CUltural COmpetencE in Healthcare...
"...describes the ability of systems to provide care to patients with diverse values, beliefs and behaviors, including tailoring delivery to meet patients’ social, cultural, and linguistic needs."
(http://www.commonwealthfund.org/usr_doc/betancourt_culturalcompetence_576.pdf)
I found the information above and below in a field study done on the subject of cultural competency in healthcare back in 2002. In it I found the barriers to cultural competence in healthcare that were discussed in introduction to this study very comparable to those we saw come to light as barriers in The Spirit Catches You and You Fall Down by Anne Fadiman. They are:
- Lack of diversity in health care’s leadership and workforce.
- Systems of care poorly designed to meet the needs of diverse patient populations.
- Poor communication between providers and patients of different racial, ethnic, or cultural backgrounds.
(http://www.commonwealthfund.org/usr_doc/betancourt_culturalcompetence_576.pdf)
Do all of those sound very familar? They should given that, in my opinion, these were the critical factors in all of the misunderstandings and fatal decisions made by Lia's parents and her medical team. For example, as far as we know, all or most of the medical professionals taking care of Lia are assumed to have been of caucasian descent. Would it have made a difference, in her outcome, if that had been different? If there had been an interpreter available during her first visit to the emergency department at MCMC, would Lia be alive today?
It seems to me that it is and was the lack of cultural competence, by both the family and Lia's medical team, that played the critical role in the fate of Lia. It also seems that the level of cultural competence that was needed in this case came at a time when the idea of cultural competence was in its beginning stages.
This study also gave some insight on how medical professionals can attain "clinical cultural competence" :
"(1) be made aware of the impact of social and cultural factors on health beliefs and behaviors
(2) be equipped with the tools and skills to manage these factors appropriately through training and education
(3) empower their patients to be more of an active partner in the medical encounter."
(http://www.commonwealthfund.org/usr_doc/betancourt_culturalcompetence_576.pdf)
"Organizations can do this through:
• cross-cultural training as a required, integrated component of the training and professional development of health care providers;
• quality improvement efforts that include culturally and linguistically appropriate patient survey methods and the development of process and outcome measures that reflect the needs of multicultural and minority populations.
• programs to educate patients on how to navigate the health care system and become an active participant in their care."
(http://www.commonwealthfund.org/usr_doc/betancourt_culturalcompetence_576.pdf)
As noted above, this study was published in 1992. In the 20+ years since its publication, do you think the organizations that we all work in have implemented the recomendations above?
References:
Betancourt, J & Green, A. (1992). Cultural competence in healthcare: emerging frameworks and practical approaches.
Retrieved from: http://www.commonwealthfund.org/usr_doc/betancourt_culturalcompetence_576.pdf
(http://www.commonwealthfund.org/usr_doc/betancourt_culturalcompetence_576.pdf)
I found the information above and below in a field study done on the subject of cultural competency in healthcare back in 2002. In it I found the barriers to cultural competence in healthcare that were discussed in introduction to this study very comparable to those we saw come to light as barriers in The Spirit Catches You and You Fall Down by Anne Fadiman. They are:
- Lack of diversity in health care’s leadership and workforce.
- Systems of care poorly designed to meet the needs of diverse patient populations.
- Poor communication between providers and patients of different racial, ethnic, or cultural backgrounds.
(http://www.commonwealthfund.org/usr_doc/betancourt_culturalcompetence_576.pdf)
Do all of those sound very familar? They should given that, in my opinion, these were the critical factors in all of the misunderstandings and fatal decisions made by Lia's parents and her medical team. For example, as far as we know, all or most of the medical professionals taking care of Lia are assumed to have been of caucasian descent. Would it have made a difference, in her outcome, if that had been different? If there had been an interpreter available during her first visit to the emergency department at MCMC, would Lia be alive today?
It seems to me that it is and was the lack of cultural competence, by both the family and Lia's medical team, that played the critical role in the fate of Lia. It also seems that the level of cultural competence that was needed in this case came at a time when the idea of cultural competence was in its beginning stages.
This study also gave some insight on how medical professionals can attain "clinical cultural competence" :
"(1) be made aware of the impact of social and cultural factors on health beliefs and behaviors
(2) be equipped with the tools and skills to manage these factors appropriately through training and education
(3) empower their patients to be more of an active partner in the medical encounter."
(http://www.commonwealthfund.org/usr_doc/betancourt_culturalcompetence_576.pdf)
"Organizations can do this through:
• cross-cultural training as a required, integrated component of the training and professional development of health care providers;
• quality improvement efforts that include culturally and linguistically appropriate patient survey methods and the development of process and outcome measures that reflect the needs of multicultural and minority populations.
• programs to educate patients on how to navigate the health care system and become an active participant in their care."
(http://www.commonwealthfund.org/usr_doc/betancourt_culturalcompetence_576.pdf)
As noted above, this study was published in 1992. In the 20+ years since its publication, do you think the organizations that we all work in have implemented the recomendations above?
References:
Betancourt, J & Green, A. (1992). Cultural competence in healthcare: emerging frameworks and practical approaches.
Retrieved from: http://www.commonwealthfund.org/usr_doc/betancourt_culturalcompetence_576.pdf