Cultural Competency Training and Performance Measures to Reduce Racial Disparities in Health Care Quality

The regulation of health care services has a range of goals. Improving the safety and quality of healthcare is one of them. However, there is a lack of good quality evidence about what members of the Australian community believe and expect in relation to the regulation of healthcare safety. To elicit the Australian public’s voice on issues related to the governance of health care quality and safety, we developed a survey instrument that reflected core elements of Australian approach to regulating health care safety and quality. This Policy Brief describes the results of the survey, highlighting the important areas of similarity and difference between the views of the community and existing regulatory frameworks. In summary, the general public expect a graduated approach to stakeholder responsibility, monitoring and regulatory responses to failures in the quality and safety of healthcare. However, Reliance on decentralised accreditation-centric quality improvement mechanisms is not sufficient. The community expects more centralised oversight, including strict norm-referenced monitoring and performance testing – including in-person ‘spot inspections’, rather than reliance on self-monitoring and reporting.

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Equitable training equals equitable care: Cultural competency training of healthcare providers for sexual minorities

10.35831/sor/schr/mm2019 ◽

2019 ◽

Author(s):

Michele Montecalvo

Keyword(s):

Health Care ◽

Cultural Competence ◽

Cultural Competency ◽

Sexual Minorities ◽

Healthcare Providers ◽

Stage Of Change ◽

Culturally Competent ◽

Competency Training ◽

Cultural Competency Training ◽

Competence Training

Abstract Introduction: The hierarchy of the American medical system and it’s disconnect of recognition beyond the binary of sexual minorities has created systematic inequitable care because of lack of appropriate cultural competency training. Healthcare providers are not adequately taught appropriate cultural competencies in standardized academic training. Methods: Given an online survey of varied health care providers (N = 208), the research examined “culturally competent health care delivery” knowledge, stage of change; precontemplation, contemplation, preparation, action, maintenance; as per the work of Prochaska & DiClemente, (1983) for taking action to be culturally sensitive, culturally competent, culturally appropriate, and future training desirability. Results: The sample population reported a high self-rating for aligning with definition of cultural competency; prevalence of 6 to 10 hours of engagement in cultural competence training; rating 3.97 (SD = .741) of quality for cultural competence training; Pre-Survey Stage of Change (N = 208) mean was 4.32 between action and maintenance, but closest to action (SD = 1.21); and with 71.2% already in maintenance it is noted that the research captured providers who have received equitable training, offering equitable care. Conclusions: Affirmation for LGBT clients is a critical adaptive response for practitioners recognizing the overt social injustices that have occurred historically as personal injustices and responding in a positive and accepting manner can dramatically improve patient engagement. Training within the confines of a grounded evidenced based theory can support appropriate and culturally competent equitable care. Keywords: healthcare providers, cultural competency, lesbian, gay, bisexual, transgender (LGBT), stages of change, transtheoretical model

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Are We Ready? A Case for Making Hematology Fellows Competent in Treating the Booming Culturally Diverse Minority Populations.

Blood ◽

10.1182/blood.v106.11.5586.5586 ◽

2005 ◽

Vol 106 (11) ◽

pp. 5586-5586

Author(s):

Uzma Iqbal

Keyword(s):

Health Care ◽

Cultural Competency ◽

Culturally Diverse ◽

Linguistic Diversity ◽

Training Programs ◽

Core Competencies ◽

National Level ◽

National Standards ◽

Competency Training ◽

Cultural Competency Training

Abstract United States is at an important phase of its growth since the dawn of the new century. US population has grown by 13% from 248 million to 281 million between 1990–2000. Projected increase in population by mid century will be 460 million. According to 2000 census, 11% of US population is foreign born and 17.9% speaks a language other than English at home. Population demographics indicate very significant trend changes. The projected race and ethnic changes are occurring sooner because of higher than expected increase in immigration rates. By 2050 the minorities will make about 50% of US population. Ethnically and culturally diverse minorities are projected to grow exponentially. Asians are expected to grow by 213% to 60 million, while Hispanics will increase in their ranks by 188% to 102.6 million i.e. roughly one quarter of the population. The black population will see a 71% increase to 61 million while Whites will grow by 7% to 210 million. These trends indicate that Asian and Hispanic populations will triple in number by mid century. This poses special challenges to the health care industry and physicians in particular. The Hematologists will be diagnosing and treating a much larger number of the diseases common in these ethnic groups e.g. Sickle cell disease, hemoglobinopathies including Thalassemias and thrombotic and hypercoaguable disorders etc. interaction with these ethnically and culturally diverse clients will be challenging for the Hematology fellows since no formal training in cultural competency training is incorporated in fellowship program structure. Review of the curricula of the training programs has revealed most of these are deficient in this regards. Some awareness of the issue is found in nursing training literature. There is awareness regarding the cultural competency issue at a national level where Health and Human Services have issued national standards for culturally and linguistically appropriate services in health care (CLAS). This initiative can be used as a road map for providing cultural competency training to Hematology fellows. This will enable them to appreciate, think and act in ways that acknowledge, respect and build upon ethnic, socio cultural and linguistic diversity. Fellows can be trained and evaluated during their training in core competencies such as self-awareness, effective communication, cultural knowledge, humility and proper use of interpreters. In conclusion I emphasize that I order to deliver quality health care to ethnically diverse populations and to decrease disparities in health care, cultural competency should be an integral part of Hematology training programs.

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