With input from experts in the field, as well as academic and clinical leaders in health care and cultural competency, NICHQ developed measures that delivery organizations can use. These measures are grouped into “Core Measures,” those that are essential to meeting the goal of cultural competency, and “Additional Measures,” those that are important but somewhat less significant. The latter may be considered optional, to be chosen by providers who wish to use them.
There are four types of measures.
Outcome Measures
Outcome measures tell a team whether the changes it is making are actually leading to improvement — that is, helping to achieve the stated aim. For example, 90% percent of patients are receiving care in their preferred language.
Process Measures
Process measures tell a team whether a specific process change has been accomplished and whether it is having the intended effect. A team often establishes several process measures in the course of its work. The assumption is that improvement in a process measure will have an eventual impact on the outcome measure.
Structural Measures
Structural measures indicate whether the pre-conditions that are established are more likely to result in effective processes and better outcomes for children and families. Structural measures include the level of training of staff and the staff ’s demographic characteristics.
Balancing Measures
Use these measures to make sure that changes to improve one part of the system aren’t causing new problems in other parts of the system.
Core Measures
Outcome Measures
Disparities
Process Measures
Language
Interpreter need documented
Interpreter provided
Care plan
Identification of race/ ethnicity/ and language preference
Structural Measures
Bi/multilingual staff
Diverse staff
Staff trained in communication skills
Staff trained in cultural competency
Staff trained in interpreter use
Staff ability to access an interpreter
Additional Measures
Outcome Measures
Condition-specific disparities
Process Measures
Health beliefs
Referral
Structural Measures
Staff training in LEP
Staff skills
Balancing Measures
Experience of Care
Wait time
Visit time
