Although we may all agree diversity is a positive thing for our society, it’s no secret that it presents some unique challenges too, especially for providers of health care services.  This is why culturally competent healthcare has become so important these days. The USA is a melting pot of cultures, and people from all over the world are now seeking a new life in America, both temporarily and permanently. This has raised a number of issues for those working within the medical profession, since their jobs rely on them relating to their patients on a personal level, and this is something that can be difficult when there are cultural differences.

In both urban and rural areas, doctors, nurses and others working in healthcare encounter those from different cultural backgrounds and ethnicities these days. Culturally competent health care, in basic terms, means having understanding, acceptance, compassion and sensitivity for patients with different behaviors, beliefs and values.

An Overview Of Cultural Competent Health Care

When healthcare providers are culturally competent, they are able to meet all the linguistic, social and cultural needs of their patients regardless of where in the world they come from. Cultural competence is something that is absolutely vital when it comes to effectively delivering high-quality healthcare, and without it, there will inevitably be poor patient outcomes and a lack of patient satisfaction, as well as frustration both for healthcare workers and patients alike.

Cultural competence is often defined as an organization or provider’s ability to deliver effective healthcare services that are able to meet the linguistic, cultural and social needs of their patients. This includes:

• Having defined principles and values that work alongside policies, attitudes and behaviors that work towards effective interactions across different cultures.
• Having the capacity to manage differences, value diversity, disseminate and acquire cultural knowledge, to use self-assessments, and to adapt to diversity in dynamic cultural contexts.
• Integrating and institutionalizing all the above factors into the organization’s practices and policy-making procedure.

The Major Components Of Cultural Competence

Being culturally competent involves four key components:

Awareness – it’s vital to examine beliefs and values relating to diversity to recognize deep-seated stereotypes and prejudices that may create barriers to personal development and learning. Many people have blind spots in terms of values and beliefs, and educational diversity may be useful when it comes to uncovering those blind spots.

Attitude – beliefs and values impact on cross-cultural effectiveness since they convey how open we are to differing opinions and views. The more strongly we feel about values and beliefs, the more we’re likely to have an emotional reaction when we collide with a cultural difference.

Knowledge – the more we know about those who are from different cultures, the more we’re likely to be able to avoid making mistakes when dealing with people from other cultures. Understanding the way that culture can impact on managing people, problem solving, and asking for assistance helps us to connect with others when interacting cross-culturally.

Skills – it’s possible to have good self-awareness, a positive attitude, and plenty of knowledge about cultural different, and yet still struggle to manage those differences effectively. If we’ve had limited chance to practice those skills or haven’t had the chance to learn them in the first place, our awareness and knowledge are insufficient to manage and avoid cross-cultural issues.

Race, Ethnicity, Identity, Heritage, Culture And Nationality

To understand what culturally competent health care is, it’s important to know the differences between various terms – nationality, race, ethnicity, heritage, identity and culture.

• Ethnicity – sometimes confused with the term “race”, the word “ethnicity” means learning customs and behavior. It embraces all the traditions that come from being from a specific geographic region.
• Race – the definition of “race” has caused a lot of controversy and disagreement over the last few years. Sometimes, it’s used to describe the biological features of an individual such as their skin tone and color, their hair and eye color, and even their tendency to develop certain diseases. Generally, race is thought to be something which cannot be altered fundamentally.
• Nationality – usually, the term “nationality” means the country that someone comes from however, that doesn’t always mean that the individual identifies with the place where they were born. For example, someone born in one country but who moved to another part of the world as a young child often considers themselves to have the nationality of the country to which they moved since they may speak that local language fluently and associate themselves most closely with the culture of that place.
• Heritage – usually, “heritage” is a reference to the beliefs and traditions of a specific group. Often, this will be based on nationality, however, in a similar way to ethnicity, an individual may not identify necessarily with the heritage of their family.
• Identity – in simple terms, the identity of a person is what they specifically identify with, in terms of their culture, religion and country.
• Culture – this is the key term when it comes to discussing being culturally competent. The definition of “culture” may vary in some ways, however, in general, culture is thought of as encompassing the learning beliefs of a person, their behaviors and thoughts, their customs, traditions and values, their way of communicating, their views about relationships, and the ways in which they interact with other people. Many things shape culture, including their race, nationality, ethnicity, socioeconomic status, heritage, education, and some other factors. When put together, these influences can be described as sociocultural factors. They all have an influence on the way the individual interacts with other people and the world around them. Culturally competent healthcare professionals and providers have to bear in mind and take account of these different aspects of the individual in order to be truly culturally competent.

Why Does Culturally Competent Healthcare Matter?

When healthcare organizations and providers are culturally competent they are able to meet all the linguistic, social and cultural needs of patients. Lying at the heart of cultural competence is respect. When patients feel that their healthcare provider respects their customs, beliefs, values, traditions and language, they feel more able to honestly and freely communicate and this, in turn, reduces disparities in health care and improves outcomes for the patient in question.

Unfortunately, data shows that disparities in health care and patient dissatisfaction are much more common among racial minorities. An AHRQ report has revealed that Hispanics, Asians and African Americans all receive worse care and all have worse access when it comes to receiving care when compared to non-Hispanic white people. In the same report, it was highlighted that language barriers represented a major factor when it came to disparities in healthcare. It was also pointed out that minority groups were more likely to feel their doctor didn’t understand or respect their beliefs or values, and they were more likely to feel their doctor was looking down on them rather than seeing them as an equal.

Those findings have sent a very clear message that cultural sensitivity is absolutely vital in the healthcare system and that culturally sensitive practices should be employed by healthcare workers in order to ensure that all patients, regardless of their nationality, ethnicity or culture receive the best possible care.

The Benefits Of Culturally Competent Healthcare

Culturally competent healthcare offers numerous benefits for healthcare organizations and professionals. The social benefits are many and include more mutual respect between patients and healthcare workers, more trust, and greater patient empowerment and responsibility for their own healthcare needs.

If patients feel understood and listened to by healthcare providers, they have been shown to be more able to participate in preventative healthcare. They are less likely to miss their appointments, and this, in turn, reduces the chance of medical errors occurring with improved health outcomes for the patient.

What Barriers Exist To Culturally Competent Healthcare?

A lack of healthcare workforce diversity is one of the biggest barriers to culturally competent healthcare, and this contributes to ethnic and racial disparity of care. The other barriers include poorly designed systems of care that don’t meet the needs of every patient population, and a lack of communication between patients and providers of different ethnic, cultural and racial backgrounds.

How Can Culturally Competent Health Care Be Achieved?

There are several steps that can be taken to achieve culturally competent healthcare. These include:

• Hiring and promoting ethnic minority health care workers.
• Establishing and strengthening programs that are aimed at developing minority leadership in healthcare settings.
• Developing a strong system for patient and community feedback through which individuals are able to express their concerns about their treatment and care.
• Gathering more information about the preferences of patients about their language and ensuring that patients can access interpreters or workers who can speak their preferred languages.
• Providing patients with forms and health education material in their home language.
  Establishing a program for interpreter services in health care facilities in which there are patients who struggle to speak English.
• Instituting a program which detects and identifies any medical errors that have occurred as a result of communication disparities and language barriers.
• Monitoring ethnic and racial disparities using data and instituting initiatives to improve wherever required.
• Collecting data about ethnicity, race and language preferences to patient needs can be better understood and care improved.
• Healthcare workers need to be better informed about the various cultural factors that influence individuals’ health behaviors and beliefs. They also need to be supplied with the tools and materials they need to serve multicultural patient communities. This may be achieved with patient interactions, roleplay, case study reviews, training and educational videos. Staff must also be assessed periodically and their success rates tracked from satisfaction scores supplied by patients.

If healthcare professionals at every level have the necessary training and tools they need to develop cultural competence, patients are more satisfied and better outcomes can be achieved.

What Are The Indicators Of A Culturally Competent Healthcare Organization?

When a healthcare organization focuses on being culturally competent, it’s possible to find ways of closing competency gaps and allowing people to work productively together. When organizations are culturally competent, they enable people to function effectively. Culturally competent organizations have the following features:

• A culturally diverse workforce that reflects the community that it serves.
• Training provided for workers about the language and culture of the people that they serve.
• Instructional literature and signage in the language most often used by patients and presented in a way that is consistent with the cultural norms that they are used to.
• Inclusive procedures and policies.
• Affinity groups.
• Fairness in promotion and retention.
• Translators or providers speaking the patients’ languages.
• Cross-cultural skills.
• The capability to recover from cultural collisions.
• More inclusive decision-making processes.
• More knowledge about differences between cultures.
• Skills in diversity management.
• Inclusive values and beliefs.
• Awareness of stereotypes and personal biases.
• Commitment to diversity from the leadership.

If healthcare providers have all of these features in place, they can be said to be culturally competent and, thus, to offer the best possible level of care to patients regardless of their ethnicity, nationality, language or background.

Culturally Competent Healthcare Settings And Their Importance In Better Patient Care

Unfortunately, people who come from other cultures and who now live in the USA often find that they are unable to fully access the healthcare system in the same way as those who are culturally American. This raises a host of issues when it comes not only to patient satisfaction but also to the outcomes that they can achieve when they are unwell and suffering.

It couldn’t be more important for healthcare professionals and the organizations that they work in to focus on becoming more culturally competent so that every patient that they serve can enjoy the same level of patient care and the same excellent outcomes that they could expect if they were not from a diverse cultural background. Luckily, the importance of cultural competence is becoming better recognized within the healthcare profession today and more organizations are now taking steps to address this need within their workforce and settings.