Effective healthcare is about more than running the correct diagnostics and prescribing the right treatment. Patients need to feel valued and understood to get the best patient care.
Unfortunately, many healthcare professionals never have the opportunity to encounter new cultures before they enter healthcare professionally. This can mean that doctors, nurses, and therapists are ill-equipped to serve a diverse patient pool.
However, diverse hospitals like Vanderbilt University Medical Center and the Mount Sinai Health System show that it is possible to make healthcare a more exclusive experience for everyone. With time and effort, anyone can learn about new cultures and understand the unique pressures that patients may be facing when they enter the healthcare system.
Cultural competency is a hot topic in healthcare settings around the country. Every medical practitioner worth their salt wants to show that they know how to serve patients from an array of backgrounds. However, few actually understand the meaning of cultural competency and how culture can impact patient healthcare outcomes.
A recent study published in the American Society of Plastic Surgeons defines culture as the “cumulative deposit of knowledge acquired by a group of people over the course of generations.” They also go on to define cultural competency as the “ability to collaborate effectually with individuals from different cultures.”
The importance of culturally competent healthcare cannot be overstated. Culturally competent healthcare providers can influence patient outcomes like:
Patient perceptions of symptoms/treatment
Reduce readmission rates
Reduce cancellation rate
It may be hard to imagine how, exactly, cultural competency affects diagnosis and readmission rates. However, cultural competency helps healthcare professionals understand unspoken cultural conventions.
For example, if a healthcare practitioner is serving a non-verbal child who avoids tasks like homework and up-close tasks, cultural queues and competency may help them realize that the child is not lazy, but is displaying the warning signs of early vision problems. A child who struggles to complete any detail-oriented tasks may have eye convergence issues that are indicative of deeper-lying vision problems or disabilities like dyslexia.
By taking the time to complete cultural competency training, healthcare practitioners can read between the lines and draw from more diagnostic data when assessing patients from a range of different backgrounds.
Cultural competency does not just improve individual experiences in the healthcare system. Being culturally competent ensures that healthcare practitioners are a productive part of the wider healthcare ecosystem in the USA. This is particularly important today, as healthcare gaps and disparities in service plague large parts of the wider populace.
Divisive healthcare gaps continue to undermine public health and patient outcomes in healthcare. Today, the United States ranks last amongst all “developed” nations on access to care, administrative efficiency, equity, and healthcare outcomes. Findings from the Commonwealth Fund show stark disparities between income groups due to financial fears related to treatment.
A recent slew of hospital closures in the wake of the pandemic means that rural patients are more likely to die from accidental causes and are less likely to receive the preventative treatment they need for conditions like cancer and heart conditions. As a result, more patients are coming from further afield to see healthcare professionals.
Healthcare providers who cherish cultural competency can better serve rural and low-income patients by understanding the unique pressures they may face. For example, rural and low-income patients may be less likely to take time off work to visit the hospital. So, instead, hospitals should offer high quality virtual healthcare. This ensures that vulnerable folks can see a doctor regardless of their location, access to transport, and work commitments.
Data collection is key to improving populace health and improving public well-being. Without an effective data collection program, healthcare providers can only provide a reactive service without addressing the root cause of common issues like heart conditions and respiratory diseases.
Cultural competency is vital when collecting and assessing wider health-related data. Decision-makers need to understand the population they serve before jumping to conclusions about patient health outcomes and data sets.
A deeper appreciation for cultural differences can help build trust and improve community outreach, too. Patients are far more likely to attend community workshops and well-being events if they trust the local healthcare providers and understand how providers serve the populace. Even small changes, like increasing the representation of underserved communities and publishing materials in multiple languages, can make a world of difference to patient trust and participation.
Healthcare is expensive for patients and providers alike. However, culturally competent healthcare professionals can reduce operating costs and improve efficiency in the workplace. That is because cultural competency improves communication and understanding between provider and patient. This is key when prescribing medicine, booking follow-up appointments, and assessing the effectiveness of treatment.
These may sound like bold claims. However, adapting to cultural expectations can be particularly important for healthcare providers who see a range of patients. Providers need to know how things like culture, race, and ethnicity intersect with other demographic factors like gender and ability.
For example, a recent survey on same-gender provider preferences found that, in general, younger women prefer to see women healthcare providers. This trend largely dissipates as women grow older, as women past the age of 49 are almost as likely to book an opposite-gender appointment as a same-gender appointment.
However, providers need to understand how intersectional cultural differences may influence these findings. Some women may buck the wider trend and continue to prefer same-gender treatment even in later life. Adapting to the needs of a diverse patient pool ensures that every patient can book an appointment with a healthcare provider who values an intersectional approach to healthcare.
Reduced costs and improved efficiency free up time for reinvestment and retraining. Providers and professionals that want to improve their service can invest in preventative healthcare measures in traditionally underserved communities to further close the healthcare gap and improve the populace’s well-being. This is particularly important in areas where underrepresented communities traditionally distrust healthcare providers.
Cultural competency is integral to the operational effectiveness of any healthcare setting. Providers who understand their patients can cut their costs, increase their data collection, and improve the effectiveness of their community outreach programs.
However, actually improving cultural competency can be hard. Instructing healthcare professionals to “be aware” of cultural differences will do little to improve the inclusivity or equity of the service that they provide.
Instead, providers need to adopt a top-down approach that encourages policy changes and re-training based on feedback, data, and current attitudes toward cultural differences.
Culturally competent healthcare starts with policy changes. Without a clear policy as a guide, cultural competency will go unnoticed by staff and patients alike. A clear policy that champions cultural competency also shows that a provider’s commitment to diversity, equity, and inclusion is sincere.
The importance of policy changes is underlined by a meta-analysis completed by the Agency for Healthcare Research and Quality (AHRQ). Researchers found that, in addition to training, “changing clinical environments can also be key to purposeful change in behavior.” While training and improved awareness are important, they found that “for gains to translate into culturally competent behaviors, there also needs to be changes in the structures and culture of health care systems and organizations.”
Suggesting specific, universal changes to the structure and culture of healthcare organizations is all but impossible. Instead, healthcare providers need to discover their weaknesses and address the most common cultural issues that persist in their facility. This ensures that policy changes are relevant to current staff and that changes make a meaningful difference to patient health outcomes.
Any policy changes that healthcare providers make should be followed up with training that seeks to improve cultural competency in the workplace. However, before budgeting for training that improves inclusion and equity, providers need to understand how cultural competency training translates to improved patient health outcomes.
Researchers from the AHRQ posit that there are two methods of training available to providers. These approaches are called:
Group-specific training seeks to improve awareness about the cultural conventions and norms of a particular demographic. This approach can be particularly effective if healthcare providers see a sudden increase in patients from a traditionally underrepresented culture. However, group-specific training can be fraught with stereotypes and stigma. Providers may mistakenly lean into stereotypes and oversimplify their approach to patients from a particular background.
General/universal training seeks to improve cultural competence by prioritizing empathy and active listening. This can be taught through “reflective awareness, empathy, active listening techniques, and the cognitive mechanisms.” This aims to produce a universally adaptable approach to cultural differences that helps healthcare professionals navigate unfamiliar cultural conventions with respect and dignity.
Cultural competency is largely subjective. However, providers can use key performance indicators and qualitative feedback opportunities to assess improvements and make future adjustments to their current operations.
Simple demographic data may help providers understand their current cultural competency. Surveying staff to find out about their unique backgrounds and skills can help providers identify issues like a lack of multilingual staff or disparities in representation at each level of the organizational hierarchy.
Providers should survey their patients, too. Surveys and feedback forms designed to produce demographic data can give providers useful qualitative feedback that can be used to improve patient health outcomes. Even simple questions like “Do you trust your doctor?” or “How confident do you feel when in the hospital” can be overlaid with demographic data to discover trends and discrepancies within the patient pool.
By partnering patient data with qualitative feedback, providers can adjust their service and track the efficacy of their training protocols. Providers that employ a large number of staff can conduct cross-departmental experiments to trial policy changes and retraining programs before they go live to the entire workforce. This gives providers the best chance of providing patients with an experience that builds trust and improves long-term health outcomes.
Cultural competency is integral to the long-term success of any healthcare professional or provider. Being culturally competent can help therapists, doctors, and nurses connect with their patients and navigate differences from a point of understanding and empathy. Respect for cultural differences can also build trust within the community and increase uptake in preventative health measures like screenings and exercise groups.
Providers can foreground cultural competency in their facility by making policy changes that reflect the need for greater inclusion and empathy for all patients. Likewise, healthcare professionals can improve their understanding by engaging in training initiatives that cover both group-specific and universal cultural differences. This should be followed up with surveys to gather qualitative and quantitative feedback that measures the efficacy of initiatives that seek to improve cultural competency in the workplace.