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5 Questions That Help Gauge Your Hospital’s Cultural Competency


The rise in healthcare consumerism, catalyzed by aspects of healthcare reform, creates a number of challenges for hospitals, not the least of which is the demand for culturally competent care. After all, how can healthcare providers hope to achieve higher levels of patient engagement and satisfaction if they’re unable to effectively meet the needs of an increasingly diverse patient population? We’ve explored what has led to failings in the area of cultural competency in healthcare in these recent posts. Now, let’s focus in on five cultural competency questions you can ask—and answer—to assess your current level of cultural competency in healthcare.

A Quick Cultural Competency Assessment

Glenn Llopis, a frequent Forbes contributor on the cultural demographic shift taking place in the U.S., has said that “the cultural demographic shift represents a natural evolution of American enterprise, its business models and what is required to compete in today’s fiercely competitive global marketplace.” Like organizations in other sectors, hospitals and healthcare providers must adapt to these changes. 

Question 1: Do you understand the current demographic and cultural composition of your community? 

If you don’t already, you need to—sooner, rather than later. In addition to making good business sense, your ability to connect with the community at large is a necessity given two regulations highlighted in a Health Affairs blog last year:

  • The IRS form Schedule H that requires non-profit hospitals to seek input from underserved community members, many of whom are minorities, to better address population health
  • The ACA provision for a community health needs assessment and planning process to encourage hospitals to develop community health improvement plans and engage with the community better to reduce the burden of illness 

Population health management only works if you’re able to make meaningful connections with ALL the populations within your community—and that means tackling economic, social, cultural and language barriers that prevent engagement. How do you develop multicultural marketing and care plans unless you know whom to target? 

Question 2: Do you have demographic, cultural, and socio-economic data on your organization’s patient population?

Hospitals and other healthcare providers are gathering data at an astronomical rate, but does that data give you the level of detail you need?  EHRs and other health IT systems should incorporate information that goes beyond health data so that providers can quickly see how to best provide care. Llopis references a statement made by Earvin “Magic” Johnson who has pioneered business development in urban areas since retiring from the NBA. He told attendees at a business summit that the urban community, for example, wants what everyone wants—quality services and goods. He cautions, “But you have to look at it almost as you would entering a foreign country. You can’t have a cookie-cutter mentality, you have to tailor your approach in terms of fitting into urban America, not the other way around.” 

Question 3:  How closely does the demographic/cultural/socio-economic composition of your staff (all staff including clinicians, nurses, and the C-Suite) reflect your patient population?

If you answer, “not much,” you aren’t alone. According to an AHA Center for Healthcare Governance survey, reports Becker’s Hospital Review, hospital boards lack diversity. For example, in 2014:

  • 88 percent of board members were Caucasian
  • 71 percent of board members were 51 years old or older.

While it may take longer to shift the balance of power for hospital boards, many hospitals have recognized that diversity in the workforce—having clinicians who intimately understand the needs of a minority population—is critical to the delivery of effective, high-quality care. The Johns Hopkins Bayview Medical Center website, for example, features a quote from Richard G. Bennett, M.D., president of JHBMC and chairman of its diversity council, which states, “We have employees and patients who come from all over the world from all sorts of backgrounds who need our care. Our goal in healthcare is to provide the safest care and best service to all, and we believe our diversity council helps us to achieve those goals.”

Question 4: Do you understand what different demographic/cultural/socio-economic patient populations value, believe and find motivating?

Even when focusing on the needs of a single demographic, cultural or socio-economic patient population, you cannot rely on a one-size-fits-all solution. Why?  Because the values, beliefs and motivations of individuals will vary. Psychographic segmentation delves deeper, looking at the unique ways in which individuals respond to health and wellness issues. This can give you better insights into where patients will seek out health information and the best ways to connect with individuals given their attitudes towards healthcare. 

The 2015 c2b Consumer Diagnostic, a national study of healthcare consumers, examined the psychographic segment distribution among races/ethnicities.  While Willful Endurers represent the largest percentage of healthcare consumers across all races/ethnicities, this segment is represented to a much greater degree among Hispanics/Latinos and Asian Americans.  Whites/Caucasians are almost twice as likely as other races/ethnicities to be a Priority Juggler.  Blacks/African Americans are the most likely to be a Self Achiever.


Each segment has its own motivations and communication preferences regarding health and wellness, so a healthcare provider must understand these differences to optimize patient engagement. 

Question 5: Do you offer unique health literature/educational materials that speak to each unique patient population?

Customizing your approach to patient populations ensures higher levels of engagement—and you need to go beyond a simple translation of a brochure. Cultural context is extremely important.  You may need to develop materials that address gaps in health literacy that go beyond the language barrier. You also need to understand what motivates patients and deliver custom communications via the right channels to make lasting connections. 

By answering these five cultural competency questions—and developing a plan to address the issues that surface—you’ll begin to make the changes needed to prepare for a more diverse population and provide culturally competent care.

Psychographic Segmentation and its Practical Application in Patient Engagement and Behavior Change


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