At Orlando Health, manager of Language Services and Cultural Development Marisol Romany has come up with her own “cultural toolkit” for working with patients of different ethnic and racial backgrounds.

In African American families, elders provide information and advice.

Muslim Arabs prefer dying patients be faced east towards Mecca, their holy city.

Among Haitians, weight loss is seen as a sign of illness.

In 2009, Florida Hospital came up with its “Guide to Religion and Culture,” which was given to all hospital employees “to enhance the delivery of pre-eminent care to our diverse patient community.”

Both hospitals have also beefed up their language interpreter services to meet the needs of Central Florida’s increasingly diverse patient population.

As the region continues to attract residents from all over the country and the world, local health care providers and educators are searching for ways to better serve them.

“It’s in everyone’s best interest to develop and promote building culturally diverse patient services,” said Romany, who was hired five years ago to help the hospital manage its multicultural patient population.

“From a business perspective, it makes a lot of sense,” said Bernardo Ramirez, assistant professor of health services administration at the University of Central Florida. “It not only allows health care providers to serve more patients, it also allows patients to use these services more effectively so they can have better health outcomes.”

The university’s colleges of medicine, nursing and health and public affairs have all instituted a number of programs and added courses designed to increase the number of health care workers who can provide linguistically and culturally sensitive services.

Assistant professor of social work Olga Molina, for example, has studied the need for bilingual mental health counselors to work with Spanish-speakers in abusive relationships.

“We absolutely have anecdotal evidence that there is a shortage of bilingual mental health professionals in the area,” said Molina. “Agencies are constantly calling us to ask if we have any bilingual students that can help them. They often don’t have translators either. That’s a big gap for a place like Central Florida, where a quarter of the population is Latino.”

Florida has the third largest number of non-English speaking residents, according to U.S. Census figures. Among the top 10 Florida counties ranked by the percentage of the population who speaks English less than “very well,” Osceola placed 5th and Orange was 8th. In Central Florida, Spanish is the most common language spoken after English, followed by Creole, Vietnamese and Portuguese.

In addition to understanding a patient’s language, Ramirez said health care providers must be aware of cultural differences.

“One of the things we’ve done to address this issue is we have required a course in social work for both the graduate and undergraduate level called ‘social work practice with diverse populations,'” said Molina. “It addresses not only the linguistic but cultural needs of persons that are different from them, whether it’s racial, ethnic, gender, sexual orientation or religious.”

At UCF’s College of Nursing, the undergraduate curriculum includes teaching “cultural competency,” which the American Association of Colleges of Nursing defines as “attitudes, knowledge and skills necessary for providing quality care to diverse populations.”

Last November, UCF nursing students produced poster displays representing a number of heritages during the school’s Diversity Week to educate them about cultural health issues.

“This event helps our future nurses learn about different cultures and also helps them understand how a patient’s cultural heritage can impact their patient care delivery plans,” said Pamela Ark, an assistant professor in the College of Nursing.

Local hospitals are working to bridge interpreter services with cultural understanding to improve the delivery and quality of health services.

“A patient is the best resource for their culture,” said Jean Aldridge, interpreter services manager at Florida Hospital. “Some cultures are highly traditional. Being aware of what some of those cultural traditions are can affect their ability or willingness to follow medical course of treatment.”

The hospital provides incentives for medical and other staff to take courses on diversity at local community colleges. At Orlando Health, employees can enroll in the hospital system’s own internal interpreter program, which includes 20 hours of medical terminology for those who are not physicians or nurses, and four hours of cultural awareness training. In the last two years, 35 employees have completed the class.

Both Florida Hospital and Orlando Health also contract with professional interpreters who are proficient in more than 150 languages and available over the phone, in-person and via video remote. State and nationally certified American Sign Language interpreters are also on hand to assist deaf patients.

Although hospital officials and educators agree there is a need for more doctors, nurses and other medical professionals who can serve Central Florida’s diverse community, they are all working together to address this critical need.

“I can sense we’re all progressing,” said Orlando Health’s Romany. “We’re all looking to each other for help. We’re all sharing the same workforce and clients, and we all recognize it will take a combined effort to continue moving forward.”

Source: Orlando Sentinel, by Fernando Quintero ( or 407-650-6333); Culture of caring: Hospitals reaching out to region’s cultural diversity