By Barbara E. Stefáno, St. Louis Nursing News, July 9, 2007

In any given year, St. Louis health care workers might encounter more than 70 foreign languages and up to 100 different cultures in the course of providing patient care. It''s estimated that 17 percent of St. Louis families speak a language other than English as their primary language.

It''s no small wonder Barnes-Jewish Hospital has taken the matter of cultural diversity so seriously. The hospital''s Center for Diversity and Cultural Competence seeks to level the playing field for people of various nationalities, lifestyles and cultures so that everyone has equal access to quality health care.

Language and cultural barriers are not just inconvenient or confusing for health care providers; they can have a very serious effect on the quality of care for people of diverse cultures and ethnic origin, said the center''s director, Brenda Battle, RN.

"The ultimate mission of the center is to eliminate health disparity for various groups through awareness of diversity," she said.

Training programs are offered to teach cultural competency to staff at the patient care level. Part of the center is the Refugee Health and Interpreter Services, which provides interpreters to help non-English speakers receive better care, as well as understand their care. To date, the RHIS employs 33 full-time interpreters who interpret 72 languages, including Braille and sign language. Battle said Barnes-Jewish Hospital is the only hospital in St. Louis with full-time paid interpreters.

"The goal is to do anything we can do that would help bring about a work force of individuals that understand the varying degree of diversity we see in our hospitals," she said. "Diversity doesn''t just mean diversity in ethnicity and race; diversity is also age, diversity in mental and physical disabilities, diversity in socio-economic status, in educational levels and how those things impact health disparity."

With the center, Barnes-Jewish Hospital seeks to improve health care workers'' knowledge of various cultures, world issues and how people of diverse backgrounds receive services. By helping staff to understand different cultures and improving the ability for patients to follow treatment plans, patient care will better meet the needs of these populations.

Battle said the center''s programming began last August, a few months before the center''s office opened in November. In the months since then, the center has instituted several approaches to create a more diverse workplace as well.

"One program we''ve started is to recruit under-represented minority physicians to come and practice here and do their residency and fellowship at Barnes-Jewish Hospital," Battle said. "We have a grant program now to attract under-represented minorities to study here, and there''s a mentor program to encourage them to come here to practice."

The center provides classes for those practitioners for whom English is a second language. The programming has already resulted in a record number of minority practitioners at Barnes-Jewish Hospital in 2006.

Less than a year into operation, it is far too early to quantify the impact the Center for Diversity and Cultural Competence has had on patient care, but Battle said the early feedback is positive.

"From an anecdotal perspective, I know that nurses and doctors are asking more appropriate questions of patients to try to get a perspective of what''s going on with patients for proper care," she said. "We''ve gotten good comments.

"I have heard that, yes, they have a better understanding of the patients they are seeing. Staff are asking for more tools and resources to be more effective with diverse patients."

For more information about Barnes-Jewish Hospital''s Center for Diversity and Cultural Competence, call (314) 362-8899.