The Commonwealth Fund’s report Cultural Competence in Health Care: Emerging Frameworks and Practical Approaches provides four brief case study examples of culturally competent healthcare service models. Your textbook outlines the U.S. Department of Health and Human Services’ Office of Minority Health’s National Standards for Culturally and Linguistically Appropriate Services (CLAS). The CLAS consists of 15 standards. Choose one of the case studies in the report and discuss which elements of the CLAS the healthcare service meets. For those standards that the service does not meet, how could the service be improved or changed to meet the additional standards? When responding to your classmates, evaluate your classmates’ recommendations and suggest additional ways in which the chosen case study’s service could be improved to meet the CLAS standards.
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Cultural Competence in Health Care: Emerging Frameworks and
Practical Approaches
This report spotlights a diverse group of health care organizations striving to improve access to and quality of care for a
growing minority and immigrant population. According to the report, these organizations are working to dismantle the
cultural and communication barriers to quality health care through innovative programs that develop minority leadership,
promote health system redesign, and train health care providers to better understand and manage the social and cultural
factors that affect patients’ health beliefs and behaviors.
In addition to highlighting these model programs, the study also provides the first comprehensive framework for health
care organizations seeking to address cultural barriers in health care delivery. The report, Cultural Competence in Health
Care: Emerging Frameworks and Practical Approaches, was written by Joseph R. Betancourt, M.D., of Massachusetts
General Hospital—Harvard Medical School, Alexander R. Green, M.D., and J. Emilio Carrillo, M.D., both of New York-
Presbyterian Hospital—Weill Medical College of Cornell University. The Fund report follows from recommendations of the
2002 Institute of Medicine report, Unequal Treatment, highlighting cultural competence as part of a comprehensive effort
to address racial and ethnic disparities in health care.
The authors conducted an extensive literature review, interviewed experts in the field of cultural competence, and
conducted site visits in academic, government, managed care, and community health settings to explore programs in
October 1, 2002 | Joseph Betancourt
https://www.commonwealthfund.org/person/joseph-betancourt
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more depth. They recommend steps health care organizations can take to implement programs that take into account
the needs of their own patient population, available resources, and the business case for improving care. The sites visited
were: White Memorial Medical Center Family Practice Residency Program, Los Angeles; Language Interpreter Services and
Translations, Washington State; Kaiser Permanente, San Francisco; and Sunset Park Family Health Center Network of
Lutheran Medical Center, Brooklyn, N.Y.
The authors outline promising practices on three levels–organizational, systemic, and clinical–used by health care
organizations to increase cultural competence. Organizational practices focus on hiring and promoting minorities in the
health care workforce. Systemic practices include providing on-site interpreters in settings with high numbers of limited-
English speaking patients and involving representatives of the community in quality improvement efforts. Clinical practices
include integrating cultural competence into training for health care providers.
Facts and Figures
Minorities make up 28% of the U.S. population but only 3% of medical school faculty. Only 7% of all physicians are
minorities.
At the San Francisco Medical Center, Kaiser Permanente established a department of multicultural services that
provides on-site interpreters in 14 different languages and dialects.
The White Memorial Medical Center Family Practice Residency Program requires 30 hours of training in issues
surrounding cultural competence.
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Publication Details
Publication Date: October 1, 2002
Citation:
1/3/2021 Cultural Competence in Health Care: Emerging Frameworks and Practical Approaches | Commonwealth Fund
https://www.commonwealthfund.org/publications/fund-reports/2002/oct/cultural-competence-health-care-emerging-frameworks-and 3/4
Cultural Competence in Health Care: Emerging Frameworks and Practical Approaches, Joseph R. Betancourt, M.D., M.P.H.,
Alexander R. Green, M.D., and J. Emilio Carrillo, M.D., The Commonwealth Fund, October 2002
Topics
Vulnerable Populations
Experts
Joseph Betancourt
Director of the Disparities Solutions Center, Institute for Health Policy
https://www.commonwealthfund.org/vulnerable-populations
https://www.commonwealthfund.org/person/joseph-betancourt
1/3/2021 Cultural Competence in Health Care: Emerging Frameworks and Practical Approaches | Commonwealth Fund
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© 2021 The Commonwealth Fund. All Rights Reserved.
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