Promoting Cultural Diversity and Cultural Competency

Full Title: Promoting Cultural Diversity and Cultural Competency: Self-Assessment Checklist for Personnel Providing Services and Supports to Children with Disabilities & Special Health Needs and their Families

Resource Author: Georgetown University National Center for Cultural Competence

Resource Type: Self Assessment

Link to resource: https://nccc.georgetown.edu/documents/ChecklistCSHN.pdf

Certified Community Behavioral Health Clinics (CCBHCs) and cultural competence

Resource Author: Substance Abuse and Mental Health Services Administration (SAMHSA)

Resource Type: Self Assessment

Link to resource: https://www.samhsa.gov/section-223/cultural-competency or

https://www.samhsa.gov/section-223/cultural-competency/resources

About the resource: Includes cultural competence resources for delivering care and services to people with LEP, military service members, and veterans. 

CCBHCs must show cultural competence, especially when treating people with limited English proficiency (LEP), military service members, and veterans.

CLAS Toolkit- New Mexico Health Equity and Learning Center

Resource Author: New Mexico Department of Health

Resource type: CC Courses

Link to resource: https://nmdohcc.org

From resource: While there are many tools and instruments to assess organizational cultural and linguistic competence, none has been specifically developed to address the unique functions of family organizations concerned with children and youth with behavioral-emotional disorders, special health care needs, and disabilities. The Cultural and Linguistic Competence Family Organization Assessment Instrument (CLCFOA) was developed to fill this void.

Promoting cultural diversity and cultural competency

Full title: Promoting cultural diversity and cultural competency: self-assessment checklist for personnel providing services and supports to individuals and families affected by sudden infant death syndrome and other infant death (SUID).

Resource Author: Georgetown University National Center for Cultural Competence

Resource type: Self Assessment

Link to the resource in English: https://nccc.georgetown.edu/documents/ChecklistSIDS-ID.pdf

Link to the resource En Espanol: https://nccc.georgetown.edu/documents/LLL_Checklist_SIDS-ID.pdf

Maternal and Child Health (MCH) leadership competencies navigator

Acknowledgements: MCH Navigator

Resource Type: Evidence-based Tools

Link to resource: https://www.mchnavigator.org/assessment/

From the resource: As Title V agencies work through the 5-year needs assessment process, an understanding of their workforce composition and learning needs is essential to gauge strengths and areas of growth. The MCH Navigator has prepared this report of professionals in New Mexico who have taken the online self-assessment from 2016 – 2018 to serve as a snapshot of workforce demographics and knowledge/skills across the MCH Leadership Competencies.

Supporting small practices- Lessons for health reform.

Link coming soon.

To understand the needs of small practices in providing the best quality care, the National Committee for Quality Assurance (NCQA) launched a quality improvement demonstration program for small physician practices serving minority populations. The results of needs assessment were that small practices need and want close and ongoing support, technical assistance and shared resources including: training and development for physicians and non-clinical staff on patient engagement, cultural competence, teamwork, quality improvement, and language needs, tools, templates, information resources, shared services, and networking opportunities. 

The Joint Commission. New and Revised Hospital EPs to Improve Patient-Provider Communication

Institution: The University of New Mexico Health Science Center

Resource type: Evidence-based report/guide

Link to resource: https://hsc.unm.edu/health/community-benefit/diversity-equity-inclusion/doc/tic-patient-provider-communications.pdf

From resource: The Joint Commission has approved new and revised requirements to improve patient–provider communication applicable to the hospital accreditation program. These requirements were developed as part of a larger initiative, supported by The Commonwealth Fund, to increase quality and safety through effective communication, cultural competence, and patient- and family-centered care. For many patients, communication can be inhibited by language and cultural differences, or by the patient’s hearing or visual impairment, health literacy, cognitive impairment, disease, or disability.

Assuring Healthcare Equity - A Healthcare Equity Blueprint

Institutions: National Public Health and Hospital Institute; National Association of Public Hospitals and Health Systems; The Disparities Solutions Center; Institute for Healthcare Improvement

Authors: Linda C. Cummings, PhD Vice President for Research, National Association of Public Hospitals and Health Systems, Director of National Public Health and Hospital Institute; Bernice A. Bennett, MPH, CHES Assistant Vice President for Quality and Performance Improvement, National Association of Public Hospitals and Health Systems; Amy E. Boutwell, MD, MPP Content Director, Institute for Healthcare Improvement; Edward L. Martinez, MS Senior Consultant, National Association of Public Hospitals and Health Systems

Resource type: Evidence-based report/guide

Link to resource: https://5536401f-20a1-4e61-a28e-914fb5dcef51.filesusr.com/ugd/888d39_e8585bda66b047178341de4a094a8b9f.pdf

From resource: The Healthcare Equity Blueprint offers strategies and practices that can be tailored to individual hospitals to address equity in providing quality care. The Blueprint is a starting point for designing and implementing interventions to address racial and ethnic disparities in health care. Aspects of this Blueprint apply to numerous health care settings, but the primary focus is on hospitals. In addition, the Blueprint should be considered “a work in progress, “to be improved and modified by hospitals that use it.”

Creating Equity Reports: A Guide for Hospitals

Authors: Robin M.Weinick, PhD; Katherine Flaherty, ScD; Steffanie J. Bristol, BS

Resource type: Evidence-based reports/guides

Link to resource: https://5536401f-20a1-4e61-a28e-914fb5dcef51.filesusr.com/ugd/888d39_dc8f87f45802454abf6090928150ebd0.pdf

From resource: From our discussions with hospitals across the country, it is clear that there is a significant interest in developing equity reports, but also a need for assistance.This guide is designed to meet this need by providing a framework for equity reporting and sharing lessons learned from experiences to date with creating and using such reports. (pg. 3)

Improving quality and achieving equity: a guide to hospital leaders.

Institutions: Massachusetts General Hospital, Institute for Health Policy; The Disparities Solutions Center

Authors: Joseph R. Betancourt, MD, MPH; Alexander R. Green, MD, MPH; Roderick R. King, MD, MPH

Contributing Authors: Aswita Tan-McGrory, MSPH; Marina Cervantes; Megan Renfrew, MA

Resource type: Evidence-based reports/guides

Link to resource: https://5536401f-20a1-4e61-a28e-914fb5dcef51.filesusr.com/ugd/888d39_76707c409ee84608984b40e5e72d85af.pdf

From resource: The Disparities Solutions Center at Massachusetts General Hospital, with support from the Robert Wood Johnson Foundation, has created Improving Quality and Achieving Equity: A Guide for Hospital Leaders. The goals of this guide are to:

  • Present the evidence for racial and ethnic disparities in health care and provide the rationale for addressing them — with a focus on quality, cost, risk management and accreditation.

  • Highlight model practices — hospitals and leaders who are actively engaged in addressing disparities and achieving equity.

  • Recommend a set of activities and resources that can help hospital leaders initiate an agenda for action in this area.

Healthcare Disparities Measurement, 2011.

Institutions: Massachusetts General Hospital, Harvard Medical School

Authors: Joel S. Weissman, PhD; Joseph R. Betancourt, MD, MPH; Alexander R. Green, MD, MPH; Gregg S. Meyer, MD, MSc; Aswita Tan-McGrory, MSPH; Jabod D. Nudel; Jessica A. Zeidman, MD; J. Emilio Carrillo, MD, MPH

Resource type: Evidence-based report/guide

Link to resource: https://5536401f-20a1-4e61-a28e-914fb5dcef51.filesusr.com/ugd/888d39_b399d3b7cffa498b821410dab155b401.pdf

From resource: The purpose of this report is to: 1) provide guidance to a National Quality Forum (NQF) Steering Committee charged with selecting and evaluating disparity-sensitive quality measures, 2) describe methodological issues with disparities measurement, and 3) identify cross-cutting measurement gaps in disparities.

Improving patient safety systems for patients with limited English proficiency- A guide for hospitals, 2014.

Prepared for: Agency for Healthcare Research and Quality, U.S. Department of Health and Human Services

Authors: The Disparities Solutions Center; Mongan Institute for Health Policy; Massachusetts General Hospital; Abt Associates; Joseph R. Betancourt, MD, MPH Director, Disparities Solutions Center; Megan R. Renfrew, MA Senior Project Coordinator, Disparities Solutions Center; Alexander R. Green, MD, MPH Associate Director, Disparities Solutions Center; Lenny Lopez, MD, MPH, MDiv Senior Staff, Disparities Solutions Center; Melanie Wasserman, PhD, Abt Associates.

Citation: Betancourt JR, Renfrew MR, Green AR, et al. Improving patient safety systems for patients with limited English proficiency: a guide for hospitals. (Prepared by the Disparities Solutions Center, Mongan Institute for Health Policy at Massachusetts General Hospital and Abt Associates, Cambridge, MA, under Contract No. HHSA290200600011I). Rockville, MD: Agency for Healthcare Research and Quality; July 2012. AHRQ Publication No. 12-0041. September 2012.

Resource type: Evidence-based report/guide

Link to resource: https://5536401f-20a1-4e61-a28e-914fb5dcef51.filesusr.com/ugd/888d39_660e7efa6bbb43bca94fa1b7054b56ba.pdf

From resource: The goal of this guide is to help hospital leaders better understand how to address the issue of patient safety for limited-English-proficient (LEP) and culturally diverse patients.1 The guide can help hospital leaders:

  1. Foster a Supportive Culture for Safety of Diverse Patient Populations.

  2. Adapt Current Systems To Better Identify Medical Errors Among LEP Patients.

  3. Improve Reporting of Medical Errors for LEP Patients.

  4. Routinely Monitor Patient Safety for LEP Patients.

  5. Address Root Causes To Prevent Medical Errors Among LEP Patients.

Guide to Reducing Disparities in Readmissions

Acknowledgements: The Guide to Reducing Disparities in Readmissions was prepared with input from Agency for Healthcare Research and Quality, Alameda Health System, AnMed Health, Baltimore Medical Systems, Camden Coalition of Healthcare Providers, CareMore Health Systems, CHRISTUS Health, Disparities Solutions Center at Massachusetts General Hospital, Healthcare Association of New York State, Holy Cross Health, Intermountain Healthcare, IPRO, Kentucky Ambulatory Network, University of Kentucky College of Medicine, MPRO, National Committee for Quality Assurance, New Jersey Hospital Association, NORC at the University of Chicago, and Qualis Health.

Resource type: Evidence-based reports/guides

Link to resource: https://www.cms.gov/About-CMS/Agency-Information/OMH/Downloads/OMH_Readmissions_Guide.pdf

From resource: Guided by The Institute of Medicine (IOM) Report Crossing the Quality Chasm, our nation charts a path to deliver equitable care that is safe, efficient, effective, and patient-centered.1 Equity is the principle that quality of care should not vary based on patient characteristics such as race and ethnicity, gender, or socioeconomic status. Recent years have seen a significant transformation of the health care system. An entire set of structures has been developed to facilitate increased access to cost-effective and high-quality care. Pursuing high-value health care is the ultimate goal, and health care provider organizations across the country are faced with the daunting challenge of succeeding—and perhaps just surviving—while delivering care to increasingly diverse populations.

Addressing disparities in diagnostic errors (DE) and medication safety in the home (MSH), 2018.

Prepared by: Solutions Center at Massachusetts General Hospital for the Gordon and Betty Moore Foundation

Resource type: Evidence-based report/guide

Link to resource: https://5536401f-20a1-4e61-a28e-914fb5dcef51.filesusr.com/ugd/888d39_deb78f570d574e29819c44682946f669.pdf

From resource: This report highlights key issues related to disparities in diagnostic errors and medication safety in the home and the objectives were to:

  1. Understand the current state of knowledge in the areas DE and MSH.

  2. Solicit input from subject matter experts to determine: (a) if any work has been done at the intersection of disparities and DE and MSH; (b) how communication difficulties (included limited health literacy, limited English proficiency, cultural beliefs, and mistrust, among other areas) might impact DE and MSH; and (c) what are areas of study, exploration, and intervention that address disparities in DE and MSH.

  3. Provide overall recommendations on key areas that require further exploration and funding to advance the field of disparities in DE and MSH.

National Standards for Culturally and Linguistically Appropriate Services in Health Care - Final Report

Prepared for: Office of Minority Health U.S. Department of Health and Human Services

Resource type: Evidence-based reports/guides

Link to Resource: https://minorityhealth.hhs.gov/assets/pdf/checked/finalreport.pdf

From resource: As the U.S. population becomes more diverse, medical providers and other people involved in health care delivery are interacting with patients/consumers from many different cultural and linguistic backgrounds. Because culture and language are vital factors in how health care services are delivered and received, it is important that health care organizations and their staff understand and respond with sensitivity to the needs and preferences that culturally and linguistically diverse patients/consumers bring to the health encounter. Providing culturally and linguistically appropriate services (CLAS) to these patients has the potential to improve access to care, quality of care, and, ultimately, health outcomes.

Unfortunately, a lack of comprehensive standards has left organizations and providers with no clear guidance on how to provide CLAS in health care settings. In 1997, the Office of Minority Health (OMH) undertook the development of national standards to provide a much-needed alternative to the current patchwork of independently developed definitions, practices, and requirements concerning CLAS. The Office initiated a project to develop recommended national CLAS standards that would support a more consistent and comprehensive approach to cultural and linguistic competence in health care.

National Standards for Culturally and Linguistically Appropriate Services in Health and Health Care: Compendium of State-Sponsored

National CLAS Standards Implementation Activities

Citation: U.S. Department of Health and Human Services, Office of Minority Health. (2016). National Standards for Culturally and Linguistically Appropriate Services in Health and Health Care: Compendium of State-Sponsored National CLAS Standards Implementation Activities. Washington, DC: U.S. Department of Health and Human Services.

Resource type: Evidence-based reports/guides

Link to resource: https://thinkculturalhealth.hhs.gov/pdfs/CLASCompendium.pdf

From resource: In 2000, the U.S. Department of Health and Human Services, Office of Minority Health first published the National Standards for Culturally and Linguistically Appropriate Services in Health Care (National CLAS Standards). In the fall of 2010, the Office of Minority Health launched the National CLAS Standards Enhancement Initiative to update the National CLAS Standards to reflect the past decade’s advancements, expand their scope, and improve their clarity to ensure understanding and implementation. This Compendium of State-Sponsored National CLAS Standards Implementation Activities presents a compilation of National CLAS Standards implementation efforts that have been undertaken by state agencies and described in publicly available sources on the Web since the initial release of the National CLAS Standards in 2000. Part 1 of the Compendium provides a brief introduction to the National CLAS Standards, discusses the methods used to identify National CLAS Standards implementation activities, summarizes the findings, and offers recommendations for enhancing state/territory-sponsored implementation of the National CLAS Standards. Part 2 of the Compendium presents the detailed findings for each state, serving as a resource on existing models of implementation.

Transition - Cultural and Linguistic Competence Checklist for Medical Home Teams

Resource Author: University of Georgetown National Center for Cultural Competence

Resource type: Self-Assessment

Link to Resource: https://nccc.georgetown.edu/documents/NCCC_Transition_Checklist.pdf

From resource: This checklist is not intended to measure the cultural and linguistic competence of any given medical home team. Rather, it is designed to provide a structure for discussion and self-examination. It is also designed to facilitate the programmatic and organizational change necessary to respond effectively to culturally defined beliefs, practices, and preferences and the inherent issues they raise in the provision of health care and related services for youth and their families.

Self-Assessment Checklist for Personnel Providing Services and Supports In Early Intervention and Early Childhood Settings

Resource Author: University of Georgetown National Center for Cultural Competence

Resource type: Self-Assessment

Link to Resource: https://nccc.georgetown.edu/documents/ChecklistEIEC.pdf

From resource: Self-Assessment Checklist for Personnel Providing Services and Supports In Early Intervention and Early Childhood Settings for promoting cultural and linguistic competency.

Cultural and Linguistic Competence Organizational Assessment Instrument for Fetal and Infant Mortality Review Programs

Resource Author: Georgetown University National Center for Cultural Competence

Resource type: Self-Assessment

Link to resource: https://nccc.georgetown.edu/documents/FIMR_Assessment.pdf

From resource: While there are many tools and instruments to assess organizational cultural and linguistic competence, none has been specifically developed to address the unique issues of local programs such as Fetal Infant Mortality Review (FIMR) teams. The Cultural and Linguistic Organization Assessment Instrument for Fetal and Infant Mortality Review Programs (CLCOA-FIMR) was developed to meet this need. The CLCOA-FIMR is intended to support FIMRs to: (1) plan for and incorporate culturally and linguistically competent policies, structures, and practices in all aspects of their work; (2) enhance the quality of case reviews and action plans within diverse and underserved communities; and (3) promote cultural and linguistic competence as an essential approach in the elimination of disparities and the promotion of health and mental health equity.

Your FIMR organization may use assessment results: (1) to provide a summary of the strengths and areas for growth to advance cultural and linguistic competence, (2) for strategic planning, and (3) to improve the quality of the FIMR process in your community.

The Cultural and Linguistic Competence Family Organization Assessment (CLCFOA)

Resource Author: Georgetown University National Center for Cultural Competence

Resource type: Self Assessment

Link to resource: https://nccc.georgetown.edu/assessments/clcfoa.php

From resource: While there are many tools and instruments to assess organizational cultural and linguistic competence, none has been specifically developed to address the unique functions of family organizations concerned with children and youth with behavioral-emotional disorders, special health care needs, and disabilities. The Cultural and Linguistic Competence Family Organization Assessment Instrument (CLCFOA) was developed to fill this void.