Cultural competency
With over 23 million people in the US with trouble communicating in English, the importance of developing cultural competence among the health services workforce and institutions that serve them has gained the attention of leaders in both public and private sectors. The Office of Minority Health's National Standards on Culturally and Linguistically Appropriate Services in Health Care (CLAS) puts forth a framework for culturally and linguistically competent care delivery. Despite the enactment of these mandates, many medical settings still see cultural barriers as largely unaddressed at healthcare’s front line. What, then, is being lost in translation?Culturally competent care providers can acknowledge, evaluate, and respect the cultural differences of their patients; they are aware of a patient’s particular needs and beliefs and can adapt to the communication style of patient in order to provide effective care. Equally important are culturally competent policies, which allow for cultural competence training, enhance the understanding of services, and ensure equitable access to care by all patients.
In response to what has been termed an ‘ethical erosion’ of medical education—wherein bedside communication skills have fallen off relative to technical expertise—some medical schools are developing strategies to balance education in the hard sciences with instruction in the social aspects of medical practice. In 2005, La Casita de la Salud (“The Little House of Health”) was founded by New York Medical College students as a clinic dedicated to providing culturally competent care to the Afro-American, Hispanic, and immigrant communities in East Harlem. The student-run organization employs medical interpreters and integrates cultural competence into both its provider training and medical planning processes. More recently, Florida International University launched an innovative placement program in which teams of third year medical, nursing, social work, and public health students are assigned to households in underserved communities. The Green Family Foundation NeighborhoodHELP curriculum allows students to get to know a local family over a four-year period and witness firsthand the profound influence of economic and cultural factors on health disparity.
The attainment of culturally competent healthcare communication requires individual- and institution-level strategies that support inclusive, comprehensible patient-provider interaction. These efforts will require dedication from faculty, students, and medical staff, as well as the availability of culturally competent healthcare materials and provider tools. At LanguageMate we’ve been able to witness firsthand that access to resources such as translated written materials—such as patient consent, in-hospital communication, and treatment information forms—will go a long way to reduce many obstacles to treatment and effective outreach for underserved patients. Just as patient-provider communication involves the overwhelming majority of professionals and patients in our healthcare system, investment in its improvement holds the potential for a correspondingly substantial return in improved efficiency and quality of care.
Associated Articles
- Current efforts to reduce racial and ethnic disparities in healthcare are modest and uneven
- The relationship between patient-centered care and cultural competence
- Sixty-three percent of hospitals encounter patients with LEP on a daily or weekly basis
- Approaches to conceptualizing cultural competence
- Cultural competence is important to healthcare stakeholders
