Transcultural Nursing

 The blending of nursing and anthropology into an area of specialization within the
discipline of nursing
 Conceptualized by Dr. Leininger
 A formal area of study that uses the concepts of culture and caring
• Transcultural nursing (TCN) is a nursing specialty focused on the comparative
study and analysis of cultures and subcultures.
• It examines these groups with respect to their:
– Caring behavior
– Nursing care
– Health–illness values and beliefs
– Patterns of behavior
• Transcultural nursing’s goal is to:
– Develop a scientific and humanistic body of knowledge in order to provide
nursing care that is both
• Culture specific
• Culture universal
• Culture-specific refers to:
– Particular values, beliefs, and patterns of behavior that tend to be special or
unique to a group and do not tend to be shared with members of other cultures
• Culture-universal refers to:
– The commonly shared values, norms of behavior, and life patterns that are
similarly held among cultures about human behavior and lifestyles
QUESTION:
• Is the following statement true or false?
Methods, rules, guidelines, and patterns of behavior about food practices can be described as
culture-specific
ANSWER:
• True
• Rationale: The need for food is a culture-universal.
• Culture-specific determines methods, rules, guidelines, and patterns of behavior. For
example, items that are considered to be edible; acceptable methods used to prepare
and eat meals; rules concerning who eats with whom, the frequency of meals, etc.

Anthropology:
• The study of humans including their:
– Origins
– Behavior
– Social relationships
– Physical and mental characteristics
– Customs
– Development through time and in all places in the world
  Culture (as defined by Leininger) the “learned, shared, and transmitted values,
beliefs, norms, and lifeways of a particular group of people that guide thinking,
decisions, and actions in a patterned way…

 Culture is the blueprint that provides the broadest and most comprehensive means
to know, explain, and predict people’s lifeways over time and in different geographic
locations.”
 Influences a person’s definition of health and illness
 Oftentimes connotes a person’s racial or ethnic background. Culture also
encompasses:
o Socioeconomic status
o Ability or disability
o Sexual orientation
o Age
o Occupation or profession
 Ethnicity
o The perception of oneself and a sense of belonging to a particular ethnic
group or groups. It can also mean feeling that one does not belong to any
group because of multiethnicity.

 Currently five classifications; however, some people may identify with more than one
ethnicity/race
 Race
o Refers to a group of people who share such genetically transmitted traits as
skin color, hair texture, and eye shape or color.
 Races are arbitrary classifications that lack definitional clarity; all cultures have their
own ways of categorizing or classifying their members.
 Transcultural nursing:
o Dr. Madeleine M. Leininger, nurse anthropologist
o Initial conception in the 1950s
o Formal creation as a specialty and new discipline within the profession in the
1960s−1970s
o Nurse scholars have generated a substantial and important body of theoretical,
research, and evidence-based knowledge in TCN, which is ongoing.
QUESTION:
• Is the following statement true or false?
• Transcultural nursing has been formally considered a nursing specialty since
2000.
ANSWER:
• False
• Rationale: Transcultural nursing was formally considered as a specialty and new
discipline within the profession in the 1960s and 1970s.
Leininger’s Contribution to Transcultural Nursing

Theory of Culture Care Diversity and Universality

• Focuses on describing, explaining, and predicting nursing similarities and
differences focused primarily on human care and caring in human cultures

Sunrise Enabler
• Visual representation of the concepts of her theory. Based on the concept of cultural
care that guides nursing judgments and activities to provide culturally congruent
care

Leininger’s Sunrise Enabler

• Established the Transcultural Nursing Society (TCNS)

• TCNS Newsletter
• Created the Journal of Transcultural Nursing (JTN) and served as founding editor
• Established the first master’s and doctoral programs in nursing with a theoretical and
research focus in TCN
• Created a new qualitative research method called enthnonursing research to
investigate phenomena of interest in TCN

QUESTION:
•Is the following statement true or false?
•Dr. Madeleine M. Leininger authored both conceptual frameworks, the Theory of
Culture Care Diversity and Universality and the Sunrise Model.
ANSWER:
• True
• Rationale: Dr. Madeleine M. Leininger is credited with authoring both of these
conceptual frameworks related to transcultural nursing.

Advancements in Transcultural Nursing

 • Expanded models by nursing scholars:
– Giger and Davidhizar Transcultural Assessment Model
– Purnell Model for Cultural Competence
– Campinha-Bacote Model of Cultural Competence in the Delivery of
Healthcare Services
• The Core Curriculum has been established to support TCN practice with a core base
of knowledge.
• Used in a variety of practice settings.
• Two certifications offered in TCN, basic and advanced
Andrews/Boyle Transcultural Interprofessional Practice (TIP) Model
• A new model, uses the scientific process for delivering culturally congruent, quality
care to people from diverse backgrounds across the life span
• Facilitates the delivery of nursing and health care consistent with cultural beliefs and
practices of clients from diverse backgrounds
• Provides a conceptual framework to guide nurses in the delivery of culturally
congruent care that is theoretically sound
• Components of the model; the context from which people's health-related
values, attitudes, beliefs, and practices emerge:
• Interprofessional Health Care Team
• Communication
• Problem Solving
• Interprofessional Health Care Team
• Client at its core
• May also include: Family and support persons, other healthcare personnel,
traditional, folk and religious healers
• All providers working together to deliver the highest quality of care
• A partnership among client and providers that establishes trust, collaboration,
cooperation, and communication
• Communication
•
Verbal—spoken word, language (over 6,000 worldwide), tone of voice,
abbreviations, idioms
• Nonverbal—how people convey meaning without words. Facial expressions,
gestures, posture, physical distance, silence, eye contact
• Mixed—modesty, technology assisted
• Problem solving
– Guides health care teams in determining what the client needs to obtain
optimal well-being and health.
•Comprehensive assessment skills
•Mutual goal setting
•Planning care
•Implementing care
•Evaluation of care to achieve the goals of:
• Culturally congruent, competent, quality care based on evidence and
best practice
 •Proficiency in using the problem-solving process requires time and repeated simulated
and/or clinical experiences.
• Developing competence is uneven and nonlinear, as is the process of developing
cultural competence.
QUESTION:
• Which of the following is an example of verbal communication?
A. Avoiding eye contact
B. Nodding to convey understanding
C. Speaking another language
D. Arms folded and legs crossed
ANSWER:
• . Speaking another language
• Rationale: Speaking another language is a verbal communication method. This is an
example of the spoken word versus nonverbal communication, which is conveying
meaning without words.

The importance of cultural competence in nursing

Cultural competence is the bedrock of a great nurse-patient relationship. Every
nurse should make it a priority in their care.
Cultural competence in nursing aids the growth and development of nurses while also
incorporating relevant societal values. Nursing as a career is versatile—from caring for the sick,
providing treatment plans, taking care of the elderly in a home, and more.

The best nurses are not only technically sound but also experts in cultural competence.

Cultural competence in nursing: what it means

Cultural competence in nursing implies the ability of health care workers to give the best medical
care to patients while demonstrating cultural awareness for their beliefs, race, and values. It
entails having knowledge of patients’ cultural diversity and treating them with this in mind.
 Cultural competence prepares nurses to empathize, relate more to patients, and attend more
deeply to their needs. Hospital patients can often be agitated or stressed. Having someone on their
care team who speaks their language or understands their unique background may help them to
relax, leading to greater therapy and overall care.

Culturally competent care in nursing

Cultural competence helps the nurse to understand, communicate, and interact with people
effectively. More specifically, it centers around:

 Understanding the relationship between nurses and patients

 Acquiring knowledge of various cultural practices and views of the world
 Developing communication skills to promote and achieve interaction among cultures
 Ensuring a positive attitude is displayed toward differences and various cultures

Cultural competence expects more than just tolerating another’s cultures and practices. Instead, it
aims to celebrate them through bridging gaps and personalizing care.

Practicing culturally competent care in nursing means taking a holistic approach that spans across
all parts of the world. As a nurse, you should always work to respect the diverse cultures you
come across when handling patients. It goes a long way to impact the capability and quality of
your work.

Components of cultural competence in nursing

Culturally competent care consists of five core building blocks.

 Cultural awareness involves examining yourself, dropping prejudices that you have

previously formed against foreign cultures, and developing the right attitude toward giving the
best health service to all patients and clients.
 Cultural knowledge involves searching for information about the culture and beliefs of your
patients to better understand and interact with them.
 Cultural skills involves your ability to collect relevant data and process it to help engage a
patient in meaningful cross-cultural interaction.
 Cultural encounter encourages nurses to venture out of the environment they are conversant
with and try new cultures and places. They improve their competence by interacting with
people from different backgrounds, cultures, and ethnicities.
 Cultural desire requires a strong motivation to learn more about other cultures. It is a strong
force that involves the ability to be open to new people, to accept and understand cultures that
are different from yours, and be willing to learn.

Examples of cultural competence in nursing

There are many examples of what a nurse who exhibits cultural competence looks like. A few key
traits include:

1. Speaking in terms that are easy for the patient to follow and understand.
2. Not judging or disregarding a patient’s belief and religious background, but encouraging them
to do what works best for them.
3. Empathizing with the patient at all times.
4. Valuing the individual and applauding strengths and individuality.

Importance of cultural competence in nursing care

Cultural competence is necessary because it helps the nurse offer the best services to every
patient, leading to high satisfaction and care on the side of the patient. Without cultural
 competence, the health sector will suffer a great loss and ultimately limit the services that it can
offer.

A strong background and knowledge of cultural competence prevents professional health

caregivers from possessing stereotypes and being myopic in their thoughts. It also helps them
offer the best service to all, regardless of their social status or belief.

Health care workers can strengthen their cultural competence by pursuing continuing education,
cross-cultural interactions, or specific assessments. These efforts help to keep their minds open
and free of judgment or preformed notions about certain cultures or locations.

The world becomes better with more culturally competent service providers in each sector.
Culturally competent nurses are essential to providing top-quality services to their patients—
translating to better health care in every community.

Nursing programs
We offer nursing programs both online and at our Dallas Campus that help prepare students to
work in today’s modern and integrated health care environment. See our full list of nursing
programs below:

 Licensed Vocational Nursing program (Dallas)

 Associate Degree in Nursing program (Dallas)
 LVN-RN Transition program (Dallas)
 RN-BSN program (Online)
 Master of Science in Nursing: Nursing Education (Online)
 Master of Science in Nursing: Nursing Leadership Administration (Online)

How to Improve Cultural Competence in Health Care

Social determinants of health, such as working and living conditions and quality
healthcare access, aren’t the same for everyone. Health inequities pose a serious
challenge to the healthcare community, but healthcare providers have a powerful tool
at their disposal: cultural competence. Cultural competence in health care addresses
the disparities that people of racially and culturally diverse backgrounds often
experience. It can ensure all patients get the care they need to live healthier lives.
What Is Cultural Competence in Health Care?
Cultural competence in health care means delivering effective, quality care to patients
who have diverse beliefs, attitudes, values, and behaviors. This practice requires
systems that can personalize health care according to cultural and linguistic
differences. It also requires understanding the potential impact that cultural
differences can have on healthcare delivery.
For example, race, socioeconomics, health literacy, and other factors can influence:
 How patients perceive symptoms and health conditions
 When and how patients seek care
 Patients’ expectations of care
 Patients’ preferences regarding procedures or treatments
 Patients’ willingness to follow doctor recommendations or treatment plans
  Who patients believe should participate in making healthcare decisions
While cultural competence in health care initially referred to meeting the needs of
people from distinctive ethnic and racial groups, it now also refers to meeting the
needs of people with disabilities, those from diverse socioeconomic backgrounds, and
members of the LGBTQ community.
The Need for Cultural Competence in Health Care
Differences between healthcare providers and patients can affect communication. This
can, in turn, impact both clinicians’ and patients’ decisions with regard to treatment.
For example, a clinician may misinterpret a patient’s silence as a lack of interestin
receiving care. As a result, the clinician may not order a diagnostic test, when in fact
the patient’s response reflected their notion of respectful behavior.
When healthcare providers fail to recognize the differences between them and their
patients, they may inadvertently deliver lower-quality care. Cultivating skills that
improve cross-cultural communication can play an important role in delivering
equitable care.
Additionally, building teams with healthcare professionals who reflect the diversityof
the patient populations served can also improve cross-cultural communication.
Diverse teams have a wider cultural knowledge base that they can share with one
another. This makes them likely to respond with empathy to the unique cultural needs
of patients.
Language accessibility is also key. Language barriers keep patients from accurately
describing their symptoms and providers from explaining diagnoses. Language
barriers can also create unsafe and inappropriate situations in other ways.
For instance, clinicians may rely on children to serve as interpreters, putting young
people in the position of telling a parent they have cancer. As another example,
clinicians may rely on abusive spouses to interpret for their battered partners. Both
situations pose significant problems.
Combining Cultural Competence with Cultural Humility
Healthcare providers strive to develop a multicultural orientation to deliver culturally
sensitive care and improve communication. However, even when healthcare
professionals have a meaningful understanding of a culture, they still can’t predict the
behaviors and attitudes of their patients simply based on their cultural backgrounds.
That’s because people are unique, and their behavior and beliefs might not always
reflect those of their cultures.
Given this, healthcare professionals must focus on building cultural competence and
cultural humility. Cultural humility recognizes the limits of people’s knowledge of
others. It also acknowledges that even people who have cultivated their cultural
awareness can still have unintentional, unconscious biases about cultures other than
their own.
Cultural humility involves an ongoing process of self-evaluation. Through exploration
of and reflecting on their own beliefs and behaviors, healthcare professionals can
improve their awareness of implicit biases and foster an approach to patients
characterized by openness and curiosity about each new patient.
Goals of Cultural Competence in Health Care
Cultural competence aims to break down barriers that get in the way of patients’
receiving the care they need. It also strives to ensure improved understanding between
patients and their providers.
The growing diversity in the U.S. population demands that the healthcare community
expand its ability to address patient needs. Cultural competence offers a pathway and
a framework to reach the goal of better health for all patients.
Culturally and linguistically appropriate services, or CLAS, respond to individual
preferences and needs of each patient. They also help improve health outcomes and
decrease health disparities.
According to the U.S. Department of Health and Human Services Office of Minority
Health, the principal standard of CLAS involves delivering equitable care that is:
 Effective
 Understandable
 Respectful
Importance of Cultural Competence in Health Care
Cultural competence significantly benefits healthcare organizations and patients alike.
It results in more patient participation and engagement, fostering respect and
improved understanding, which can lead to:
 Increased patient safety
 Reduced inefficiencies
 Reduced care disparities
 Decreased costs
Improved Patient Outcomes
Cultural competence improves communication, which keeps patients safer. Clear
communication allows healthcare providers to collect accurate medical information. It
also encourages active dialogues in which patients and providers can ask questions,
correct misunderstandings, and build trust.
Studies have shown that the absence of culturally competent care can lead to
preventable mistakes and adverse events.
For example, a recent study in Hospital Pediatrics that examined patient safety in
hospitals across the U.S. suggests that patients lacking English language proficiency
experience more adverse safety events during hospitalization than fluent English
language speakers. The events they experience tend to be more severe as well.
Examples of Improved Patient Outcomes
On the flip side, the use of culturally competent strategies can lead to marked
improvements in health outcomes. A Plos One study reviewing culturally competent
strategies found numerous examples of interventions that made noteworthy
differences.
For example, after a medical center introduced a bilingual Russian internist to help
resolve language barriers, Russian-speaking patients with diabetes experienced
significant reductions in their blood pressure and cholesterol.
In another example, an in-patient psychiatric unit that incorporated Spanish language
proverbs into therapy sessions found increased participation, improved motivation,
and greater willingness to explore emotional topics among Spanish-speaking patients.
Improved Patient Experiences
Healthcare environments that show an awareness of and respect for differences create
more satisfying experiences for patients. When providers adjust treatments to meet
patient needs and preferences, patients notice, and their overall experience improves.
The Plos One review found that Black men rated providers’ behaviors and attitudes
significantly higher after the clinic gave its providers cultural competence training.
Another recent study published in the Journal of Sport Rehabilitation found cultural
competence positively affects how patients experience health care. In addition to
raising patient satisfaction, it increases the likelihood that patients will follow medical
advice. The more culturally competent patients find their providers to be, the better
their experiences. The study also indicated that patients treated by providers who
could speak their language felt more satisfied as well.
If a healthcare provider uses medical jargon unfamiliar to a patient or makes
assumptions about a patient because they use public health insurance, the patient may
likely feel frustrated. Conversely, if clinicians show nonjudgmental openness in
response to differences, actively listen, and make efforts to verify patients have
understood them, their patients are more likely to feel satisfied with their care.
Examples of Cultural Competence in Health Care
The following examples of cultural competence in health care illustrate ways that
healthcare organizations address cultural differences when providing care even when
obstacles and differences in perspectives exist. Consider the following situations:
Navigating a Challenging Birth
A pregnant farm laborer from Mexico arrives at an emergency room in medical
distress. Doctors discover the patient’s placenta has separated from the uterine wall,
making an urgent C-section necessary. The patient responds “yes” to all questions,
though it appears they have little understanding.
After the C-section, doctors admit the newborn to the NICU because the baby is
premature and has respiratory distress syndrome. The patient, their husband, and their
mother, all indigenous, speak only a smattering of Spanish and no English. Spanish-
speaking staff members try to get a clear history about the mother and explain the
baby’s condition to the family, but communication is a challenge.
As the baby’s condition becomes tenuous, the family wants to bring in a traditional
healer to cleanse the baby of its illness.
Culturally Competent Responses
In this case, delivering culturally competent care requires securing an interpreter who
speaks the patient’s native language. Only then can the healthcare providers take a
thorough medical history of the patient, learn about potential exposure to pesticides
through their work, and give the patient the opportunity to fully understand the
medical conditions of both the mother and the baby.
Additionally, with aninterpreter in place, healthcare providers can explain their
medical perspective and engage the patient and their family in a conversation to
understand their cultural perspectives and preferences in receiving care. Such a
conversation gives the family a chance to express its desire to bring a traditional
healer, as well as any other desires or concerns.
Once the medical team has better information and back-and-forth communication, it
can recommend culturally appropriate care and negotiate a plan of actionthat everyone
agrees on.
Adapting to a New Patient Population
A local hospital experiences an influx of ultra-orthodox Jewish patients as a newly
established Hasidic community nearby grows. The hospital staff has little knowledge
of the customs or traditions of this growing segment of the facility’s patient
population.
However, the staff has already encountered:
 Situations of patients refusing to eat
 Complaints that visitors who couldn’t use elevators on Jewish holidays lacked
access to stairwells
 Confusing exchanges when members of the orthodox community refused to
shake hands with healthcare providers of the opposite sex
Culturally Competent Responses
The hospital invites representatives from the Hasidic community to meet with
administrators and staff members to openly discuss traditions and customs potentially
relevant to their health care. The hospital also asksthe community representatives to
explain their community’s specific needs.
In this way, the hospital gets ideas and suggestions about established solutions the
community already has for dealing with customs, such as not using electricity on
Shabbat. The hospital also learns of other customs, such as no physical contact
between members of different genders.
Based on the conversations, the hospital proposes policies and procedures that can
better serve the needs of the Hasidic patient population. It then discusses those
policies and procedures with the community representatives to ensure the proposals
are appropriate.
Respecting a Patient’s Choices
A severely ill 80-year-old patient learns that one of their heart valves has stopped
working. To survive, they need surgery to replace the valve. The patient has a history
of excessive bleeding. This will require doctors to perform blood transfusions during
the surgery.
The patient is a devout Jehovah’s Witness. According to their religious beliefs and
interpretations, the Bible does not allow any type of blood transfusion, so the patient
refuses the surgery.
Culturally Competent Responses
The patient’s medical team engages the patient, their family, and trusted members
within the patient’s religious community in discussions about the nature of the surgery
and the risk that the patient might not survive without it. After the patient gets all the
information and seems to understand all the risks, the medical team respects their
choice to forgo the operation.
How to Improve Cultural Competence in Health Care
To meet the needs of all patients, organizations must learn how to improve cultural
competence in health care. They can begin by implementing strategies that develop
and improve cultural competence among healthcare teams.
Promote Awareness and Education to Improve Cultural Competence in
Health Care
Promoting awareness and education plays a key role in improving cultural
competence in health care. To develop cultural competence, healthcare professionals
need to identify their beliefs and build an awareness of their culture. This gives them a
basis to improve their cross-cultural awareness.
Cross-cultural awareness makes healthcare providers more open to unfamiliar
attitudes, practices, or behaviors. It also improves collaboration with patients and
helps them respond with flexibility. Benefits of cross-cultural awareness include:
 Improved rapport
 Tailored treatment plans
 Improved patient attendance and compliance
How can healthcare organizations best promote the cross-cultural awareness and other
skills needed for culturally competent health care?
Cultural Competence Training
Cultural competence training teaches healthcare providers intercultural
communication skills and helps trainees respond to cultural differences with greater
agility.
Additionally, cultural competence training can help organizations uncover
organizational policies or practices that act as barriers to different communities. Then,
they can adjust them to ensure they meet the needs of diverse patients.
Accessibility Leads to Improved Cultural Competence in Health Care
Cultural competence in health care demands accessibility. Accessibility means
ensuring that language, culture, race, and other such factors don’t become barriers to
patients’ receiving quality care. How can healthcare organizations make health care
more accessible?
Build Knowledge About the Local Community
Healthcare organizations should learn about the populations they serve. Collecting and
analyzing demographic data and sending targeted surveys to specific communities
builds important knowledge about local communities, which puts them in a much
better position to meet patient needs and ensure accessibility.
In this way, a hospital may learn it needs interpreters in Korean or Farsi, or it may
discover a large segment of the population requires Halal dietary options for hospital
stays.
Surveys and community engagement can uncover other key information that enables
healthcare organizations to become more accessible. For instance, community
engagement may clarify the need for staff members familiar with Nepalese culture or
the need to bolster a diabetes outreach program.
Recruit and Retain Diverse Team Members
Recruiting and retaining team members who accurately reflect the populations they
serve gives healthcare organizations a clear advantage in their efforts to deliver
culturally competent health care.
When patients encounter team members who look like them, speak their language, and
share their culture, they tend to feel more welcome. Healthcare providers who share
cultural similarities with their patients often have a greater capacity to communicate
with them, understand their perspectives, and anticipate their needs.
Diverse team members can also share their insights with their colleagues, deepening
everyone’s capacity to deliver culturally competent care.
Barriers to Cultural Competence in Health Care
Promoting cultural competence can present challenges. Some of the barriers to
cultural competence in health care include:
Adequate Knowledge of an Organization’s Cultural Competence
To successfully address cultural competence, healthcare organizations need to first
gauge their current performance. This involves answering questions such as:
  Where does the organization fall short in providing language accessibility?
 Where do care disparities exist within the system?
Without knowing where disparities exist, leadership can’t properly channel its energy
and resources.
As such, healthcare organizations that value cultural competence must collect data
about their patients’ races, language preferences, sexual orientations, ethnicities, etc.,
as well as track disparities. Patient surveys can also offer insight into an organization’s
level of cultural competence.
With the right information, healthcare organizations can target areas to improve.
As an example, data might reveal an organization serves a larger number of patients
from the LGBTQ community than previously realized. This gives leadership the
opportunity to make sure it has enough healthcare providers with specialized
knowledge in LGBTQ health care.
Putting Cultural Competence Into Action
To put cultural competence into action, healthcare organizations must create an
institutional framework that:
 Demonstrates culturally competent practices
 Cultivates cross-cultural awareness and communication
 Maintains a diverse workforce
Cultural competence demands an ongoing commitment and multipronged approach.
Healthcare organizations must build an infrastructure that supports activities and
protocols that ensure culturally competent practices.
Additionally, organizations must weather pushback from staff members who may
perceive cultural competence as limited to racial and ethnic diversity and already
consider themselves culturally competent. In such cases, healthcare organizations can
implement educational programs that broaden definitions of cultural competence.
Limited Resources to Support Cultural Competence
Realizing cultural competence in health care takes resources. Organizations must
invest time, money, and leadership into developing the infrastructure required to make
cultural competence more than just a value.
This means budgeting for, among other things:
 Linguistically diverse materials
 Interpreters
 Cultural competence training
 Diverse staff recruitment programs
Though prioritizing cultural competence comes with a price tag, it ultimately offers an
essential return on investment.
Promote Cultural Competence in Health Care
Healthcare administrators have an instrumental role to play in promoting cultural
competence in health care. Their expert knowledge in organizational behavior,
financial management, and information systems and analysis empowers them to build
the infrastructures needed to support culturally competent systems.
Explore how Tulane University’s Online Master of Health Administration equips
graduates with the skills needed to develop culturally competent systems capable of
meeting the needs of diverse communities.

The Need for Cultural Competence in Healthcare

In order to meet the needs of patients, healthcare providers will need to promote cultural
competency.

Certain types of cultural barriers in healthcare have the power to negatively impact outcomes
and lead to expensive consequences for health systems. Language barriers, for example, can
have devastating effects, as they did when a two-year-old Latina girl had two serious injuries
within two months – one of which caused her collarbone to fracture.

According to Smithsonian, the girl’s mother told the attending resident “Se pegó, se pegó,”
which sounded like “she was hit.” The resident understood the phrase as though the girl
was physically struck by someone. That interpretation combined with the girl’s recent
medical history led to her and her brother being taken away from their mother for several
days due to suspected child abuse.

Another story involves a high school teenager collapsing during a sporting event. He and his
girlfriend spoke little English, and the girl kept repeating the word “intoxicado.” The boy
received treatment for drug abuse and spent 48 hours in a coma. However, while “intoxicado”
can mean “intoxicated,” it can also refer to a “sick to the stomach” feeling, a symptom of a
brain aneurysm. That misunderstanding resulted in a $71 million malpractice lawsuit.

The previous examples illustrate how language barriers can prevent healthcare practitioners
from the getting information they need. Data from the U.S. Census Bureau indicates
that 8.5% of the population speaks English “less than very well.” In areas with the greatest
need for language services, about 36% of hospitals lack those systems, according to a study
in Health Affairs.

Language barriers are just one of several issues that prevent healthcare professionals from
delivering quality care. To meet patients’ needs, healthcare providers need to promote
cultural competency.

What is Cultural Competency? How Does it Relate to Healthcare?

Cultural competency refers to the ability to interact with people across cultures. When used in
healthcare, the term focuses on being able to care for patients with diverse values, beliefs, and
behaviors. Healthcare delivery needs to be tailored to patients’ social, cultural, and
linguistic needs, according to a report from Health Research & Educational Trust, the not-for-
profit research and educational affiliate of the American Hospital Association.

“A key component to new care delivery models, such as patient-centered medical homes and
accountable care organizations, is the ability to engage and educate patients about their health
status,” the report added. “While doing this is challenging with all patients, for diverse patient
populations it can be even more difficult due to language barriers, health literacy gap, and
cultural differences in communication styles.”

Cultural competency in healthcare can overcome health disparities such as language barriers,
cultural beliefs and practices, unconscious and conscious medical bias, variations in care
access and quality, and low health literacy, according to the global health service company
Cigna. The organization noted that racial and ethnic minorities currently comprise around a
third of the U.S. population. By 2055, minorities are expected to become the majority.

The Importance of Cultural Competence in Healthcare

Culturally competent care benefits the organization, patients, and the community, according
to Health Research & Educational Trust. “Organizations that are culturally competent have
improved health outcomes, increased respect and mutual understanding from patients, and
increased participation from the local community,” the report said.

It outlined three primary benefit areas of becoming a culturally competent healthcare

organization.

 Business benefits include enhancing the efficiency of care services, increasing the

market share of the organization, decreasing barriers that slow progress, helping to
meet legal and regulatory guidelines, and incorporating different perspectives, ideas,
and strategies into the decision-making progress.
 Health benefits include reducing care disparities in patient population, enhancing
preventive care, improving collection of patient data, and reducing the number of
medical errors, treatments, and medical visits.
 Social benefits include increasing trust, promoting community member inclusion,
involving the community in health issues, assisting patients and families in their care,
promoting patient and family health responsibility, and increasing mutual respect and
understanding for patients and the organization.

How to Become a Culturally Competent Practice

Healthcare providers and employers can take several steps toward becoming culturally
competent.

Consulting the National Culturally and Linguistically Appropriate Services (CLAS)

Standards is a good starting point for healthcare organizations. The 15 action steps of the
National CLAS Standards aim to advance health equity, improve quality, and eliminate
healthcare disparities.

Another strong resource comes from Health Research & Educational Trust and the Institute
for Diversity in Health Management. The guide explores how to enhance cultural
competency in healthcare, and it presented seven tasks hospital leaders can focus on. Self-
assessment questions are provided to go along with the seven recommendations that are
provided here.

1. Collect race, ethnicity, and language preference (REAL) data.

2. Identify and report disparities.
3. Provide culturally and linguistically competent care.
4. Develop culturally competent disease management programs.
5. Increase diversity and minority workforce pipelines.
 6. Involve the community.
7. Make cultural competency an institutional priority.

From an employer perspective, expanding staff to include experts in cultural competency and
diversity can help the institution become stronger in this area, according to Cigna. The
institution can provide materials and benefits information that is culturally competent, to help
staff members enhance their knowledge in the field. Other ideas include obtaining feedback
from diverse groups of employees about their personal experiences in healthcare and having
multicultural staff representatives support onsite health services, like health fairs and open
enrollment.

Achieving cultural competence in healthcare starts at a system level. You can help healthcare
organizations cater to the needs of patients with diverse values, beliefs, and behaviors by
earning your healthcare administration and public health degree online. This degree will help
you develop the skills and knowledge you’ll need to work in non-clinical settings. In a
convenient online format, you’ll learn from dedicated professors who have years of
experience in their fields.

By earning your degree online through Husson University, you’ll also have the opportunity to
earn a traditional MBA or a specialized MBA in healthcare management with only one
additional year of study. Over 95% of Husson graduates are employed or in graduate school
within one year of graduation.