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DALLAS (AP) — A dozen years ago, employees of Parkland Memorial Hospital were paid an extra 25 cents an hour if they could greet Hispanic patients and give them simple directions in Spanish.
It was 2002, and an influx of Spanish-speaking patients was challenging Dallas County's public hospital to become bilingual almost overnight.
The Dallas Morning News (http://bit.ly/1DKr3Tg ) reports some staffers were fluent, but untested, in Spanish; others were willing to learn. Doctors were using "medical Spanish," which meant they relied on a pocket-sized Spanish phrasebook of anatomical terms when translators were unavailable.
Such crude attempts are no longer part of Parkland's strategy to become a more culturally sensitive institution.
Ildemaro Gonzalez, Parkland's new chief of inclusion and diversity, said the hospital is striving to offer "culturally competent care." That means the staff not only must understand the culture of the patient, including language and background, but also must modify the way they provide care as needed.
In adopting the hospital's first diversity plan in January, the board of managers pledged to improve how minority patients are treated at Parkland. That includes a promise to fill Parkland's jobs with more diverse leadership.
"After more than 100 years, it's about time Parkland had a diversity plan," said Patricia Rodriguez Gorman, one of three minority members on the hospital's seven-member board of managers. "We treat very humble patients, and we have to keep a better eye on who we're serving."
Dr. Fred Cerise, Parkland's chief executive officer, said he hopes to improve upon the current mix of top managers. Of the hospital's 57 vice presidents, 26 percent are minorities. Only 5 percent are Hispanic.
Cerise said he wants "a diverse leadership team that can relate to the realities of our diverse patients." The plan, however, does not specify any goals for how many VPs should be minority members.
The hospital's diversity policy calls for seeking more minority candidates when there are management openings. Such a process should identify a "pipeline" of talented people, who would be ready to apply when the time comes.
"The government sees goals as quotas, which are illegal," Cerise said. "That is why we don't have specific hiring goals."
Dallas County Commissioner John Wiley Price said he wants a portion of Cerise's compensation to be linked to hiring more minority executives. "Unless he matches the demographic makeup of the community he serves, as far as I'm concerned, he won't get paid (that portion)," Price said.
Last year, Parkland cared for almost 295,000 patients, of whom 161,757, or 55 percent, were Hispanic. The hospital's minority patients appear to exceed 85 percent.
However, Parkland no longer considers the Hispanic population to be its own racial group. Those patients who list "Hispanic" as their "race" are now designated as white, the hospital said, and are also listed as an ethnic group in a separate count.
Price said he's frustrated to hear that but not surprised.
"You've been counting all these people for years, and all of a sudden, it's illegal to count them?" he said.
Cerise said Parkland is committed to improving its language services, considering that the hospital staff handles 45,000 patient encounters monthly in a language other than English. In the past year, these encounters were in 110 languages, although 90 percent in Spanish.
Federal law requires that patients who are not proficient in English be provided an interpreter in certain critical situations, including hospital care.
Parkland has teams of interpreters along with translation services provided by telephone and video. The hospital's emphasis has moved to certifying more medical interpreters. It has 86 who speak Spanish, and Parkland hopes to add 300 within the next 18 months.
"We do not have the resources now to pair up every patient with a live interpreter," Gonzalez said. "So we designed a tiered-level approach."
Patients who are acutely ill get a face-to-face interpreter when talking to hospital caregivers. Less acute patients rely on interpretation by phone or video services.
"If an employee can speak another language, and you are not certified by us, you cannot use the language with patients," Gonzalez said. "It's a compliance breach."
The hospital is restaffing its bilingual program to certify employees as either speaking a second language or speaking and writing in that language, Gonzalez said.
Board member Gorman said she was relieved that Parkland employees have learned when to call in an interpreter, rather than try to patch together a conversation in another language.
"At least, we've got our doctors and nurses thinking about it," she said.
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Information from: The Dallas Morning News, http://www.dallasnews.com
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