Underserved and Rural Beneficiaries

What is cultural competence?
Cultural competence is "the ability of systems to provide care to patients with diverse values, beliefs and behaviors including tailoring delivery of care to meet patients' social cultural and linguistic needs. The ultimate goal is a health care system and workforce that can deliver the highest quality of care to every patient, regardless of race, ethnicity, cultural background, or English proficiency." Every clinical encounter is cross-cultural, and health care professionals benefit by learning to provide culturally and linguistically responsive care. Cultural and linguistic competence training will increase patient satisfaction, improve patient compliance, and work to eliminate racial and ethnic health disparities.

Does disparity really exist?
You may have read the recent New England Journal of Medicine study on quality of health care that found whites and minorities get similar treatment. This article asserts that regardless of race or ethnicity, American consumers receive mediocre health care (view full article)

This finding does not contradict other research on disparities. Consider the following adapted from the Commission to End Health Care Disparities 2005 Summary:

• African American women are more than twice as likely to die of cervical cancer, as are white women.
• In 2000, death rates from stroke were 40 percent higher among African American adults than among white adults.
• Although African Americans and Hispanics represented 26 percent of the U.S. population in 2001, they accounted for 66 percent of adult AIDS cases.
• In 2001, African Americans and Hispanics over age 65 were less likely than non-Hispanic whites over 65 to report receiving influenza and pneumococcal vaccinations.
• Rates of blindness caused by diabetes are half as high for whites as they are for others.

CLAS Project
The right care for every person every time.

The importance of knowing how to properly treat patients from various cultures, religions and ethnicities can make the difference in achieving optimal health outcomes. Language barriers, coupled with not understanding a patient’s ethnic background, religion and traditions, appear to be the main reason medical errors occur, according to the Office of Management and Budget.

The Centers for Medicare & Medicaid Services (CMS) is committed to reducing health care disparities and has launched the Culturally and Linguistically Appropriate Services (CLAS) initiative. The CLAS initiative supports practitioners in implementing the national CLAS standards by promoting cultural competency training.

NMMRA is pleased to offer New Mexico’s CLAS Project, an online course in cultural competency, at no cost to New Mexico practitioners. Participants will work on provider and practice site system changes related to the CLAS standards and cultural competency over the next two years.

• Eliminate undesired outcomes and improve communication with your patients
• Access online training tools, videos, and workbooks on culturally responsive care
• Receive NMMRA consulting services at no charge to the practice
• Receive assistance in introducing culturally and linguistically appropriate tools to the practice setting, including signage, interpreter services, and patient education materials
• Develop a management plan that treats patients from all cultures as partners
• Improve staff and patient satisfaction
• Earn up to 9 hours of CME or CEU at no cost

Office of Minority Health Training
The U.S. Department of Health and Human Services' Office of Minority Health provides an online training course entitled "A Physicians Practical Guide to Culturally Competent Care." This training is offered to health care providers at no cost.

Resources
The following resources offer information on translation and interpretation services, strategies to improve patient communication, and links to articles detailing the impact of health disparities and a highlight of Hispanic American health.  Census data indicate New Mexico’s ethnic distribution will increase in African American, Asian and Hispanic populations.  These increases will increase demand for multilingual patient education materials.  Use these resources to understand the basics of race, ethnicity and health care. 

CLAS Strategic Planning Tool

NMMRA is pleased to provide this tool to help health care organizations develop a strategic plan to address culturally and linguistically appropriate services.  This template can be filled out electronically (MS Word) or printed (PDF) and completed by hand.   MS Word    PDF

CLAS Standards and Resources

The CLAS Standards and Resources document is a comprehensive listing of all 14 Culturally and Linguistically Appropriate Service standards paired with Web-based resources and tools to help implement the standards.   Download CLAS Standards and Resources

(The following links provided are intended to be helpful to providers interested in cultural competency and diversity issues. The views at these sites do not necessarily represent those of NMMRA;  NMMRA does not evaluate Web sites for content accuracy or application to any specific clinical situation and does not endorse any featured organizations.)

Translation and Interpretation Services

• Health Information Translations is a collaborative initiative to improve health education for limited English proficiency patients.
• Bilingual Advantage, Inc., based in Albuquerque, strives to improve the health care and education of multicultural populations by providing quality bilingual and multicultural services for the medical and educational community.
• Certified Languages International provides real-time telephone interpreting services in over 150 languages.

Improved Patient Communication

• Interplay, Inc., specializing in training caregivers to work powerfully and compassionately with patients, offers a selection of whitepapers and articles on cultural competency.
• The Robert Wood Johnson Foundation, which seeks to improve the health and health care of all Americans, provides an interactive photo essay: “More than Words: From Translation to Interpretation”

Articles

• “Reshaping Bedside Manner in a Diverse World” (Washington Post, Sunday, February 26, 2006)
• “Consumer Research Findings: Summary Report on the Hispanic/Latino Medicare Population” (Centers for Medicare & Medicaid Services (CMS) (formerly the Health Care Financing Administration, or HCFA), reporting findings of a 1997-1999 study under the project "Market Research for Beneficiaries.")

Hispanic American Health

• “Hispanic American Health” (Anuario Hispano Hispanic Yearbook, published by TIYM Publishing Company, Inc., 2006/2009 edition) 

Census Data or Population Change Distribution

• Census 2000 Briefs and Special Reports (U.S. Census Bureau, created March 7, 2001)
  

Multilingual Patient Education Materials

• The Stanford Health Library provides multilingual patient education and materials to help consumers gain greater understanding of health and medical issues.
• Hablamos Juntos, a project funded by the Robert Wood Johnson Foundation, and administered by the UCSF Fresno Center for Medical Education & Research, offers tools and resources including signage using universal symbols, interpreter services, non-English materials, and information on Hablamos Juntos demonstrations.

Race, Ethnicity and Health Care

• The Henry J. Kaiser Family Foundation, providing students, faculty and others interested in learning about health policy easy access to the latest data, research, analysis, and developments in health policy, includes information on race, ethnicity, and health care.

For information about the CLAS Project or NMMRA’s underserved efforts, contact Willa Pilar, NMMRA quality improvement coordinator, at (505) 998-9731.