Chapter 9 Creating Culturally Competent Health Care Organiz

Chapter 9:
Creating Culturally Competent Health Care Organizations
Copyright © 2016 Wolters Kluwer Health | Lippincott Williams
& Wilkins
Copyright © 2016 Wolters Kluwer • All Rights Reserved
1
Defining a Culturally Competent Health Care Organization #1
A culturally competent organization is an organization that
provides services that are respectful of and responsive to the
cultural and linguistic needs of the clients they serve.
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Defining a Culturally Competent Health Care Organization #2
Cultural competence includes providing respectful care that is
consistent with cultural health beliefs of the clients and family
members, with consideration of:
Age, culture, ethnicity, gender, language, race, religion, sexual
preference, and socioeconomic status

3
Question #1
Is the following statement true or false?
To be culturally competent, an organization should provide
respectful care that is consistent with cultural health beliefs of
the clients, family members, and staff.
4
Answer to Question #1
True
Rationale: Humans need care to survive, thrive, and grow.
According to Leininger (1996), organizations need to
incorporate universal care constructs, including respect and
genuine concern for clients and staff.

5
The Need for Culturally Competent Organizations: External
Motivations
The need for culturally competent organizations has been
recognized by many external agencies, including:
Transcultural Nursing Society (TCNS)
American Nurses Association (ANA)
Sigma Theta Tau International (STTI)
American Organization of Nurse Executives (AONE)
The Joint Commission
The Institute of Medicine (IOM)
National Standards for Culturally and Linguistically
Appropriate Services in Health Care (CLAS Standards)
6
The Need for Culturally Competent Organizations: Eliminating
Health Disparities #1
Racial and ethnic disparities influence unequal health care
treatment.
Disparities in health are “differences in the incidence,
prevalence, mortality, and burden of diseases and other adverse
health conditions that exist among specific population groups in
the United States” (National Institutes of Health, 2010).

7
The Need for Culturally Competent Organizations: Eliminating
Health Disparities #2
Key factors in achieving good health outcomes include:
Access (getting into the health care system)
Quality care (receiving appropriate, safe, and effective
health care in a timely manner)
8
Question #2
Which of the following would support Access and Quality of
Care issues in eliminating health disparities?
Universal health care
Organizational culture
Joining TCNS
External auditing of health care organizations (e.g., Joint
Commission)
B. Organizational culture
Rationale: Organizational culture is one area that may

influence both cultural competence and health disparities.
Individuals must deliver culturally competent health care that
focuses on risk reduction, vulnerability reduction, and
promotion and protection of human rights.
10
Assessing Organizational Culture #1
Organizational culture: the goals, norms, values, and practices
of an organization in which people have goals and try to achieve
them in beneficial ways.
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An organization’s culture:
Consists of shared beliefs, assumptions, perceptions, and norms
leading to specific patterns of behaviors
Results from an interaction among many variables including
mission, strategy, structure, leadership, and human resource
practices
Is self-reinforcing; once in place, it provides stability and
changes are resisted by organizational members

12
An inclusive workplace is characteristic of a caring
organization.
Inclusive workplaces:
Encourage members of the workforce to become active in the
community and participate in state and federal programs
Draws staff members who are committed to cultural
competence and who value diversity and mutual respect for
differences
13
Assessment tools:
The Magnet Hospital Recognition Program for Excellence in
Nursing Services
Evidence-based practice
Leininger’s culture care model
Andrews’ assessment tool

14
Building Culturally Competent Organizations #1
Specific areas are critical to fostering culturally competent
health care organizations:
Governance and administration
Board members, mission/vision/values, budget
Internal evaluation of adherence to cultural competence
standards
Availability, accessibility, affordability, acceptability, and
appropriateness
15
Fostering culturally competent health care organizations :
Staff competence
Organizational support, orientation, and ongoing education
Physical environment of care
Assessment of environment and barriers
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Fostering culturally competent health care organizations (cont.):
Linguistic competence
Complete, accurate, timely, unambiguous, and understood by
the patient
Community involvement
Partnerships
Culturally congruent services and programs
Implement effective programs
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Question #3
Is the following statement true or false?
Building culturally competent organizations may result in
increased patient satisfaction rates.
18
True
Rationale: Research found that inpatients reported higher
satisfaction with hospitals that had greater cultural competency.

19
Overcoming the Barrier of Institutional Racism in Health Care
Institutional racism is defined as differential access to goods,
services, and opportunities based on race, including differential
access to health insurance.
More often done unintentionally.
Cultural differences must be acknowledged and celebrated.
The strategies outlined build culturally competent health care
organizations.
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