Review of Literature on Culturally Competent Care
A significant body of research exists within the field of cultural competency in health care. The following
sections provide a brief overview of the literature relating to the needs for and benefits of improving
cultural competency within the hospital setting.
Culturally Competent Model for Care Delivery
The delivery of high-quality primary health care requires an in-depth understanding of the sociocultural
background of patients, their families and their environments.
4 Such an understanding is commonly
referred to as cultural competency.
5 Cultural competency in health care describes the ability of systems
to provide care to patients with diverse values, beliefs and behaviors, including tailoring delivery to meet
patients' social, cultural and linguistic needs.
6 Ultimately, cultural competency is recognized as an
essential means of reducing racial and ethnic health care disparities7 and improving equity of care.
This knowledge, coupled with major demographic shifts in the U.S. population, underscores the
necessity of making all health care organizations culturally competent.
9 A culturally competent health
care system is defined as one that acknowledges the importance of culture, incorporates the assessment
of cross-cultural relations, recognizes of the potential impact of cultural differences, expands cultural
knowledge, and adapts services to meet culturally unique needs.
10 Key means of achieving culturally
competent care delivery consist of increasing the diversity of the health care workforce and leadership
(including trustees and senior management), as well as incorporating strategies to promote diversity
within all hiring and recruitment practices. 11 In addition, providing compassionate, patient-centered
care will further require health care leaders to assess the existence of bias, stereotypes and prejudice in
their own behaviors.
The Importance of Culturally Competent Governance
One critical mechanism for improving cultural competency is the engagement of hospitals’ governing
13 Hospital governance is responsible for identifying and actualizing the institution’s core mission
and values. In this interest it is essential that hospital governance embrace the concept of cultural
competency to ensure that the delivery of culturally and linguistically appropriate care is ingrained within
the organization’s mandate. Once this is achieved, the delivery of culturally competent care can become
an area of priority for hospital executives.
This, in turn, provides a strong incentive for executives to
enact policies and procedures to improve cultural competency, like diversity management programs, and
to ensure that necessary resources, such as interpretation services, are made available. More than any
other entity, the governance structure must reflect and promote those practices that earn the public’s
trust and ensure a delivery process that is safe and equitable.
The Importance of Cultural Diversity in Leadership
As the United States becomes more culturally diverse, it becomes increasingly important to expand
minority recruitment efforts in health care to meet the needs of this changing population.
anecdotal evidence suggests that the lack of diversity in health care leadership can result in policies and
procedures that do not adequately meet the needs of diverse populations.
16 Therefore, the goal of
managing diversity is to enhance the hospital workforce, promote customer satisfaction, and to further
improve organizational performance.
Managing diversity is not a social requirement. Rather, diversity
management represents a business requirement that will grow in intensity as the general population, and
accordingly the patient population, continues to become more racially and ethnically varied.