Description
Build organizational and clinical skills to deliver equitable care to diverse populations
The second edition of Cultural Competence in Health Care: A Systems Approach presents the growing evidence base for a systems approach to cultural competence and strategic diversity management in health care and explains how health care professionals and organizations can use that knowledge to ensure that every patient receives high-quality, safe, and cost-effective personalized health care. The impact of race and ethnicity, gender and gender identity, sexual orientation, age, language, socioeconomic status, and religion on health and health care are discussed.
Despite the current challenges, private sector organizations that accredit health care providers, health plans, and educational programs in medicine, nursing, and allied health continue to affirm the need for cultural competence through their accreditation criteria. Voluntary health care professional associations continue to provide membership with support, encouragement, and resources for the delivery of culturally and linguistically competent health care. And health care providers strive every day to deliver personalized care and work diligently to improve their patients' health by delivering health care in a manner that is respectful of each patient's needs and preferences.
Written by the same three nationally known scholars and experts as the first edition, the second edition presents principles and practices that can be realistically incorporated into the ongoing work of any health care provider or organization. Each chapter contains learning objectives, summary, key terms, and review questions and activities designed to allow the reader to explore, analyze, and apply concepts and practices identified throughout the text.
Table of Contents
Figures and Tables xii
About the Authors xiv
Preface xvii
Acknowledgments xxii
About the Companion Website xxiv
Part One THE DIVERSITY IMPERATIVE 1
Chapter 1 Systems Approach to Cultural Competence 3
Dimensions of Diversity 7
Health Care Diversity Challenges 20
Health Care Disparities in the United States 22
Changing the US Health Care System 23
Systems Approach in the Health Care Delivery Organization 27
The Importance of Leadership 29
Summary 30
Key Terms 30
Review Questions and Activities 31
References 32
Chapter 2 Systematic Attention to Health Care Disparities 37
What Are Health Care Disparities? 38
Racial and Ethnic Disparities in Health Status 39
Disparities Across Other Diversity Dimensions: Gender, Gender Identity, Sexual Orientation, the Elderly 53
Stakeholder Attention to Health Care Disparities 62
Systematic Strategies for Reducing Health Care Disparities 66
Summary 70
Key Terms 70
Review Questions and Activities 71
References 71
Chapter 3 Workforce Demographics 78
Trends in the US Labor Force 79
Diversity and the Health Professions 83
Drivers of Disparities in the Health Professions 86
Recommended Organizational- Level Actions 91
Workforce Diversity Challenges 93
Summary 97
Key Terms 98
Review Questions and Activities 98
References 99
Part Two The Development of Cultural Competence 103
Chapter 4 Foundations for Cultural Competence in Health Care 105
What Is Cultural Competence in Health Care? 106
Long Journey Toward Cultural Competence 117
Cultural Competence and the Health Care Provider Organization 124
Cultural Competence and the Multicultural Health Care Workforce 130
Summary 134
Key Terms 135
Review Questions and Activities 135
References 136
Chapter 5 Hallmarks of Cultural Competence in Health Care Professionals 138
Personal Journey of Cultural Competence 140
Framework for Role Development 148
Journey of Self- Discovery 152
Summary 161
Key Terms 162
Review Questions and Activities 162
References 164
Chapter 6 Training for Knowledge and Skills in Culturally Competent Care for Diverse Populations 165
Eight Principles for Knowledge and Skills Training 167
Cultural Competence Knowledge and Skills for Administrators and Directors 171
Cultural Competence Training for Health Care Professionals in Direct Patient Care 177
Cultural Competence Training for Support Staff 201
The Role of Assessment in Cultural Competence Training 203
Receptivity to Knowledge and Skills Training 206
Summary 208
Key Terms 208
Review Questions and Activities 209
References 210
Part Three Cultural Competence and Health Care Delivery 215
Chapter 7 Cultural Competence in Health Care Encounters 217
Models from Transcultural Nursing 221
Giger– Davidhizar Transcultural Assessment Model (GDTAM) 234
Being Culturally Responsive 246
Summary 248
Key Terms 249
Review Questions and Activities 249
References 250
Chapter 8 Language Access Services and Crosscultural Communication 254
Language Use in the United States 256
Language Differences in Health Care Encounters 258
Attitudes Toward Limited- English Speakers 263
Changing Responses to Language Barriers in Health Care 266
An Expanding Profession: The Medical Interpreter 277
Translation in Written Health Care Communication 283
Communication Is More Than Words 286
Summary 289
Key Terms 290
Review Questions and Activities 290
References 291
Chapter 9 Group Identity Development and Health Care Delivery 297
Research Highlights 299
Minority Status Group Identity Development 303
Majority Status Group Identity Development 311
Using the Models 323
Summary 325
Key Terms 326
Review Questions and Activities 327
References 328
Part Four Cultural Competence and the Health Care Organization 331
Chapter 10 The Centrality of Organizational Behavior 333
The Science of Organizational Behavior 335
Organizations as Contexts for Behavior 336
OB Research Highlights 338
Can Culturally Competent Health Care Professionals “Go It Alone”? 350
Summary 356
Key Terms 357
Review Questions and Activities 357
References 358
Chapter 11 The Business Case and Best Demonstrated Practices 362
Evolution of the Business Case 364
The Business Case for Cultural Competence in Health Care 364
Workforce, HRM, and the Business Case 375
Best Demonstrated Practices 378
Assessment and the Systems Approach 391
Benchmarking 393
Role of Metrics in the Systems Approach 394
Summary 399
Key Terms 400
Review Questions and Activities 401
References 402
Chapter 12 The Future of Diversity and Cultural Competence in Health Care 406
Trends That Support Widespread Adoption of the Systems Approach 407
The Sustainability Movement and the Systems Approach 417
Change Management and Force- Field Analysis: Tools to Envision and Shape the Future 418
Summary 424
Key Terms 424
Review Questions and Activities 425
References 425
Glossary 429
Index 437
