Cultural competency in health care describes the ability of systems to provide care to patients with
diverse values, beliefs and behaviors, including the tailoring health of care delivery to meet patients'
social, cultural and linguistic needs. A culturally competent health care system is one that acknowledges
the importance of culture, incorporates the assessment of cross-cultural relations, recognizes the
potential impact of cultural differences, expands cultural knowledge, and adapts services to meet
culturally unique needs. Ultimately, cultural competency is recognized as an essential means of reducing
racial and ethnic disparities in health care.
This guide serves to explore the concept of cultural competency and build the case for the enhancement
of cultural competency in health care. It is recommended that hospital leaders undertake the following
seven tasks within their organizations and answer the associated self- assessment questions:
1. Collect race, ethnicity and language preference (REAL) data.
• Do you systematically collect race, ethnicity and language preferences of all your patients?
2. Identify and report disparities.
• Do you use REAL data to look for variations in clinical outcomes, resource utilization, length of
stay, and frequency of readmissions within your hospital?
• Do you compare patient satisfaction ratings among diverse groups and act on the information?
• Do you actively use REAL data for strategic and outreach planning?
3. Provide culturally and linguistically competent care.
• Have your patient representatives, social workers, discharge planners, financial counselors and
other key patient and family resources received special training in diversity issues?
• Has your hospital developed a “language resource,” identifying qualified people inside and outside
your organization who could help your staff communicate with patients and families from a wide
variety of nationalities and ethnic backgrounds?
• Are your written communications with patients and families available in a variety of languages
that reflect the ethnic and cultural makeup of your community?
• Based on the racial and ethnic diversity of the patients you serve, as well as those in your service
area, do you educate your staff at orientation and on a continuing basis about cultural issues
important to your patients?
• Are core services in your hospital, such as signage, food service, chaplaincy services, patient
information and communications, attuned to the diversity of the patients for whom you care?
4. Develop culturally competent disease management programs.
• Does your hospital gather information to determine conditions of high prevalence within your
community’s minority populations?
• Does your hospital offer disease management programs that effectively address these conditions?
• Do your disease management programs address the barriers to care that are particularly
challenging for minority patients?