Perspectives on the Acute Care Continuum

The Acute Care Continuum is the integration of urgent, emergent, inpatient and post-discharge care of patients with acute medical conditions.

Mindful “Global Intelligence” in Medicine Is Cultural Competence at Its Best

2/2/2016 5:18:45 PM | 5 comments

Welcome to Mindfulness in Medicine, an ongoing column by best-selling author Anne Bruce, designed to cultivate leadership and collaborative relationships among hospital leaders, nurses, providers and ancillary staff. Mindfulness is a powerful leadership tool that enhances emotional intelligence in medicine. It is a tool that, when practiced, can help us develop and implement relational coaching skills and illuminate various ways to improve hospital operations and cross-departmental performance. Mindfulness also improves our capacity for decision-making and participatory medicine, all while enhancing our own health and well-being. Your comments and insights on these postings are greatly valued.
In 2016 and beyond, success in the healthcare industry will require leaders who are not only mindful but who have the capability to navigate an increasingly global marketplace.
The face of healthcare is diversifying both domestically and globally. Some of these changes mirror population trends:
Other changes are economically driven:
  • To address workforce shortages, healthcare employers are increasingly recruiting across borders.
  • Consumers in general are more mobile. They may travel specifically to seek healthcare, or they may experience injury or illness away from home.
  • Companies worldwide are now offering medical equipment, health services and insurance products on the U.S. market.
  • Technology has advanced to the point where international telehealth, virtual rounds and distance education have become realities.
Healthcare leaders of the past could rely on traditional management theory to serve a relatively homogenous workforce and consumer base. However, evidence suggests that many of the current shortcomings of our healthcare system result from the lack of what’s termed “global intelligence," also known as “cultural competency."
Leadership in today's healthcare environment requires going beyond the status quo. We have to think bigger and be more mindful of the complex environments in which we operate.

6 Keys to Mindful Global Intelligence

Working in a multicultural, multigenerational workplace often heightens the stress that healthcare leaders and providers face. The more global and diverse the workforce and consumer base, the more demanding our roles become.
When healthcare leaders work with diverse stakeholders, new frameworks and practical approaches are required. Complexity increases exponentially because of differences in language, culture, customer preferences, compliance and ethical standards. In some hospitals and communities, this gap can be quite intimidating. But there are notable success stories, including Sutter Health, Harvard Medical School and Barnes-Jewish Hospital.
So where can we start? First, it's important to remember that global intelligence is rooted in mindfulness — the nonjudgmental awareness of our thoughts and feelings in a given moment. Only when we're in touch with our own attitudes and beliefs can we begin to improve our relationships with others.
Beginning from this foundation of mindfulness and self-awareness, we can cultivate greater global intelligence by keeping six competencies top of mind:

1. Collaboration

In a global context, collaboration is the ability to create horizontal networks that cut across geographic and cultural lines. It's the process of bringing the best people together —wherever they may be — in pursuit of common goals.
Keys to multicultural collaboration include:
  • Knowing and leveraging the strengths of diverse leaders and team members.
  • Working to align teams and individuals who have the same goal, but disagree on how to reach it.
  • Creating a supportive environment in which teams can take risks and experiment with blended approaches.
  • Emphasizing that good teamwork honors different cultures and identities rather than trying to force individuals into a mold.
When we use mindful global intelligence in tandem with cultural competency, we work together as strategic partners. We put our patients and hospitals first, not our personal needs or desire for professional gain. In the best cases, this creates a synergy that transcends geographic and cultural boundaries.

2. Curiosity

Leaders in medicine today must have deep curiosity about the people they encounter.
Above all, curiosity requires humility. We must recognize that approaches from other cultures may be equally valid — and even superior — to our own.
This curiosity should extend vertically to all levels of the organization. Who are the "thought leaders?" In answering, don't overlook your frontline providers. The people at the bedside are often in the best position to understand patient and departmental needs.
Take the Einstein approach. Keep it simple whenever possible, and be open-minded to everyone’s contribution and experiences — including administration, nurses, providers and ancillary staff.

3. Awareness

As a leader, it's important to understand the environment in which you operate. And in some cases, that environment now extends across countries and continents.
In what ways are you privileged in your workplace and community? Not-so-privileged? How do these power imbalances color your interactions with colleagues and patients?
If you don't personally experience bias very often, take time to explore the effects of power and privilege in our society through reading, exercises and personal conversations. By doing so, you become more open, more self-aware and more capable of recognizing harmful bias within your organization.


4. Adaptability

Healthcare has always been a rapidly evolving environment, and the pace of change is accelerating. Do you really “see” what’s on the horizon? Are you trying to better understand today’s volatile world and predict coming shifts? Are you and your teams developing contingency plans to cope with adverse situations?
Global intelligence requires that we do all of this and more. Be prepared to alter your tactics quickly. At the speed at which we are moving, there most likely won’t be much advance notice.

5. Empathy

We all know the meaning of empathy: the ability to walk in someone else’s shoes. Empathy also requires humility and the ability to engage with others — colleagues, lawmakers, administrators, providers, patients and their families. 
Empathy is a mindful and powerful element in global intelligence. It builds fast rapport and bonding and creates long-lasting relationships.
Only with the help of empathy can healthcare leaders engage fully with their colleagues, teams, co-workers and the community while helping others to achieve exceptional performance and positive outcomes.

6. Integration

Integration is perhaps the biggest challenge facing medicine today. And just as we must integrate clinical care across settings, we must now coordinate our operations with external partners and stakeholders.

Shifting an Old Paradigm

Healthcare leaders are quickly learning to blend global practices with local ones in order to compete. That is the true definition of cultural competency.
The adage used to be: Think local, act global.
But today, the opposite – think global, act local – may be more useful.
In other words, we must adopt an open, global outlook in order to relate more effectively to colleagues and patients. Only then can we deliver superior, patient-centered healthcare that truly meets the community's needs.

About the Author

Anne Bruce has provided training and performance coaching for MedAmerica and CEP America. She also serves as MBSI's Employee Development Coach and Leadership Facilitator. Anne is a bestselling author with more than 20 books published by McGraw-Hill Publishing, New York. Her next book on mindful behavior is titled Conscious Engagement and is scheduled for release in 2017. She considers her award-winning life-coaching book, Discover True North: A 4-Week Approach to Ignite Passion and Activate Potential (McGraw-Hill Publishing) to be one of her most "mindful" books to date. She also leads a popular Discover True North Expedition group on LinkedIn. Anne can be reached at 214-507-8242 or by writing to her at, or visiting her on LinkedIn or Facebook.

Bob Jenkins
Great article Anne. I completely agree that managers should listen to the frontline providers, because they are the ones in the trenches dealing with patients. They see the direct affect of policies and directly interact with the patients and their families.

This article does a great job in making healthcare providers aware of their actions, their opinions and their beliefs.

The world is becoming smaller everyday and reading Anne's article reminds me of the importance to "Think Global - and Act Local".
2/4/2016 8:42:08 PM

Anne Bruce
Dorothy, I appreciate your insights immensely. Yes, the telemedicine part of all this is mind staggering. I can only glimpse into the dramatic affect this is all going to have in emergency medicine and, actually, already is having. It will be a major game changer for our society and I'm looking forward to researching and writing more on the subject. Thank you for taking time to share your thoughts on this post.
2/4/2016 12:49:09 PM

Dorothy Maples
I am intrigued with the philosophies in this article! Referencing the Einstein approach to being open-minded toward the contributions and experiences of frontline providers certainly veers from traditional management practices of the past - and thankfully so. Frontline contributors are in perfect position to identify with both patient and departmental needs.
The element of empathy is indeed powerful - if missing, there is likely no meaningful rapport or opportunity for collaboration.
I've thought very little about telemedicine until now. The thought that technological advancements allow medical professionals to not only share expertise globally, but also provides patients in remote or underserved regions the means to pursue treatment is remarkable. Your link to the Shanghai East International Medical Center working in tandem with the chief of cardiology at UC Davis is a fascinating story.
I couldn't agree more with the new adage "Think global, act local". A brilliant motto!
2/4/2016 10:38:59 AM

Anne Bruce
Ms. Hinshaw's comment is a real eye-opener. Thank you for posting your insight on this subject.
2/3/2016 10:05:54 PM

Dolly Hinshaw
It is reassuring to note that enrollment in medical schools offering a Master of Science in Global Medicine degree has been rising to meet the challenges you discuss. Your article serves as a reminder for all of us in the healthcare profession to reassess our own competencies.
2/3/2016 9:45:35 PM