"I think I've been a Diversity Champion for a long time, I just didn't have a name for it."
I think I've been a Diversity Champion for a long time, I just didn't have a name for it," says Ralph Falvo, a registered nurse at the INOVA Loudoun Hospital in Leesburg, VA.
Loudoun County, VA is the fastest growing county in the United States. The population is growing both in size and ethnic diversity. Ralph Falvo is the driving force behind celebrating that growth in healthcare.
As a self-described "Army brat," Ralph Falvo, an Italian American, has lived diversity. Traveling and living all over Europe, Asia and the United States actually drove him into healthcare. He reflects, "I was exposed to many different cultures and different ethnic groups all my life. It was probably the reason I went into nursing, which is really caring and understanding people. Nursing is a very social career, so you have to be socially aware to do this kind of work.
Story tell offers helpful tool
"Most of diversity education is story telling, says Falvo. "Stories have power behind them. You'd be amazed at how quickly people open up and share when you want to hear their stories. It's one of the training techniques I use."
A story Mr. Falvo often tells is his experience moving from Savannah, Georgia in 1963 (mind you, segregation is still in full swing) to a boarding school in London, England where the Beatles were entering the scene and life was very, very different. He was 400 miles away from his family and friends. What did that teach him? To be adaptable and flexible.
Inclusion, sensitivity, awareness
"In the healthcare profession you have to be culturally competent to deliver quality patient care. If care givers aren't familiar with differences, we could have gaps in patient care,"
The three components that define diversity according to Falvo, are inclusion, sensitivity and awareness. But he takes it one step further. "In the healthcare profession you have to be culturally competent to deliver quality patient care. If care givers aren't familiar with differences, we could have gaps in patient care," he says.
Falvo's mentor, Josepha (Josie) Campinha-Bacote is considered a guru in culturally competent patient care. She's known internationally and theorized the idea of a culturally competent nursing program. She formulated the concepts of Transcultural Nursing in the United States. Falvo has taken on her passion and knowledge to implement culturally competent nursing in Loudoun County.
Treating diverse patients competently
Because every person comes from a unique and different background, Falvo accommodates each individual patient to make a hospital stay as comfortable as possible.
For example, Falvo and his nurses know how to cater to a deaf person. They know what to be aware of when treating an African American woman. His team knows what room numbers mean bad luck to Asian Americans. They pass out food surveys so everyone can request their own comfort food. When a lesbian couple gave birth, Falvo and his staff were right there to give them available resources in the area.
Falvo educates his staff so they can accommodate the personal needs and comforts of each patient.
Helping nurses gain cultural competence
"It is like the UN working on our units, because everyone brings a certain twist to what they do. I really get involved with the staff on a weekly basis to make sure everyone's needs are met."
An ongoing challenge Falvo has is preparing nurses for what's called the Magnet recognition designation, a national nursing excellence award, which encompasses and includes diversity concepts. This year, only two percent of hospitals around the country earned the recognition, one of which was INOVA Loudon Hospital in May 2006.
The Diversity Workgroup Committee of Loudon Hospital, of which Falvo is a member, designed and made an entire kit to help nurses become more culturally competent with their patients. The kit includes reference books on different cultures so nurses can look up food preferences, use of religious items such as, rosary beads, and personal needs, such as wide combs and picks for people with non-white silky hair. The kit also comes with a resource binder that lists all social services and interpreters in the area.
On a weekly basis, Falvo makes diversity rounds in the hospital, consulting with staff about the cultural necessities patients have and the quality of communication between nurses. Falvo says, "It is like the UN working on our units, because everyone brings a certain twist to what they do. I really get involved with the staff on a weekly basis to make sure everyone's needs are met."
For fun and education, Mr. Falvo highlights specific groups that may live in the area or who are moving into the area in greater numbers. For example, in Loudoun County, there is a recent increase of the Korean population, so Falvo focused his education efforts on Korean-Americans. For three months, nurses were given a question of the day about the Korean culture, and at the end of this time, Korean-American staff nurses dressed in traditional Korean dresses and passed out traditional Korean food and treats to fellow staff members. Families and friends of patients and nurses are invited to the hospital to learn about different cultures.
Training others
"Have a great suit of armor, and don't be afraid to wear it,"
Falvo developed the education and training program that over 650 nurses use to deliver culturally competent care. By developing a survey, assessing his organization's diversity competency and interviewing experts, Falvo was able to make a video that is used for training new employees at the hospital.
He has been chair of the committee on patient care services and a member of the hospital's diversity committee for 5 years. Part of his job includes helping to organize the INOVA health system Heathcare Disparity Symposium to be held in Washington, DC, October 27, 2006. International speakers on health care disparity related to diversity will present their research and program successes.
Advice to other Diversity Champions
"Have a great suit of armor, and don't be afraid to wear it," says Falvo. "Senior management has good intentions, and I always say their frame and domain are to excel in program structuring and supporting mid-management and staff people.
"Take your suit of armor, persistence, knowledge, benchmarking and measurement - and tie it into service excellence. Diversity is a huge part of how we operate, how we recruit. It is part of our mission statement to provide the highest quality care at all times, so we just have to be aware culturally to do it."
For more information, contact Ralph Falvo at rfalvo@lh.org
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