Presentation on theme: "Developing Organizational Commitment to Cultural Competence"— Presentation transcript:
1 Developing Organizational Commitment to Cultural Competence Peter J. Guarnaccia, Ph.D.Institute for Health, Health Care Policyand Aging ResearchRutgers, The State University of New JerseyPresentation at the Annual Research Meeting Of Academy Health in the session on “National Standards For Culturally & Linguistically Appropriate Behavioral Health Care: Are We Kidding Ourselves,” June 27, 2005, Boston, MA
2 Focus on Health Disparities IOM report “Unequal Treatment: Confronting Racial and Ethnic Disparities in Health Care Surgeon General’s report on “Mental Health: Culture, Race and Ethnicity” President’s New Freedom Commission on Mental Health’s report “Achieving the Promise: Transforming Mental Health Care in America” 
3 CULTURAL SENSITIVITY AND DIVERSITY CULTURAL SENSTIVITY: How staff explore their own backgrounds and attitudes towards consumers.CULTURAL DIVERSITY: How an organization deals with differences among staff and matches staff to consumers.
4 CULTURAL COMPETENCE CULTURAL COMPETENCE: System‑level, organizational issues in dealing with a multicultural consumer populationIncludes cultural sensitivity and cultural diversityGoes beyond attitudes and staffing patternsIncludes skills and program elements which enhance services to a diverse consumer population
5 CLAS & SAMHSA Standards Culturally and Linguistically Appropriate Standards (CLAS) from the Office of Minority Health, DHHSProvide a comprehensive overview of the components of a culturally competent health care organizationLack implementation guidelines or performance standardsSAMHSA Cultural Competence Standards for Managed Behavioral Health Care OrganizationsProvide consensus guidelines developed through a multi-ethnic process of developmentLack implementation guidelines, but provide extensive performance standards for organizations
6 Barriers to Implementation of Organizational Cultural Competence Cultural competence training needs to incorporate the senior leadershipThere are significant costs to implementing cultural competence trainingStaff in managed mental health care programs are often overwhelmed by productivity demands and paperwork requirements.
7 Barriers to Implementation of Organizational Cultural Competence There is a dearth of research establishing the impact of cultural competence interventions on:improving program qualitysuccess in recruiting and retaining a diverse patient population.Management information systems need to be adapted to identify the differential experiences of diverse client populations.
8 Crossing Cultural Bridges Research team at large northeastern, university-based managed behavioral health care programFunding from SAMHSA to develop a model curriculum for training mental health professionals to provide culturally competent careWilliam Vega & Paulette Hines, PIsComprehensive program of organizational and clinical training with links to quality improvement processes
9 Important Elements of the Organizational Component Creating dedicated time for senior leadership to focus on cultural competence issues (4 half days and 2 full day models)Providing a structured format for working through the issuesWorksheetsResource materialsData and photos from their programsIntegrating the Directors of Training and Quality Improvement into the programEmphasizing a Quality Improvement Focus
10 Organizational Curriculum Elements Module 1Overview of Cultural CompetenceNational and Local Standards for Cultural Competence – The Context of ChangeAdapting Mission Statement and Objectives to Incorporate Cultural Competence
11 Organizational Curriculum Elements Module 2Community Demographics and Staffing PatternsRecruitment/Retention of Multicultural StaffReview and Assessment of the Program Environments for Cultural Competence
12 Organizational Curriculum Elements Module 3Cultural Competence Self-Assessment: Tools and How to Use ThemIntegrating Cultural Competence into Human Resource Development Programs
13 Organizational Curriculum Elements Module 4Integrating Cultural Competence into Quality Improvement ProgramsPutting It All Together: Agency’s Cultural Competence Plan and Planning Process
14 Ethnic Diversity in State and Among Program Clients and Staff
15 Interventions on Staffing Presented data on demographics of local communities for each of the sitesDuring the training, leadership spoke with personnel office about recruitment approachesDiscovered major method was an ad in a single regional newspaperBrainstormed alternative approaches
16 Sub Scores on the Agency Cultural Competence Survey Remember: lower scores mean better cultural competence!
17 Agency Cultural Competency A Staff Survey Developed by head of QIDesigned to be easily administered and analyzedGiven to all staff to report on their perceptions of the organizationIdentifies weaknesses and strengthsDesigned to assess organization; not evaluate individualsProvides benchmark to measure progress
18 No-Shows for Follow-Up Appointments by Ethnicity and Site
19 Focus on Quality Improvement Cultural competence efforts need to be tightly linked to quality improvement effortsNeed to include ethnicity in management information systemNeed to work with staff to collect data on ethnicity of clientsNeed to make the data readily available in ways that program staff can use
20 Lessons to Be LearnedStart with leadership and programs that are ready to innovate, rather than trying to transform the entire agencyIntroduce data on client outcomes and processes early in the effortLink clinical training to regular clinical work (e.g. case consultations)Infuse cultural competence into on-going training programs (orientation, treatment modalities, clinical assessments)