Planning, Implementing and Evaluating Culturally Competent Service Delivery Systems in Primary Health Care Settings
Implications for Policy Makers and Administrators
Tawara D. Goode - National Center for Cultural
Competence
3307 M Street, NW, Suite 401, Washington, D.C. 20007-3935
202-687-5387 * 800-788-2066 (voice) * 202-687-8899 (fax) * cultural@georgetown.edu
This checklist was developed by the National Center for Cultural Competence (NCCC). It is designed to assist programs and organizations which are concerned with the delivery of primary and community-based health care, to begin strategic development of policies, structures, procedures and practices that support cultural and linguistic competence. It is also designed to support the campaign launched by the Bureau of Primary Health Care, "Zero Disparities and One Hundred Percent Access".
Nationally, health care programs and organizations are struggling with the challenges and opportunities to respond effectively to the needs of individuals and families from racially, ethnically, culturally and linguistically diverse groups. There is no one method for getting started on the journey towards cultural competence. Individuals and programs/organizations may embark on this journey at different points of departure with different estimated times of arrival for achieving specific goals and outcomes. Health and human service organizations and their personnel are at various levels of awareness and stages along the cultural competence continuum. Few have evolved to a degree of proficiency in which they systematically incorporate culturally competent principles and practices into the policy making, administrative, practice/service delivery and consumer levels. This checklist provides guidance for getting started.
-
Convene a cultural competence committee, work group or task force within your program or organization. This group should have representation from policy making, administration, practice/service delivery and consumer levels and reflect the diversity within the program or organization and the community at large. The group can serve as the primary body for planning, implementing and evaluating organizational cultural competence initiatives.
-
Ensure that the program's or organization's mission statement commits to cultural competence as an integral component of all of its activities. The mission statement should articulate principles, rationale and values for culturally and linguistically competent health care service delivery. The cultural competence work group should be involved in or facilitate the development of this statement.
-
Determine the racially, ethnically, culturally and linguistically diverse groups within your geographic locale served by your program or organization. Assess the degree to which these groups are accessing services and the level of satisfaction with the services received.
-
Determine what percentage of the population that resides in the geographic locale served by your program or organization is affected by the following six health disparities: cancer, cardiovascular disease, infant mortality, diabetes, HIV/AIDS, and child and adult immunizations. Collaborate with consumers, community-based organizations and informal networks of support to develop approaches for delivering preventive health messages in a culturally and linguistically competent manner. This collaborative process can help to inform your program or organization of adaptations to service delivery that respond to the needs and interests of diverse populations.
-
Conduct a comprehensive program or organizational cultural competence self-assessment. Determine which instrument(s) and or consultant(s) best match the needs and interests of your program or organization. Use the self-assessment results to develop a long-term plan, with measurable goals and objectives, strategies and fiscal resources. This plan should allow for the incorporation of cultural and linguistic competence into all aspects of your program or organization. This may include, but is not limited to, changes in the following: mission statement, policies, procedures, program administration, staffing patterns, position descriptions, personnel performance measures, professional development, pre-service and inservice training activities, service delivery practices, strategies for outreach, telecommunications and information dissemination systems.
-
Conduct an assessment of staff to determine their perceived staff development needs that will enable them to provide services to racially, ethnically, culturally and linguistically diverse groups.
-
Convene focus groups or use other approaches to solicit consumer input on professional or staff development needs related to the provision of culturally and linguistically competent health care.
-
Network and dialogue with other programs or organizations, concerned with primary and community-based health care, that have begun the journey towards developing, implementing and evaluating culturally competent service delivery systems. Adapt their processes, policies and procedures and other information to meet your program's or organization's needs and interests. Encourage partnerships and establish mechanisms to share training resources at the local, state or regional levels.
-
Seek resources from federally and privately funded technical assistance centers that catalog information on cultural and linguistic competence, primary health care, and health care issues specific to racially, ethnically, culturally and linguistically diverse groups (e.g., treatment, interventions, how to work with natural healers, outreach approaches, consumer education programs etc).
-
Convene informal brown bag lunches or other forums to engage program or organization personnel in discussions and activities that offer an opportunity to explore attitudes, beliefs and values related to cultural diversity and cultural and linguistic competence.
-
Identify and include budgetary expenditures each fiscal year for resource development and professional development through participation in conferences, workshops, colloquia and seminars on cultural and linguistic competence and other issues related to primary and community-based health care.
-
Gather and categorize resource materials related to primary health care and culturally diverse groups for use as references by program or organization personnel.
-
Build and utilize a network of natural helpers, community informants and other "experts" who have knowledge of the racially, ethnically, culturally and linguistically diverse groups served by your program or organization.
-
Network with advocacy organizations concerned with specific health care, social and economic issues impacting racially, ethnically, culturally and linguistically diverse communities. Solicit their involvement and input in the design, implementation and evaluation of primary and community-based health care service delivery initiatives at the local, state, regional and national levels.
RESOURCES
Monographs
-
Building Cultural Competence: A Blueprint for Action (1995). Washington State Department of Health, Division of Community & Family Health.
-
Diversity Journal, (1997). Harvard Pilgrim Health Care, Inc., Brookline, MA
Web Sites
-
Health Care Rx: Access For All, The President's Initiative on Race.
-
Health Care Rx: Access For All, Boston Town Hall Meeting, July 10, 1998
-
The Initiative to Eliminate Racial & Ethnic Disparities in Health
Available: http://raceandhealth.hhs.gov [May 7, 1999] -
Minority Health is the Health of the Nation
-
Office of Minority Health
Available: http://minorityhealth.hhs.gov/ [May 7, 1999] -
The Office of Minority and Women's Health
Available: http://www.cdc.gov/ncezid/ohd/omwh-retired.html [May 18, 1999]
About the National Center for Cultural Competence
The National Center for Cultural Competence (NCCC) is a funded
project of the Health Resources and Services Administration (HRSA).
The project is a collaboration between: the Maternal and Child
Health Bureau's (MCHB) Division of Services for Children and Youth
with Special Health Needs and its Infant and Child Health Branch;
and the Bureau of Primary Health Care (BPHC). The mission of the
NCCC is to increase the capacity of health care programs to design,
implement and evaluate culturally competent service delivery systems.
The NCCC is focusing on HRSA funded programs including: 1) Maternal
and Child Health Title V programs concerned with Children and Youth
with Special Health Needs and their families; 2) primary health
care programs such as Community Health Centers, Migrant Health
Centers, Health Care for the Homeless Grantees, Healthy Schools,
Healthy Communities Grantees, Primary Care Associations and Primary
Care Offices; and 3) programs supporting families affected by Sudden
Infant Death Syndrome and Other Infant Death.
The NCCC is a component of the Georgetown University Center for
Child and Human Development (also known as Georgetown University
Child Development Center), Center for Child Health and Mental Heath
Policy, and is housed within the Department of Pediatrics of the
Georgetown University Medical Center. For additional information
contact the NCCC as listed below.
Permission is granted to reproduce this document for distribution.
The only requirement is that proper credit be given to the National
Center for Cultural Competence and the author.
Tawara D. Goode - National Center for Cultural
Competence
3307 M Street, NW, Suite 401, Washington, D.C. 20007-3935
202-687-5387 * 800-788-2066 (voice) * 202-687-8899 (fax) * cultural@georgetown.edu
Other Pages
-
Full-text of NCCC Policy Brief "Rationale for Cultural Competence in Primary Care"
-
Self-Assessment Checklist for Personnel Providing Services and Supports to Children with Special Health Needs and their Families
Has this page been useful? E-mail us your comments
