1. Aligning Cultural Competency
to
Improve Safety, Quality and Equity
An ACHE Qualified Education (Category II) Session – 1.0 Hour CEU
Richelle Webb Dixon, FACHE
Vice President Ambulatory Care
CHI St. Luke’s Health
ACHE-SETC is
Carlos R. Escobar, FACHE
Associate Vice President, Business Operations & Facilities
UTMB Health -Galveston

2. Learning Objectives
 Why cultural competence and patient-centeredness are integral
components in improving health care quality
 Initiatives to eliminate cultural and linguistic barriers between health
care providers and patients
 Recognize the importance in training culturally competent providers
and design culturally competent health care systems
 Emphasis on patients as individuals with unique experiences and
perspectives, rather than as members of ethnic or cultural groups,
thereby minimizing providers to stereotype and make inappropriate
assumptions

3. Session Agenda
I. Defining Cultural Competency
II. Social, Health and Organizational Benefits
III. Key Steps to Cultural Competency
IV. Current State of US Hospitals
V. Leading Practices
VI. Cultural Examples
VII. Summary and Resources

4. Defining Cultural Competency
In health care, cultural competency describes the ability
of systems to provide care to patients with:
 Diverse Values, Beliefs and Behaviors
 Including tailoring care delivery to meet patients’ social, cultural
and linguistic needs
Culturally competent health care systems acknowledge:
 Importance of culture
 Incorporates assessment of cross-cultural relations
 Recognizes potential impact of cultural differences
 Expands cultural knowledge
 Adapts services to meet culturally unique needs
Source: HRET

5. Why Cultural Competency?
 Addressing equity of care remains an imperative for hospitals and health
systems.
 By 2050 working age population will be more than 54% minority – US
Census Bureau
 36% of the population belongs to a racial or ethnic minority
 Limited English Proficiency (LEP) continues to be a significant factor
influencing how a healthcare facilities ensure high standards of care
 The number of patients in the U.S who do not speak English or limited
English has risen in recent decades, presenting a challenge

6. Social Benefits
Social Benefits
– Increases mutual respect and understanding between patient and
organization
– Increases trust
– Inclusion of all community members
– Increases community participation and involvement in health issues
– Assists patient and families in their care
– Promotes patient and family responsibilities for health
Source: “Becoming a Culturally Competent Health Care Organization,” Institute for Diversity in Health Management and the
Health Research & Educational Trust, 2013

7. Health Benefits
Health Benefits
– Improves Patient data collection
– Increases preventive care by patients
– Reduces care disparities in the patient population
– Increases cost savings from a reduction of medical errors, number
of treatments and legal cost
– Reduces the number of missed medical visits
Source: “Becoming a Culturally Competent Health Care Organization,” Institute for Diversity in Health Management and the
Health Research & Educational Trust, 2013

8. Organizational Benefits
Organizational Benefits
– Incorporates different perspectives, ideas and strategies in the
decision-making process
– Decreases barriers that slow progress
– Moves toward meeting legal and regulatory guidelines
– Improves efficient-of-care services
Source: “Becoming a Culturally Competent Health Care Organization,” Institute for Diversity in Health Management and the
Health Research & Educational Trust, 2013

9. Three Key Steps to Cultural Competency
Step One
COMMUNITY SURVEY
The hospital or health care system analyzes demographic data to
determine the composition of the local community and the hospital’s
patient population. With this analysis, the hospital or care system can
conduct micro-targeting surveys to determine the needs for specific
communities.
Source: “Becoming a Culturally Competent Health Care Organization,” Institute for Diversity in Health Management and the
Health Research & Educational Trust, 2013

10. Three Key Steps to Cultural Competency
Step Two
COMMUNITY ENGAGEMENT
The hospital or health care system communicates survey findings to
community members and determines priorities. This information serves
as the basis for staff education.
Source: “Becoming a Culturally Competent Health Care Organization,” Institute for Diversity in Health Management and the
Health Research & Educational Trust, 2013

11. Three Key Steps to Cultural Competency
Step Three
STAFF EDUCATION
Working with community feedback and survey data, the hospital or care
system educates staff on the importance of cultural competence and the
particular cultural needs of patients with whom staff interact each day.
Source: “Becoming a Culturally Competent Health Care Organization,” Institute for Diversity in Health Management and the
Health Research & Educational Trust, 2013

12. Leading Practices
I. CHRISTUS Health – Texas
II. Lutheran Medical Center – New York City
III. Massachusetts General Hospital – Boston

14. Data Collection

15. Data Use

16. When Image does not Match Words
“Hay” for Sale
“Hay” = Spanish language expression for “There is”

17. When Words do not Match the Image
Take by mouth “once” a day vs. Once = 11x in Spanish

18. Initiatives
New
News /Health IT Outcomes – March 26, 2014
Nine year old Girl Dies Due to Language Barrier,
Interpreting Absence at Hospital – Stratus Video
Says Lack of Industry Standardization Creating
Healthcare Hazard
VRI – Video Remote Interpreting

19. Embracing Cultural Competency
 Important step toward reducing health disparities
 Promotes cultural and linguistically appropriate care
 Collection and use of REAL data improves equity of care
 Decreases medical errors, number of treatments and legal
cost
 Improves quality, efficacy and equity of care

20. Equity of Care ~ Call to Action
Hospitals and health systems possess a great opportunity to
affect health care disparities using three core areas:
I. Increasing the collection and use of race, ethnicity and
language preference (REAL) data
II. Increasing cultural competency trainings
III. Increasing diversity in leadership and governance

21. Equity of Care Pledge
https://youtu.be/gLeBhKsEXKs

22. Richelle Webb Dixon, FACHE
Richelle currently serves as the Vice President for Ambulatory Care at Baylor
St. Luke’s Medical Center in Houston, Texas. In this position, Richelle has
responsibility for ambulatory services including the THI Outpatient Clinic, Heart
and Lung Transplant Center, Center for Liver Disease, Kirby Glen Diagnostic
and Treatment Center, Radiation Therapy and Executive Health Program. Prior
to joining CHI St. Luke’s Health, Richelle held several national positions within
Catholic Health Initiatives (CHI) based in Englewood, Colorado. CHI is a
faith‐based healthcare system with 105 hospitals in 19 states.
Richelle is President-Elect for the National Association of Health Services
Executives (NAHSE); she serves on the ACHE -SouthEastTexasChapter Board
and is a Fellow in the American College of Healthcare Executives. Richelle
serves as an examiner with Quality Texas ‐ a foundation that assists
organizations with improving performance based upon the Baldrige performance
excellence criteria. Richelle is also a board member with the Fort Bend YMCA.
Richelle received a Bachelor of Arts in Psychology and a Masters in Health
Services Administration both from the University of Michigan, Ann Arbor.
Richelle Webb Dixon, FACHE
Vice President, Ambulatory Care
CHI St. Luke’s Health
Baylor St. Luke’s Medical Center
rdixon@stlukeshealth.org

23. Carlos R. Escobar, FACHE
Carlos R. Escobar, BED-Arch., M.H.A., FACHE joined UTMB in July 2010. Mr. Escobar came to
UTMB with more than 25 years of experience with the U.S. Department of Veterans Affairs (VA).
He began his career as an architect for the Olin E. Teague Veterans Center in Temple, TX. He
has also held several progressive management positions in VA institutions in Ann Arbor, MI,
Kansas City, MO, St. Louis, MO., as Interim CEO, and Houston, TX as a Chief Operations
Officer. Mr. Escobar's contributions to innovations in federal health services and capital asset
management have been recognized at a national level.
During his tenure at UTMB, he has been directly responsible for Environmental Health and Safety
programs, Institutional Preparedness and Auxiliary Services. In March of 2012, his scope of
responsibilities was expanded to include Supply Chain Operations (Purchasing, Contracting,
Logistics and Accounts Payable) and Mail. He also provides leadership and operational oversight
for all functions of the Business Operations and Facilities group encompassing all aspects of
Capital Assets Management.
Mr. Escobar is a strong advocate of giving back to the community. He is a volunteer with the Boy
Scouts of America, currently serving as an Assistant Scout Master for an area troop. He is an
elected Board Member in the National Board of Directors for the National Forum for Latino
Healthcare Executives (NFLHE) where his goal is to develop a Houston Chapter. He serves on
the Math and Science Advisory Council at St. Thomas University at Houston, and has taught a
one-day healthcare leadership seminar at the UT School of Public Health. He is currently a
Senior Fellow of the American Leadership Forum (ALF), Houston Chapter Medical Class I and
the Senior Executive Program of the American College of Healthcare Executives (ACHE).
Carlos Escobar, FACHE
Associate Vice President,
Business Ops/Facilities
University of Texas Medical
Branch
crescobar@utmb.edu

24. Questions?

25. On Behalf of
Thank you for attending this session
and