Health care leaders talk about providing culturally competent care, but one Brooklyn hospital is taking things a step further.
Lutheran Medical Center has a "Sabbath elevator" that stops at all six floors without pressing a button, assisting Orthodox Jews who were taking the stairs instead. Jewish law forbids those observing the Sabbath from using electrical switches. Caregivers offer longer "modesty gowns" for Muslim women who can't show any skin. And the 468-bed acute care hospital even has a wing devoted to its Chinese patients, with everyone from doctors to orderlies who speak the language and know the culture.
"Patient-centered care is the mantra now," says Virginia Tong, vice president of cultural competence at Lutheran HealthCare, the medical center's parent system. "Well, the patient comes with all kinds of things, and a lot of it is their culture and their family. It's not just about language, but what are their belief systems? Who are the decision-makers? What kinds of alternative medicine do they use?"
The Health Research & Educational Trust late last week released a report on the topic, titled Becoming a Culturally Competent Health Care Organization, which cites Lutheran Medical Center as an example of an organization that's doing it right. In the report, the American Hospital Association-affiliated organization spells out seven specific actions hospitals can take to help increase patient satisfaction and reduce disparities in care:
- Collect race, ethnicity and language preference data
- Identify and report disparities
- Provide culturally and linguistically competent care
- Develop culturally competent disease management programs
- Increase diversity and minority workforce pipelines
- Involve the community
- Make cultural competency an institutional priority
HRET found that about 81 percent of hospitals already educate their clinical staff during orientation on the cultural and linguistic factors that affect care, and some 61 percent of hospitals require employees to attend diversity training. That's a start, but those numbers should really be closer to 100 percent, says Matthew Fenwick, director of program and partnership development with HRET.
"We want to make sure that all hospitals are doing this in the near future, and also want to make sure that the training is tailored to their community, that it's providing benefit and ongoing, and we want to open it up to all staff as well," he says.
Both Tong and Fenwick point out that culturally competent care spans far beyond race, religion and ethnicity, and includes tailoring needs to everyone from the elderly population to the disabled, and patients who are gay, lesbian, bisexual or transgender.
HRET also believes that bolstering cultural awareness can provide not just health benefits, but also social and financial perks to the organization. Socially, such culturally competent care increases respect and trust for the hospital, promotes inclusion and community involvement with health issues, and makes patients and their families take responsibility for their health.
Creating a culturally competent staff can also impact a hospital's market share, improve the efficiency of care and help meet any culturally related legal and regulatory guidelines, according to the report. Tong argues that hospital leaders who think they can't afford to dedicate resources to reducing disparities may be losing out on important revenue streams, and putting themselves at legal risk if they're unintentionally putting up barriers to care.
"From a business standpoint, it's bringing patients into you. Most hospitals will understand that," she says. "They understand outreach and they understand marketing, and there's a business case for bringing patients who have different needs into your hospital."