Cultural competence has become a strategic and business imperative for all healthcare providers and organizations.
Cultural competence is becoming an increasingly critical focus for healthcare providers, especially in the delivery of patient-centered care and the management of chronic disease. It is not a new topic. However, we are currently seeing increasing engagement with our healthcare client-partners in creating, designing and implementing the organizational transformation necessary to become a culturally competent provider of healthcare.
The Health Resources and Services Administration (HRSA) defines cultural competence as “a set of congruent behaviors, attitudes, and policies that come together in a system, agency, or among professionals and enable that system, agency or those professionals to work effectively in cross-cultural situations.”
HRSA believes that organizational cultural competence is an integral component of systematic, patient-centered care and has the potential to fulfill the IHI Triple Aim. The organization serves as the driver of provider cultural competence by providing the managers, policies and systems to support the reality of delivering culturally competent care.
Although policies are in place that mandate culturally and linguistically competent health care, and several national organizations and accreditation bodies require the inclusion of training in cultural competence in continuing education and academic programs, health organizations and professionals still are not prepared to interact adequately with the diverse cultures in our nation’s patient populations. Resources are fragmented by profession and highly specialized with no set of common standards for education, assessment, or ongoing training in the four domains used to measure cultural competence: knowledge, skills, attitude or encounters.
Published research by organizations like the Institute of Medicine (IOM), the Agency for Healthcare Research and Quality (AHRQ), the Health Resources and Services Administration (HRSA) and the Robert Wood Johnson Foundation (RWJF) has shown that not only do people from different backgrounds and origins have unequal access to care, but they also have disparities in health outcomes and in healthcare itself.
Improving delivery of care according to the six aims enunciated by the Institute of Medicine in its “Bridging the Quality Chasm” report means providing care that is safe, effective, patient-centered, timely, efficient, and equitable. As our population becomes more diverse and we experience growing cultural and language challenges, we must strive to make quality improvement itself more culturally and linguistically competent.
This article is the first in a series about the increasing relevance of cultural competence in healthcare in the United States today, and the reasons it has become a strategic and business imperative for all healthcare providers and organizations.
The next article will be centered on a discussion of the provisions of the Patient Protection and Affordable Care Act regarding cultural competence.