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    Cultural Competence

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    A. Define culturally competent care appropriate for your own workplace (a hospital in the Midwest), based on your assigned readings.

    b. Identify the populations served and any issues of population vulnerability.

    c. Comment on standards of cultural competence that appear to be met and any that are not met

    d. Identify potential impacts of delivery of nursing care where standards are being met, and where standards are not being met.

    e. Comment on solutions that could be implemented where standards are not being met

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    1. Prepare a 2800 - 3500 word paper that explores the following topics in your own workplace or a setting that you select for this discussion:

    One way to help you with a paper assignment like this one is to look at each section from various sources, which you can draw on for your final copy. This is the approach this response takes.

    Let's use Advocate Bethany Hospital in the Chicago (http://www.ucomparehealthcare.com/hospital/Illinois/Advocate_Bethany_Hospital.html) area as the example.

    a. Define culturally competent care appropriate for your own workplace (a hospital in the midwest), based on your perusal of the assigned readings.

    Advocate Health Care is one of the largest employers in the Chicago area and is ranked among the nation's top 10 health care systems. With more than 200 sites of care, Advocate offers you outstanding career and educational opportunities in a variety of health care-related fields (http://www.advocatehealth.com/system/jobsedu/edu/). Cultural competent care is imperative in recent decades; there has been increasing recognition of the prevalence of racial and ethnic disparities in health care delivery and outcomes in the United States. Culturally and linguistically diverse groups and individuals of limited English proficiency (LEP) typically experience less adequate access to care, lower quality of care, and poorer health status and outcomes. In fact, the Institute of Medicine's recent report, Unequal Treatment: Confronting Racial and Ethnic Disparities in Health Care, states that: "Racial and ethnic minorities tend to receive a lower quality of health care than non-minorities, even when access-related factors, such as patient's insurance status and income, are controlled."

    What is cultural competence?

    Cultural Competence is a set of congruent behaviors, attitudes, and policies that come together in a system or agency or among professionals that enables effective interactions in a cross-cultural framework (Cross et al. 1998. Towards a Culturally Competent System of Care: A Monograph on Effective Services for Minority Children Who Are Severely Emotionally Disturbed. Washington DC: CASSP Technical Assistance Center, Georgetown University Child Development Center).

    In other words, cultural competence requires organizations and their personnel to:

    ? Value diversity.
    ? Assess themselves.
    ? Manage the dynamics of difference.
    ? Acquire and institutionalize cultural knowledge.
    ? Adapt to diversity and the cultural contexts of individuals and communities served (http://www.ahrq.gov/about/cods/cultcomp.htm).

    National Standards on Culturally and Linguistically Appropriate Services (CLAS) standards are primarily directed at health care organizations; however, individual providers are also encouraged to use the standards to make their practices more culturally and linguistically accessible. The principles and activities of culturally and linguistically appropriate services should be integrated throughout an organization and undertaken in partnership with the communities being served. There are three of the fourteen standards specifically related to Culturally Competent Care (Standards 1-3). (http://data.georgetown.edu/research/gucchd/nccc/). These are relevant to Advocate Bethany Hospital which operates through its mission, values and hospital policies:

    Standard 1: Health care organizations should ensure that patients/consumers receive from all staff member's effective, understandable, and respectful care that is provided in a manner compatible with their cultural health beliefs and practices and preferred language.
    Standard 2: Health care organizations should implement strategies to recruit, retain, and promote at all levels of the organization a diverse staff and leadership that are representative of the demographic characteristics of the service area.
    Standard 3: Health care organizations should ensure that staff at all levels and across all disciplines receive ongoing education and training in culturally and linguistically appropriate service delivery. ...

    Solution Summary

    By addressing the questions and by example, cultural competence is discussed on various dimensions e.g. definition of cultrual competence, population served by the hospital example in the Midwest, vulnerable populations, standards of cultural competence, impacts on delivery of nursing care, recommendations, etc.