Chapter 9 Creating Culturally Competent Health Care Organiz.docx

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.
2
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.
11
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
16

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
17
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.
20
Math 2568, Sec 001 Spring 2020
Homework 3 Due Tuesday, March 3, 2020
Instructions:
• Complete each of the problems to the best of your ability.
Show all work that leads to your final
answer. Any explanations or justifications should be written out

in full sentences and (reasonably)
correct grammar.
• Only submit your final product. Scratch work should be
worked separately and then recopied neatly
onto standard letter-sized paper before submission. Your
assignment should be stapled with your name
clearly labelled on each page. Your work should be legible and
the problems should be in the correct
order. Do not make me hunt for problems or their supporting
work!
Calculator Use:
You may use the ref and rref functions on your calculator to
perform any row reduction. You must write
the original matrix and the resulting echelon form as part of
your work.
Problems:
The following problems are related to the material in Section
Two.I.2.
1. Let W be the subspace of P3 consisting of all third degree
polynomials p(x) such that p(−1)= p(1)=0.
(a) Determine whether f (x)=4+x −4x2 −x3 is in W.
(b) Verify that W contains the the ‘zero vector’ of P3.
(c) Show W is closed under addition and scalar multiplication.
(d) Find a set of third degree polynomials that spans W. That is,
parametrize W.

2. Let V be the subset of R2 given by
V =
{(
x
0
) ∣ ∣ ∣ ∣ x is an even integer
}
Using the standard notion of addition and scalar multiplication
of 2-dimensional vectors:
(a) Show that V is closed under addition.
(b) Show that V is not subspace of R2.
3. (a) Consider the homogeneous linear system represented by
the following augmented matrix:(
1 −3 2 0
0 0 3 0
)
Show that the solution set SH to this system is a subspace of
R3.
Math 2568, Sec 001 Spring 2020
(b) Consider the related nonhomogeneous system:(
1 −3 2 8
0 0 3 1

)
Determine whether the solution set SN of the nonhomogeneous
is a subspace of R3. Explain.
In part (a) you showed that the solution set to the given
homogeneous linear system is a subspace of
R3. In fact, the solution set to any homogeneous system is
always a subspace:
Proposition 1: The solution set of any homogeneous linear
system is a subspace of Rn, where n is the
number of variables in the system.
4. Give an example of each or explain why it it is impossible:
(a) A subspace of M2×3 that contains exactly one vector.
(b) A subspace of R2 that contains exactly two vectors.
(c) A nonempty subset of P1 that is not a subspace of P1.
5. Let S = {A,B,C} be a subset of M2×2 where:
A=
(
4 0
−2 −2
)
B =
(

1 −1
2 3
)
C =
(
0 2
1 4
)
(a) Determine whether each of the following matrices in the
span of S.
i.
(
6 −8
−1 −8
)
ii.
(
0 0
0 0
)
iii.
(
−1 5
7 1
)

(b) Extra Credit: For each matrix in part (a) that is in the span
of S, express the matrix as a linear
combination of A,B, and C.

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Chapter 9 Creating Culturally Competent Health Care Organiz.docx