Hospital cultural competency as a systematic organizational intervention: Key findings from the national center for healthcare leadership diversity demonstration project.

Abstract:

BACKGROUND:Cultural competency or the ongoing capacity of health care systems to provide for high-quality care to diverse patient populations (National Quality Forum, 2008) has been proposed as an organizational strategy to address disparities in quality of care, patient experience, and workforce representation. But far too many health care organizations still do not treat cultural competency as a business imperative and driver of strategy. PURPOSES:The aim of the study was to examine the impact of a systematic, multifaceted, and organizational level cultural competency initiative on hospital performance metrics at the organizational and individual levels. METHODOLOGY/APPROACH:This demonstration project employs a pre-post control group design. Two hospital systems participated in the study. Within each system, two hospitals were selected to serve as the intervention and control hospitals. Executive leadership (C-suite) and all staff at one general medical/surgical nursing unit at the intervention hospitals experienced a systematic, planned cultural competency intervention. Assessments and interventions focused on three organizational level competencies of cultural competency (diversity leadership, strategic human resource management, and patient cultural competency) and three individual level competencies (diversity attitudes, implicit bias, and racial/ethnic identity status). In addition, we evaluated the impact of the intervention on diversity climate and workforce diversity. FINDINGS:Overall performance improvement was greater in each of the two intervention hospitals than in the control hospital within the same health care system. Both intervention hospitals experienced improvements in the organizational level competencies of diversity leadership and strategic human resource management. Similarly, improvements were observed in the individual level competencies for diversity attitudes and implicit bias for Blacks among the intervention hospitals. Furthermore, intervention hospitals outperformed their respective control hospitals with respect to diversity climate. PRACTICE IMPLICATIONS:A focused and systematic approach to organizational change when coupled with interventions that encourage individual growth and development may be an effective approach to building culturally competent health care organizations.

journal_name

Health Care Manage Rev

authors

Weech-Maldonado R,Dreachslin JL,Epané JP,Gail J,Gupta S,Wainio JA

doi

10.1097/HMR.0000000000000128

subject

Has Abstract

pub_date

2018-01-01 00:00:00

pages

30-41

issue

1

eissn

0361-6274

issn

1550-5030

journal_volume

43

pub_type

杂志文章
  • Organizational characteristics and administrative strategies associated with staff turnover.

    abstract::In a study at 55 hemodialysis facilities, turnover was not associated with organizational size, location, or ownership but varied according to administrative strategies. Technician turnover (32 percent) was lower in facilities with shorter hours and choice of work schedule even though workload was higher. Clerical tur...

    journal_title:Health care management review

    pub_type: 杂志文章

    doi:10.1097/00004010-199301840-00009

    authors: Bame SI

    更新日期:1993-10-01 00:00:00

  • The importance of team level tacit knowledge and related characteristics of high-performing health care teams.

    abstract::Team level tacit knowledge is related to the collective knowledge of the team members. It is the shared experience that results in the ability to successfully anticipate the reactions of teammates in typical and nontypical situations. This study evaluates how tacit knowledge and related team characteristics influence ...

    journal_title:Health care management review

    pub_type: 杂志文章

    doi:10.1097/00004010-200607000-00008

    authors: Friedman LH,Bernell SL

    更新日期:2006-07-01 00:00:00

  • Transformational change in health care systems: an organizational model.

    abstract:BACKGROUND:The Institute of Medicine's 2001 report Crossing the Quality Chasm argued for fundamental redesign of the U.S. health care system. Six years later, many health care organizations have embraced the report's goals, but few have succeeded in making the substantial transformations needed to achieve those aims. ...

    journal_title:Health care management review

    pub_type: 杂志文章

    doi:10.1097/01.HMR.0000296785.29718.5d

    authors: Lukas CV,Holmes SK,Cohen AB,Restuccia J,Cramer IE,Shwartz M,Charns MP

    更新日期:2007-10-01 00:00:00

  • Hospital diversification into long-term care.

    abstract::In the 1990s, acute care hospitals in the United States encountered an unstable operating environment created by a series of transformations in the health care delivery system and long-term-care market. Confronted with an array of economic pressures and demographic changes, hospitals were motivated to engage in long-t...

    journal_title:Health care management review

    pub_type: 杂志文章

    doi:10.1097/00004010-200107000-00009

    authors: Shah A,Fennell M,Mor V

    更新日期:2001-07-01 00:00:00

  • Beyond service quality: the mediating role of patient safety perceptions in the patient experience-satisfaction relationship.

    abstract:BACKGROUND:Although the extant literature on patient safety is rich, few studies have specifically examined safety from the patient perspective. In addition, little is known about how patients decide whether they are safe or satisfied with their care. From a foundation of attribution theory, we suggest that patients ma...

    journal_title:Health care management review

    pub_type: 杂志文章

    doi:10.1097/HMR.0b013e318219cda1

    authors: Rathert C,May DR,Williams ES

    更新日期:2011-10-01 00:00:00

  • Transformational leadership and workplace injury and absenteeism: analysis of a National Nursing Assistant Survey.

    abstract:BACKGROUND:Transformational leadership (TL) has long been popular among management scholars and health services researchers, but no research studies have empirically tested the association of TL with workplace injuries and absenteeism among nursing assistants (NAs). PURPOSE:This cross-sectional study seeks to explore ...

    journal_title:Health care management review

    pub_type: 杂志文章

    doi:10.1097/HMR.0b013e3182100bf7

    authors: Lee D,Coustasse A,Sikula A Sr

    更新日期:2011-10-01 00:00:00

  • The end of autonomy? Reflections on the postprofessional physician.

    abstract::Of the many characteristics that classify the practice of medicine as a profession, autonomy plays the most important role. There are currently assaults on the profession's ability to select, train, and license its own practitioners and on the medical knowledge base itself, as well as the standards for applying it. Th...

    journal_title:Health care management review

    pub_type: 杂志文章

    doi:10.1097/00004010-199201710-00008

    authors: O'Connor SJ,Lanning JA

    更新日期:1992-01-01 00:00:00

  • Organizational development in academic medicine: an educational approach.

    abstract::Can organizational development work in the academic setting? Because current cost constraints and federal regulations are forcing departments and services to integrate, organizational development may be the best option for management. The study reported here shows that it can work successfully in the family medicine d...

    journal_title:Health care management review

    pub_type: 杂志文章

    doi:10.1097/00004010-198501010-00005

    authors: Aluise JJ,Bogdewic SP,McLaughlin CP

    更新日期:1985-01-01 00:00:00

  • Evaluating health care advertising.

    abstract::Evaluating health care advertising is a four-part process that enables health care managers to target particular markets and to determine the effects of advertising particular services and products. ...

    journal_title:Health care management review

    pub_type: 杂志文章

    doi:

    authors: MacStravic RS

    更新日期:1988-07-01 00:00:00

  • Designing a physician leadership development program based on effective models of physician education.

    abstract:BACKGROUND:Because of modern challenges in quality, safety, patient centeredness, and cost, health care is evolving to adopt leadership practices of highly effective organizations. Traditional physician training includes little focus on developing leadership skills, which necessitates further training to achieve the po...

    journal_title:Health care management review

    pub_type: 杂志文章

    doi:10.1097/HMR.0000000000000146

    authors: Hopkins J,Fassiotto M,Ku MC,Mammo D,Valantine H

    更新日期:2018-10-01 00:00:00

  • Determinants of job satisfaction for novice nurse managers employed in hospitals.

    abstract:BACKGROUND:Numbering close to 300,000 nurse managers represent the largest segment of the health care management workforce. Their effectiveness is, in part, influenced by their job satisfaction. PURPOSE:We examined factors associated with job satisfaction of novice frontline nurse managers. METHODOLOGY/APPROACH:We us...

    journal_title:Health care management review

    pub_type: 杂志文章

    doi:10.1097/HMR.0000000000000102

    authors: Djukic M,Jun J,Kovner C,Brewer C,Fletcher J

    更新日期:2017-04-01 00:00:00

  • An epidemiological approach to quality assurance in the hospital.

    abstract::This article discusses epidemiological methodology: comparing rates, confounding, the use of confidence intervals, Bayes' theorem, and occurrence screening. An appreciation of the limits of epidemiological methods will provide the manager with realistic expectations of the quality assurance process. ...

    journal_title:Health care management review

    pub_type: 杂志文章

    doi:

    authors: Everett WD

    更新日期:1993-01-01 00:00:00

  • The discount rate for capital expenditure analysis in health care.

    abstract::The appropriate discount rate for evaluation of capital expenditures depends on leverage, taxation, cost-based reimbursement, and risk. A method is presented to account for these effects that is both practical and consistent with theory. ...

    journal_title:Health care management review

    pub_type: 杂志文章

    doi:

    authors: Wheeler JR,Smith DG

    更新日期:1988-04-01 00:00:00

  • The dimensions of service quality for hospitals: development and use of the KQCAH scale.

    abstract::Using a combination of qualitative and quantitative research methodologies, this study identifies the dimensions of hospital service quality, operationalizes the dimensions, and develops an instrument to measure patient satisfaction. This instrument, the Key Quality Characteristics Assessment for Hospitals (KQCAH) sca...

    journal_title:Health care management review

    pub_type: 杂志文章

    doi:10.1097/00004010-200104000-00005

    authors: Sower V,Duffy J,Kilbourne W,Kohers G,Jones P

    更新日期:2001-04-01 00:00:00

  • A premerger profile of Columbia and HCA hospitals.

    abstract::This article profiles the premerger marketing, management, and mission characteristics of the combined Columbia and Hospital Corporation of America (HCA) entity relative to local market hospitals. The findings show that the Columbia/HCA hospitals had fewer Medicaid patients, lower proportion of outpatient revenues, hi...

    journal_title:Health care management review

    pub_type: 杂志文章

    doi:10.1097/00004010-199605000-00006

    authors: McCue MJ

    更新日期:1996-04-01 00:00:00

  • The more things change, the more they stay the same.

    abstract::For decades, the hospital environment has been described as turbulent and hostile. At the same time, the transfer of business practices into hospitals has been advocated, accompanied by the largely untested assumption that these practices are crucial to performance and even survival. As this pattern became entrenched,...

    journal_title:Health care management review

    pub_type: 杂志文章,评审

    doi:10.1097/00004010-200001000-00008

    authors: Bigelow B,Arndt M

    更新日期:2000-01-01 00:00:00

  • Career paths of physician executives.

    abstract::Survey data from a sample of physicians whose primary professional activity is administration were used to examine their previous administrative positions and career paths. Forty percent reported administrative positions in more than one type of health care organization, and time spent in administration increased with...

    journal_title:Health care management review

    pub_type: 杂志文章

    doi:

    authors: Kindig DA,Dunham NC,Chun LM

    更新日期:1991-10-01 00:00:00

  • Physician participation in a teaching hospital's planning: the English experience.

    abstract::A systematic, continuous approach to the problem of rising medical care costs and the need for improved resource management clearly require some level of input from physicians. ...

    journal_title:Health care management review

    pub_type: 杂志文章

    doi:

    authors: Larson JG

    更新日期:1980-01-01 00:00:00

  • Managing teenage pregnancies: success and failure in two U.S. communities.

    abstract::Can APHA's policies effectively help U.S. communities reduce excess fertility rates among their sexually active teenagers? A study of two communities reveals to what extent APHA's policies are being adopted and whether they are successful. :Two communities with differing outlooks on the management of adolescent ferti...

    journal_title:Health care management review

    pub_type: 杂志文章

    doi:

    authors: Allen JE,Bender D

    更新日期:1980-04-01 00:00:00

  • To make or buy patient safety solutions: a resource dependence and transaction cost economics perspective.

    abstract:BACKGROUND:For almost a decade, public and private organizations have pressured hospitals to improve their patient safety records. Since 2008, the Centers for Medicare & Medicaid Services has no longer been reimbursing hospitals for secondary diagnoses not reported during the point of admission. This ruling has motivat...

    journal_title:Health care management review

    pub_type: 杂志文章

    doi:10.1097/HMR.0b013e318225998b

    authors: Fareed N,Mick SS

    更新日期:2011-10-01 00:00:00

  • Assessing Catholic community hospitals versus nonprofit community hospitals, 1989-1992.

    abstract::Catholic community hospitals are becoming more like nongovernment, not-for-profit community hospitals of a similar bed size located in the same states. After controlling for state, urban-versus-rural location, and bed-size range, a matched set of 303 Catholic community hospitals are compared with nongovernment, not-fo...

    journal_title:Health care management review

    pub_type: 杂志文章

    doi:

    authors: Prince TR

    更新日期:1994-10-01 00:00:00

  • The efficiency of hospital-based clusters: evaluating system performance using data envelopment analysis.

    abstract:BACKGROUND:The rapid increase in the number of hospitals becoming members of multihospital systems in recent decades has led to the formation of local and regional clusters that have the potential to function as regional systems, a model long advocated as a policy strategy for improving health system performance. PURP...

    journal_title:Health care management review

    pub_type: 杂志文章

    doi:10.1097/HMR.0b013e3181a16ba7

    authors: Sikka V,Luke RD,Ozcan YA

    更新日期:2009-07-01 00:00:00

  • Hospital bankruptcies: an exploration of potential causes and consequences.

    abstract::Although small in number, hospitals are increasingly seeking bankruptcy protection. This article explores the potential forces that might motivate hospitals to seek bankruptcy protection and the potential consequences for hospitals that obtain it. Case reviews of 11 hospital bankruptcies that occurred in 1990 and 1991...

    journal_title:Health care management review

    pub_type: 杂志文章

    doi:10.1097/00004010-199401930-00006

    authors: Bazzoli GJ,Cleverley WO

    更新日期:1994-07-01 00:00:00

  • Specialty hospitals: the challenge of the 1980s.

    abstract::Specialty care institutions will face many concerns during the remainder of this decade. Increased intermediary and community education, establishing reliable benchmarks, understanding and dealing with a competitive marketplace, and establishing improved professional productivity are some of the major challenges. ...

    journal_title:Health care management review

    pub_type: 杂志文章

    doi:10.1097/00004010-198300810-00002

    authors: Eckenhoff EA,Kerstetter AL,White AR

    更新日期:1983-01-01 00:00:00

  • Implications of complex adaptive systems theory for the design of research on health care organizations.

    abstract:BACKGROUND:Because health care organizations (HCOs) are complex adaptive systems (CASs), phenomena of interest often are dynamic and unfold in unpredictable ways, and unfolding events are often unique. Researchers of HCOs may recognize that the subject of their research is dynamic; however, their research designs may n...

    journal_title:Health care management review

    pub_type: 杂志文章

    doi:10.1097/HMR.0b013e31819c8b38

    authors: McDaniel RR Jr,Lanham HJ,Anderson RA

    更新日期:2009-04-01 00:00:00

  • A theoretical framework for shedding additional light on the determinants of medical practice value.

    abstract:BACKGROUND:Over the years, business valuation techniques have been widely used to appraise the financial worth of medical practices. However, it has been argued that medical practices are one of the most complex and difficult types of business enterprises to value. PURPOSE:The purpose of the current study is to develo...

    journal_title:Health care management review

    pub_type: 杂志文章

    doi:10.1097/HMR.0b013e3181afc0d3

    authors: Hoffman JJ,Ewing BT,Hoffman JG

    更新日期:2009-10-01 00:00:00

  • Interpersonal mentoring and its influence on retention of valued health care workers: the moderating role of affective commitment.

    abstract:BACKGROUND:Health care organizations (HCOs) invest in knowledge transfer to promote improved patient outcomes; however, these investments prove costly when health care workers with enhanced knowledge and skills leave to seek better employment opportunities. PURPOSE:The aim of this study was to examine the impact of in...

    journal_title:Health care management review

    pub_type: 杂志文章

    doi:10.1097/HMR.0000000000000011

    authors: Fleig-Palmer MM,Rathert C

    更新日期:2015-01-01 00:00:00

  • Fads, fashions, and bandwagons in health care strategy.

    abstract:BACKGROUND:Many observers have alleged that "fads," "fashions," and "bandwagons" (imitation strategies) are prominent feature of the health care organizational strategy landscape. "Imitation behavior" may fulfill symbolic functions such as signaling innovativeness but results in the adoption of strategies that are effe...

    journal_title:Health care management review

    pub_type: 杂志文章

    doi:10.1097/01.HMR.0000304498.97308.40

    authors: Kaissi AA,Begun JW

    更新日期:2008-04-01 00:00:00

  • Service line structure and decision-maker attention in three health systems: Implications for patient-centered care.

    abstract:BACKGROUND:Scholars have noted a disconnect between the level at which structure is typically examined (the organization) and the level at which the relevant coordination takes place (service delivery). Accordingly, our understanding of the role structure plays in care coordination is limited. PURPOSE:In this article,...

    journal_title:Health care management review

    pub_type: 杂志文章

    doi:10.1097/HMR.0000000000000172

    authors: Louis CJ,Clark JR,Gray B,Brannon D,Parker V

    更新日期:2019-01-01 00:00:00

  • Controlling America's health care costs via health care futures.

    abstract::This article examines the new health care futures contract to be released by the Chicago Board of Trade sometime during calendar year 1995. Health care futures--futures contracts on health care insurance--represent a new class of financial products never before available to financial practitioners. The innovation allo...

    journal_title:Health care management review

    pub_type: 杂志文章

    doi:

    authors: Ray R

    更新日期:1995-04-01 00:00:00