Monday, October 22, 2012

DAO - Patient's Cultural Assessment Card

I realized that I never published these tools, I hope you find them useful.  This is a patient's cultural assessment card.  Note that some patients may not feel comfortable answering to some of the questions, so you can try to implement it based on your own practice's policies. If you want to use the tools let me know and I will email you a copy.

About the author
Helen Dao, MHA
Dao Consulting Services, Inc.
Tel. (201) 448-2046

CLAS Standard 8

“Health care organizations should develop, implement, and promote a written strategic plan that outlines clear goals, policies, operational plans, and management accountability/oversight mechanisms to provide culturally and linguistically appropriate services.”

A clearly written strategic plan is the framework for culturally and linguistically appropriate services. While it is important to identify the barriers in patient care, it is even more important to outline the changes we must make.

According to the Office of Minority health, a strategic plan should help an organization “define and structure activities, policy development, and goal settings relevant to culturally and linguistically appropriate settings.”

Defining what strategies and activities relevant to specific community may seem daunting at first, especially for a small health care organization. However, one of the easiest and most valuable way to address a community’s need to speaking to leaders and active individuals in that community. We will expand on working with community members in Standard 12.

The Office of Minority steps recommends a multi-step plan to define and carry out culturally and linguistically appropriate services. A few of these steps include:
·      An internal assessment of the organization, its staff, and members
·      A “community profile”
·      Engaging the community
·      Ensuring a linguistically diverse staff that caters to community needs
·      Conducting ongoing assessment of staff and organizational structure
·      An organization’s missions that commits to culturally and linguistically appropriate services for people serve.

A healthcare organization needs to have synergy with its mission, goals, values, strategic plan, and be in sink with its consumer’s cultural and linguistic unique needs.   The next is a diagram explaining the “Synergetic Model”.

About the author:
Helen Dao, MHA
Dao Consulting Services, Inc
"A Public Health Company - Connecting Providers & Communities"
Tel. (201) 448-2046

Wednesday, October 10, 2012

Accountable Care through the Health Home

Accountable care is about partnering with providers and community members to identify and address the complex needs of people with chronic health conditions,  and to create a supportive, accessible, and cohesive environment of care.

The Health Home initiative is an innovative approach with the promise to helping patients access comprehensive care coordination, meet their physical, mental, and social needs.  However, their are significant challenges when trying to engage and serve these individuals.  

In a report released by the Center for Disease Control (CDC), August 2012.  It mentions that Chronic Diseases are the Leading Causes of Death and Disability in the U.S.

  • 7 out of 10 deaths among Americans each year are from chronic diseases. Heart disease, cancer and stroke account for more than 50% of all deaths each year.
  • In 2005, 133 million Americans – almost 1 out of every 2 adults – had at least one chronic illness.
  • Obesity has become a major health concern. 1 in every 3 adults is obese and almost 1 in 5 youth between the ages of 6 and 19 is obese (BMI ≥ 95th percentile of the CDC growth chart).
  • About one-fourth of people with chronic conditions have one or more daily activity limitations.
  • Arthritis is the most common cause of disability, with nearly 19 million Americans reporting activity limitations.
  • Diabetes continues to be the leading cause of kidney failure, nontraumatic lower-extremity amputations, and blindness among adults, aged 20-74.
  • Excessive alcohol consumption is the third leading preventable cause of death in the U.S., behind diet and physical activity and tobacco. 

Health home providers are charged with engaging and enrolling medicaid/manage care plan participants into the program.  But there are a few things that health home providers should considerate the early stages of the program.
  • A supportive staff structure to meet the program needs such as outreach activities and follow up.
  • A well defined enrollment process (responsible staff and timeline).
  • Keeping participants engaged with monthly or necessary care coordination.
  • Upper management having a clear understanding of resources needed to serve this complex population.
  • Realistic goals that can be achievable.
  • The State having a good understanding of the resources that health home programs will need to invest to make this program a success.
The health home program has a lot of potential, we will see how this initiative evolves and changes with the unique needs that people with chronic diseases are faced with on a daily basis.

About the Author:
Helen Dao, BA, MHA
Dao Consulting Services, Inc.
A public Health Company Connecting Providers and Communities
Jersey City, New Jersey
Tel. (201) 448-2046


  1. Kung HC, Hoyert DL, Xu JQ, Murphy SL. Deaths: final data for 2005. National Vital Statistics Reports 2008;56(10). Available from: Adobe PDF file [PDF-2.3MB]
  2. Wu SY, Green A. Projection of chronic illness prevalence and cost inflation. Santa Monica, CA: RAND Health; 2000.
  3. Ogden CL, Carroll MD, McDowell MA, Flegal KM. Obesity among adults in the United States—no change since 2003–2004. NCHS data brief no 1. Hyattsville, MD: National Center for Health Statistics; 2007. Available from: Adobe PDF file [PDF-366KB]
  4. Ogden CL, Carroll MD, Flegal KM. High body mass index for age among US children and adolescents, 2003–2006. JAMA 2008;299:2401–2405.
  5. Anderson G. Chronic conditions: making the case for ongoing care. Baltimore, MD: John Hopkins University; 2004.
  6. Centers for Disease Control and Prevention. Prevalence of doctor-diagnosed arthritis and arthritis-attributable activity limitation—United States, 2003–2005. MMWR 2006;55:1089–1092. Available from:
  7. Centers for Disease Control and Prevention. National diabetes fact sheet, 2007. Atlanta, GA: U.S. Department of Health and Human Services; 2008. Available from:
  8. Mokdad AH, Marks JS, Stroup DF, Gerberding JL. Actual causes of death in the United States, 2000. JAMA 2004;291(10):1238–1245.)

Wednesday, October 3, 2012

CLAS Standard 7

Health care organizations must make available easily understood patient-related materials and post signage in the language of the commonly encountered groups and/or groups represented in the services area.

In Standard 5, we stressed the importance of ensuring patients understand their right to language services.  This week, we advise health care professionals to ensure these services are indeed available.  Standard 7 states patient-related materials must be readily available in patients’ preferred languages.  Moreover, facility signs should be presented in English and commonly encountered languages. 

According to U.S. Department of Health and Human Services, important patient-related materials include “applications, consent forms, and medical or treatment instructions.”  Moreover, the department identifies commonly encountered languages as “languages used by a significant number or percentage of the population in the service area.” 

In addition to providing translated patient-related materials, health care professionals should also consider the literacy levels of the populations.  It is also important to take careful precision when translating technical and medical terms into the target languages. 

Tuesday, October 2, 2012

"Inactivity and Our Health"

A couple of months ago I wrote a blog on "health disparities-Latinos/Hispanics"

Someone contacted me about her piece on a similar topic.  Check it out and amazing graphics! (copy and paste to your browser).  I  really like her work because it visualizes the story and the consequences for staying inactive.

Way to go Allison!

Helen Dao, MHA