Cultural Competence in Healthcare: Why it Matters to Reduce Health Disparities

The United States of America has been a kaleidoscope of cultures for hundreds of years. In urban areas it is not unusual for a doctor to have a diverse patient lineup–seeing a patient in the morning who recently emigrated from the Philippines, a multi-generational family of Indian descent later in the afternoon and a tourist from China in the evening might be a typical day for some in the healthcare profession. Even doctors and nurses who work in rural areas will inevitably encounter people of various ethnicities and cultural backgrounds in their careers, especially as the U.S. countryside continues to become more ethnically and racially diverse.

Sensitivity, compassion, understanding and acceptance of patients and colleagues with different values, beliefs and behaviors are essential qualities for those who work in the medical arena.

Cultural competence is the ability of healthcare providers and organizations to meet the cultural, social and linguistic needs of their patients. Below, you will find why cultural competence is so important for the effective delivery of quality healthcare, and we’ll look at how a lack of cultural competence can lead to poor patient satisfaction and outcomes and frustration for both patients and healthcare workers. It is also important for healthcare facilities to attain cultural competence through in-house training and education for nurses, doctors and other healthcare workers.

Benefits of Cultural Competence

Cultural competence provides many benefits for healthcare professionals and healthcare organizations. Social benefits include increased mutual respect between healthcare workers and patients, increased trust and promotion of patient responsibility and empowerment in their own healthcare. When patients feel heard and understood by their healthcare providers, they are more likely to participate in preventive care and less likely to miss appointments. This can reduce medical errors and related legal costs for healthcare facilities, and it can improve health outcomes for patients. In addition, challenges with communication and respect can be enhanced between APP’s and other providers. Ultimately, a culturally competent organization can help reduce health disparities among patient populations–still a persistent problem today. It is important to recognize cultural competence is a journey and not a destination.

Steps to Achieving Cultural Competence

Maximizing diversity is the key to achieving organizational cultural competence. Organizations should:

• Hire and promote minority population healthcare workers.
• Establish or strengthen existing internal programs aimed at minority population leadership development.
• Develop a system for gathering community and patient feedback where individuals can express concerns about their care and treatment.
• Collect data on race/ethnicity and language/access preferences to better understand and meet patient needs as well as improve care.
• Provide patients with health education materials and forms in different languages and modes of access.
• Establish an interpreter services program in healthcare facilities where there are significant patient populations with limited proficiency in English.
• Institute a program that detects medical errors resulting from language barriers and other communication disparities.
• Monitor racial, ethnic and other disparities using data, and institute quality improvement initiatives where needed.

Healthcare workers must be informed about the cultural and lived-experience factors that influence people’s health beliefs and behaviors, and they must be provided with the tools they need to serve a multi-cultural patient community. This can be achieved through training, case study reviews, live interactions with patients, role-playing and continuing education opportunities. Staff should be periodically assessed based on established standards with success rates tracked against patient satisfaction scores and healthcare disparities data.

When healthcare workers at all levels of care are given the tools and training they need to become culturally competent, improved patient satisfaction and outcomes are the inevitable result.

Steps to Achieving Cultural Competence

The following organizations have recognized the importance of this journey to competence:

• The Accreditation Council for Graduate Medical Education (ACGME) has recognized cultural competency as a part of three out of six core competencies (patient care, interpersonal and communication skills and professionalism) that residency training programs are to provide training in.
• The Association of American Medical Colleges (AAMC) has developed the Tool for Assessing Cultural Competence Training (TACCT) to assist schools in developing and evaluating cultural competence curricula to meet these requirements.
• The Institute of Medicine’s (IOM) publication Unequal Treatment: Confronting Racial and Ethnic Disparities in Healthcare documented that biases, prejudices and stereotypes by healthcare providers result in lower quality healthcare provided to racial and ethnic minority groups.
• The Liaison Committee on Medical Education (LCME), the accrediting body for US medical schools requires that medical students demonstrate a standard level of cultural competence upon graduation.
• US Department of Health and Human Services, Substance Abuse and Mental Health Services Administration (SAMSHA), has published 14 National Standards for Culturally and Linguistically Appropriate Services (CLAS) in Health and Health Care. Four of the standards are mandatory for organizations that receive federal funds.

We Can Help

VITAL WorkLife is here to support you and your healthcare organization on your journey to cultural competence in service of improved patient satisfaction and a reduction in health disparities. To explore Cultural Competency offerings for your organization, contact us at 952.230.5109, 877.731.3949 (toll free) or contact us online.