Resources
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
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
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