Three Change Concepts and potential strategies for Culturally Competent Care:

1. Assess organizational and individual understanding of culturally and linguistically effective care and implement appropriate strategies making and sustaining improvements.

• Cultural competence is part of job descriptions.
• Use a standardized tool for annual organizational assessment of cultural competency (including signs, materials, trainings, staff diversity, etc).
• Collect, analyze, and report patient population data by race, ethnicity, and language.
• Analyze all quality and patient safety indicators by race, ethnicity, and language to identify areas of disparities in care.
• Integrate cultural competency related measures into internal audits, performance improvement, and error reduction programs. (e.g., use of interpreters).
• Use varied methods (e.g. online, self-paced, in-person training) to educate providers and staff about culturally competent care, and evaluate the training outcomes.
• Educate providers and staff about how to elicit and document families’ cultural beliefs and practices.
• Identify bi- and multi-lingual staff and train them to be interpreters.
• Train providers in the use of trained and untrained interpreters.
• Provide training in CLAS standards, Limited English Proficiency
• (LEP) guidelines, Title VI, and general culturally competent care strategies to all staff and providers.
• Include information about culturally proficient care in employee orientation programs.

2. Demonstrate organizational and leadership commitment and support for culturally and linguistically effective care.

• Educate organizational leaders about why culturally competent care is essential to high quality care.
• Adopt written policies and procedures that support culturally and linguistically competent care.
• State organizational intent with regards to cultural competency in strategic plan and policy and mission statements.
• Have organizational leaders develop/review, revise, and recommit to organization’s mission in the area of culturally effective care; develop specific goals to support mission.
• Establish a budget line and a reporting system within the institution for all cultural competency related activities including interpreter services and staff/provider training.
• Provide and adequately fund interpreter services.
• Implement a system to link bi- or multi-lingual staff with LEP patients.
• Visibly and accessibly provide information about patients’ right to receive language assistance in multi-lingual signage throughout the system.
• Visibly and accessibly list local options for interpretation (e.g., telephone interpreters, in person interpreters, etc.).
• Identify cultural/linguistic barriers to care in order to help patients navigate the healthcare system.
• Identify pertinent demographic information that will assure referral settings are knowledgeable of specific patient needs (e.g., preferred language, need for interpreter).
• Use a “navigator” program for new immigrants.
• Integrate cultural competency into all discussions of patient care and operations at staff meetings, presentations, and other core activities.
• Business and service decisions should consider identified disparities and understanding of the population served.
• Remain transparent when dealing with any errors and barriers to quality care in areas where disparities have been identified.
• Implement a system (that includes dedicated staff time) to recruit, retain, and promote minority staff who are reflective of the patient population served.
• Designate staff responsible for overseeing implementation of activities to promote acceptance, understanding, and enthusiasm for all aspects of culturally proficient care.

3. Provide linguistically effective care at all points of contact

• Provide grievance process information that is available in the preferred languages of the patient population served.
• Provide incentives to encourage improvement of quality of care for all patients.
• Integrate cultural competency related measures into patient satisfaction assessments.
• Include cultural competency related issue on new patient/intake forms. (e.g., use of complimentary and alternative medicine, traditional healers).
• Increase allotted visit time for patients requiring interpreters.
• Reflects by organizational setting the patient population served through artwork, color scheme, and multi-lingual signage.