ASSURING CULTURAL COMPETENCE IN HEALTH CARE

1
ASSURING CULTURAL COMPETENCE IN HEALTH CARE

• NATIONAL STANDARDS FOR CULTURALLY AND
  LINGUISTICALLY APPROPRIATE SERVICES IN HEALTH
  CARE (CLAS)
• Johnette L. Meadows, PT, MS
• Director
• Department of Minority/International Affairs
• American Physical Therapy Association
• 1-800-999-2782, ext. 3143
• E-mail johnettemeadows_at_apta.org

2
HISTORY

• Office of Minority Health-Department of Health
  and Human Services drafted 14 standards in
  December 1999
• Standards are recommendations with a goal of
  creating a more consistent way of looking at
  expectations for cultural competency across the
  country.

3
DEFINITION OF CULTURAL COMPETENCE

• Cultural and linguistic competence is a set of
  congruent behaviors, attitudes, and policies that
  come together in a system, agency or among
  professionals that enables effective work in
  cross-cultural situations

4
FIVE ELEMENTS OF CULTURAL COMPETENCE

• VALUING DIVERSITY
• CAPACITY FOR CULTURAL SELF-ASSESMENT
• CONSCIOUS OF DYNAMICS INHERENT WHEN CULTURES
  INTERACT

5
FIVE ELEMENTS

• INSTITUTIONALIZED CULTURE KNOWLEDGE
• DEVELOPED ADAPTATIONS TO SERVICE DELIVERY
  REFLECTING AN UNDERSTANDING OF CULTURAL DIVERSITY

6
DEFINITION OF CULTURE

• Culture refers to integrated patterns of human
  behavior that include the language, thoughts,
  communications, actions, customs, beliefs, values
  and institutions of racial ethnic, religious or
  social groups

7
DEFINITION OF COMPETENCE

• Competence implies having the capacity to
  function effectively as an individual and an
  organization within the context of the cultural
  beliefs, behaviors, and needs presented by
  consumers/clients and their communities

8
APTA PARTICIPATION

• Public comment period in winter/spring 2000
• APTAs Advisory Panel on Minority Affairs (now
  the Committee on Cultural Competence) reviewed
  standards and provided comments for final version
  to the Office of Minority Health

9
HEALTH CARE INEQUITIES

• Disparities in health status of persons from
  racial/ethnic minority backgrounds in diseases
  such as
• Cancer
• Diabetes
• Cardiovascular Disease

10
DATA COLLECTION

• Not readily available or limited for persons from
  racial/ethnic minority groups
• Outlined standards recommend that data be
  collected on individual patients race, ethnicity
  and spoken/written language
• Data collection included in APTAs Guide to
  Physical Therapist Practice documentation
  template

11
FINAL VERSION OF STANDARDS

• Published in December 2000
• 14 Standards based on analytical review of key
  laws, regulations and standards currently in use
  by federal and state agencies and other national
  organizations

12
THEMES OF STANDARDS

• Standards 1-3 Culturally Competent Care
• Standards 4-7 Language Access Services
• Standards 8-14 Organizational Supports for
  Cultural Competence

13

• AUDIENCES

14
Educators

• To incorporate cultural and linguistic competence
  into curricula
• To raise awareness about impact of culture and
  language on health care delivery
• Importance of recruitment and retention of
  diverse students
• Continuing education and training of faculty and
  staff

15
Accrediting Agencies

• To asses and compare providers who say they offer
  culturally competent services and education
• To assure quality for diverse populations
• Examples include APTAs Commission on
  Accreditation of Physical Therapy Education
  (CAPTE)

16
STANDARD 2 RECRUITMENT OF DIVERSE STAFF

• Health care organizations should implement
  strategies to recruit, retain, and promote at all
  levels of the organization a diverse staff and
  leadership that are representative of the
  demographic characteristics of the service area

17
STANDARD 3 STAFF TRAINING

• Health care organizations should ensure that
  staff at all levels and across all disciplines
  receive ongoing education and training in
  culturally and linguistically appropriate service
  delivery

18
HEALTH RESOURCES AND SERVICES ADMINISTRATION

• Excellent on-line resources for training
• Providers Guide to Quality and Culture with
  modules on common health problems of different
  racial/ethnic minority groups
• To be found at http//erc.msh.org/qualityculture

19
STANDARD 8 STRATEGIC PLAN

• Health care organizations and education
  institutions should develop, implement and
  promote a written strategic plan that outlines
  clear goals, policies, operational plans, and
  management accountability/oversight mechanisms to
  provide culturally and linguistically appropriate
  services

20
STANDARD 9 EVALUATION

• Health care organizations should conduct initial
  and ongoing organizational self-assessments of
  CLAS related activities and are encouraged to
  integrate cultural and linguistic
  competence-related measures into their internal
  audits, performance improvement programs, patient
  satisfaction assessments and outcomes-based
  evaluations

21
STANDARD 10 DATA COLLECTION

• Health care organizations should ensure that data
  on the individual patients/consumers/clients
  race, ethnicity, and spoken and written language
  are collected in health records, integrated into
  the organizations management information
  systems, and periodically updated.

22
STANDARD 14 PROGRESS

• Health care organizations are encouraged to
  regularly make available to the public
  information about their progress and successful
  innovations in implementing the CLAS standards
  and to provide public notice in their communities
  about the availability of this information

23
RESOURCES

• APTA WEB PAGE WWW.APTA.ORG
• APTA DEPARTMENT OF MINORITY/INTERNATIONAL AFFAIRS
• US DEPARTMENT OF HEALTH AND HUMAN SERVICES
  OFFICE OF MINORITY HEALTH WWW.OMHRC.GOV

24
RESOURCES

• NATIONAL CENTER FOR CULTURAL COMPETENCE
• GEORGETOWN UNIVERSITY CHILD DEVELOPMENT CENTER
• 3307 M STREET NW, SUITE 401
• WASHINGTON, DC 20007-3935
• PHONE [phone] OR 202/687-5387
• E-MAIL CULTURAL _at_GUNET.GEORGETOWN.EDU

25
RESOURCES

• CULTURAL COMPETENCE COMPENDIUM
• (ORDER NUMBER OP209199)
• AMERICAN MEDICAL ASSOCIATION
• 515 NORTH STATE STREET
• CHICAGO, IL 60610
• PHONE [phone]
• INTERNET WWW.AMA-ASSN.ORG/CATALOG

26
CULTURALLY COMPETENT HEALTH CARE STANDARDS

• PUBLISHED BY THE OFFICE OF MINORITY
  HEALTH-CULTURALLY AND LINGUISTICALLY APPROPRIATE
  SERVICES IN HEALTH CARE CAN BE FOUND AT
  WWW.OMHRC/GOV/CLAS/FINALCULTURAL1A