Creating Culturally Competent Health Care Organizations

Chapter 9: Creating Culturally Competent Health Care Organizations

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Defining a Culturally Competent Health Care Organization #1

A culturally competent organization is an organization that provides services that are respectful of and responsive to the cultural and linguistic needs of the clients they serve.

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Defining a Culturally Competent Health Care Organization #2

Cultural competence includes providing respectful care that is consistent with cultural health beliefs of the clients and family members, with consideration of:

Age, culture, ethnicity, gender, language, race, religion, sexual preference, and socioeconomic status

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Question #1

Is the following statement true or false?

To be culturally competent, an organization should provide respectful care that is consistent with cultural health beliefs of the clients, family members, and staff.

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Answer to Question #1

True

Rationale: Humans need care to survive, thrive, and grow. According to Leininger (1996), organizations need to incorporate universal care constructs, including respect and genuine concern for clients and staff.

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The Need for Culturally Competent Organizations: External Motivations

The need for culturally competent organizations has been recognized by many external agencies, including:

Transcultural Nursing Society (TCNS)

American Nurses Association (ANA)

Sigma Theta Tau International (STTI)

American Organization of Nurse Executives (AONE)

The Joint Commission

The Institute of Medicine (IOM)

National Standards for Culturally and Linguistically Appropriate Services in Health Care (CLAS Standards)

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The Need for Culturally Competent Organizations: Eliminating Health Disparities #1

Racial and ethnic disparities influence unequal health care treatment.

Disparities in health are “differences in the incidence, prevalence, mortality, and burden of diseases and other adverse health conditions that exist among specific population groups in the United States” (National Institutes of Health, 2010).

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The Need for Culturally Competent Organizations: Eliminating Health Disparities #2

Key factors in achieving good health outcomes include:

Access (getting into the health care system)

Quality care (receiving appropriate, safe, and effective health care in a timely manner)

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Question #2

Which of the following would support Access and Quality of Care issues in eliminating health disparities?

Universal health care

Organizational culture

Joining TCNS

External auditing of health care organizations (e.g., Joint Commission)

Answer to Question #2

B. Organizational culture

Rationale: Organizational culture is one area that may influence both cultural competence and health disparities. Individuals must deliver culturally competent health care that focuses on risk reduction, vulnerability reduction, and promotion and protection of human rights.

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Assessing Organizational Culture #1

Organizational culture: the goals, norms, values, and practices of an organization in which people have goals and try to achieve them in beneficial ways.

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Assessing Organizational Culture #2

An organization’s culture:

Consists of shared beliefs, assumptions, perceptions, and norms leading to specific patterns of behaviors

Results from an interaction among many variables including mission, strategy, structure, leadership, and human resource practices

Is self-reinforcing; once in place, it provides stability and changes are resisted by organizational members

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Assessing Organizational Culture #3

An inclusive workplace is characteristic of a caring organization.

Inclusive workplaces:

Encourage members of the workforce to become active in the community and participate in state and federal programs

Draws staff members who are committed to cultural competence and who value diversity and mutual respect for differences

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Assessing Organizational Culture #4

Assessment tools:

The Magnet Hospital Recognition Program for Excellence in Nursing Services

Evidence-based practice

Leininger’s culture care model

Andrews’ assessment tool

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Building Culturally Competent Organizations #1

Specific areas are critical to fostering culturally competent health care organizations:

Governance and administration

Board members, mission/vision/values, budget

Internal evaluation of adherence to cultural competence standards

Availability, accessibility, affordability, acceptability, and appropriateness

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Building Culturally Competent Organizations #2

Fostering culturally competent health care organizations :

Staff competence

Organizational support, orientation, and ongoing education

Physical environment of care

Assessment of environment and barriers

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Building Culturally Competent Organizations #3

Fostering culturally competent health care organizations (cont.):

Linguistic competence

Complete, accurate, timely, unambiguous, and understood by the patient

Community involvement

Partnerships

Culturally congruent services and programs

Implement effective programs

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Question #3

Is the following statement true or false?

Building culturally competent organizations may result in increased patient satisfaction rates.

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Answer to Question #3

True

Rationale: Research found that inpatients reported higher satisfaction with hospitals that had greater cultural competency.

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Overcoming the Barrier of Institutional Racism in Health Care

Institutional racism is defined as differential access to goods, services, and opportunities based on race, including differential access to health insurance.

More often done unintentionally.

Cultural differences must be acknowledged and celebrated.

The strategies outlined build culturally competent health care organizations.

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