Can Hospital Cultural Competency Reduce Disparities in Patient Experiences With Care?

Abstract

Background Cultural competency has been espoused as an organizational strategy to reduce health disparities in care. Objective To examine the relationship between hospital cultural competency and inpatient experiences with care. Research Design The first model predicted Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) scores from hospital random effects, plus fixed effects for hospital cultural competency, individual race/ethnicity/language, and case-mix variables. The second model tested if the association between a hospital’s cultural competency and HCAHPS scores differed for minority and non-Hispanic white patients. Subjects The National CAHPS® Benchmarking Database’s (NCBD) HCAHPS Surveys and the Cultural Competency Assessment Tool of Hospitals (CCATH) Surveys for California hospitals were merged, resulting in 66 hospitals and 19,583 HCAHPS respondents in 2006. Measures Dependent variables include ten HCAHPS measures: six composites (communication with doctors, communication with nurses, staff responsiveness, pain control, communication about medications, and discharge information), two individual items (cleanliness, and quietness of patient rooms), and two global items (overall hospital rating, and whether patient would recommend hospital). Results Hospitals with greater cultural competency have better HCAHPS scores for doctor communication, hospital rating, and hospital recommendation. Furthermore, HCAHPS scores for minorities were higher at hospitals with greater cultural competency on four other dimensions: nurse communication, staff responsiveness, quiet room, and pain control. Conclusions Greater hospital cultural competency may improve overall patient experiences, but may particularly benefit minorities in their interactions with nurses and hospital staff. Such effort may not only serve longstanding goals of reducing racial/ethnic disparities in inpatient experience, but may also contribute to general quality improvement.

Getting satisfaction: drivers of surgical Hospital Consumer Assessment of Health care Providers and Systems survey scores

“…These racial disparities can be addressed through improved cultural competency. In a study evaluating the impact of cultural competency on HCAHPS scores satisfaction for minorities was significantly higher in institutions with greater cultural competency [14]. Disparity in satisfaction among non-whites may thus be addressed through attention to cultural competency assessment and improvement programs.…”

eSimulation: A novel approach to enhancing cultural competence within a health care organisation

“…The program was interesting and thought provoking 78% The feedback I received through the program was constructive 78% The resources provided in the program were useful 78% The most engaging aspects of the program were: Its interactivity 61% Being in the role of the nurse 43% Viewing the interaction between the interpreter and the patient 55% Viewing the interviews with the patient, daughter in law and interpreter 55% effectiveness in improvement of health outcomes for patients from culturally and linguistically diverse backgrounds (Renzaho et al, 2013;Weech-Maldonado et al, 2012;Betancourt and Green, 2010).…”

The Net Promoter Score – an asset to patient experience surveys?

“…The question involves 4 labelled categories: (i) Definitely no; (ii) Probably no; (iii) Probably yes and (iv) Definitely yes (identical to the American Hospital CAHPS survey. 22 ).…”