External Programs, Division of General Internal Medicine, Lehigh Valley Health Network, Allentown, Pennsylvania, USA.
J Healthc Manag. 2010 May-Jun;55(3):190-204; discussion 204-5.
The number of cultural competency initiatives in healthcare is increasing due to many factors, including changing demographics, quality improvement and regulatory requirements, equitable care missions, and accreditation standards. To facilitate organization-wide transformation, a hospital or healthcare system must establish strategic goals, objectives, and implementation tasks for culturally competent provision of care. This article reports the largely successful results of a cultural competency program instituted at a large system in eastern Pennsylvania. Prior to the development of its cultural competency initiative, Lehigh Valley Health Network, Allentown, Pennsylvania, saw isolated activities producing innovative solutions to diversity and culture issues in the provision of equitable care. But it took a transformational event to support an organization-wide program in cultural competency by strengthening leadership buy-in and providing a sense of urgency, excitement, and shared vision among multiple stakeholders. A multidisciplinary task force, including senior leaders and a diverse group of employees, was created with the authority and responsibility to enact changes. Through a well-organized strategic planning process, existing patient and community demographic data were reviewed to describe existing disparities, a baseline assessment was completed, a mission statement was created, and clear metrics were developed. The strategic plan, which focused on five key areas (demographics, language-appropriate services, employees, training, and education/communication), was approved by the network's chief executive officer and senior managers to demonstrate commitment prior to implementation. Strategic plan implementation proceeded through a project structure consisting of subproject teams charged with achieving the following specific objectives: develop a cultural material repository, enhance employee recruitment/retention, establish a baseline assessment, standardize data collection, provide language-appropriate services, and develop an education program. Change management and project management methodologies; defined roles and responsibilities; and specific, measurable, attainable, realistic, and time-bound goals were used in the implementation. This process has supported organizational change, thereby promoting high-quality, safe, and equitable care through widespread expectations of culturally competent care delivery across the entire network. Using this "ecologic approach" will ensure long-term success.
由于多种因素，医疗保健领域的文化能力举措不断增加，包括人口结构变化、质量改进和监管要求、公平护理使命以及认证标准。为了促进全组织的变革，医院或医疗保健系统必须为文化能力护理制定战略目标、目的和实施任务。本文报告了宾夕法尼亚州东部一个大型系统实施的文化能力计划的主要成功结果。在制定其文化能力计划之前，宾夕法尼亚州阿伦敦的利哈伊谷健康网络（Lehigh Valley Health Network）看到了孤立的活动，这些活动为提供公平护理的多样性和文化问题提供了创新的解决方案。但是，需要一个变革性的事件来支持全组织范围内的文化能力计划，增强领导层的认可，并在多个利益相关者之间营造紧迫感、兴奋感和共同愿景。创建了一个由高级领导人和多元化员工组成的多学科工作组，赋予其实施变革的权力和责任。通过精心组织的战略规划过程，审查了现有患者和社区人口统计数据，以描述现有差距，完成基线评估，创建使命陈述，并制定明确的指标。该战略计划侧重于五个关键领域（人口统计、语言适当的服务、员工、培训和教育/沟通），并得到网络首席执行官和高级管理人员的批准，以在实施之前表明承诺。战略计划的实施通过一个项目结构进行，该结构由负责实现以下具体目标的子项目团队组成：开发文化材料库，增强员工招聘/保留，建立基线评估，标准化数据收集，提供语言适当的服务，并制定教育计划。在实施过程中使用了变更管理和项目管理方法；定义了角色和职责；以及具体、可衡量、可实现、现实和有时限的目标。这个过程支持了组织变革，从而通过整个网络广泛期望提供文化能力护理，促进高质量、安全和公平的护理。使用这种“生态方法”将确保长期成功。
