National Quality Forum sets bar for culturally competent care

Doctors and hospitals must account for an increasingly diverse patient pool in developing quality improvement programs, guidelines say.

By Kevin B. O’Reilly — Posted March 19, 2009

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The National Quality Forum has endorsed 45 changes it said doctors and hospitals should make to reduce disparities and provide more culturally competent medical care. More than 22 million U.S. residents speak limited English, and 34 million were born in another country, according to the American Medical Association's Ethical Force Program.

The NQF standards, adopted in late February, cover areas ranging from leadership and management systems to patient communication and health care work force diversity. A comprehensive approach is critical to improving the care that patients with low health literacy and different cultural expectations receive, said Winston Wong, MD, who co-chaired the committee that endorsed the best practices first developed by other health care organizations.

"One does not just go through a checklist and declare the organization as culturally competent," said Dr. Wong, director of the disparities improvement and quality initiative at Kaiser Permanente in Oakland, Calif. "It needs to be a dynamic process."

Dr. Wong said tackling disparities should not be an afterthought.

"Cultural competency is not to be marginalized," he said. "The guidelines talk about how to embed these things so you can systematically go about putting these essential parts in place to provide better quality of care to the diverse set of individuals who come into your organization."

Among other things, the guidelines call on health care organizations to measure properly the demographic, cultural and linguistic characteristics of their patient population, and improve training for doctors and other health professionals to provide appropriate care.

The nonprofit Commonwealth Fund and California Endowment funded the work of NQF's 19-member expert panel. NQF is a voluntary, consensus standards-setting body that counts the AMA as a member, along with many other organizations representing medical professionals, hospitals, employers, labor unions and patients.

The new guidelines will help set the stage for cultural competence standards that the Joint Commission, which accredits hospitals and other health care organizations, plans to unveil in January 2010.

The guidelines are available at the NQF Web site (link).

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