours to solve a problem for a Vietnamese man
whose wife had just died in the CCU following palliative surgery for cancer. The CCU needed the bed, but the
husband told the nurse that he needed to be with his wife for three days in case her spirit returned. At about
this point, Dr. Needleman wondered out loud what the problem was since the nurse seemed to be listening in a
neutral fashion- an important early step in culturally competent care. She went on. She looked through the
hospital for a room where the man could be in private with his wife. In addition, she negotiated with some
service that needed to have the body for standard hospital procedures after a death. Ultimately, she succeeded
in getting the service to back off. In addition she found that the hospice conference room might work for the
sitting process. However, there was a conference in there; she threw them out. At this point, Dr. Needleman
was astounded that the nurse felt that she needed more education/practice in cultural competence. She had
exhibited the kind of system savvy that he thought was essential in cultural competence and engaged in a
negotiation process that is the essence of cultural practice. What, he wondered, was the problem? I asked
again. She said simply: “But the husband does not believe that his wife is dead.”
Discussion Questions:
What are the known facts in each scenario? What else may be going on? What cultural differences might
explain the misunderstandings in these cases? original post should be a minimum of 100 words. Thank you!