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Why Is There a Need to Provide Culturally Appropriate Communication in Care Delivery During Hospitalization?

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Patterns of health care access among CALD patients with low English proficiency (LEP) highlight the experience of compromised care, longer hospital stays, higher rates of medical errors, and poorer patient satisfaction. Existing health services need to adapt in order to promote the health and wellbeing of CALD populations. The provision of a culturally competent health care service has been posited as a key factor towards improving health outcomes, increasing the efficiency of clinical staff, and improving patient satisfaction. Growing work highlights key organisational components that have been shown to promote cultural competency including: the provision of health professional training and creating policies that streamline care and facilitate communication

However barriers towards the provisions of culturally competent care include a lack of value in and resources towards staff training and education as well as the provision of culturally appropriate health education materials and other support to help patients navigate the health system.

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Promoting culturally competent communication at the provider, care institution, health plan, and national levels is likely to contribute to success in reducing racial and ethnic disparities in the receipt of high quality care. Although some health plans recently have shown interest in addressing racial and ethnic disparities in care, very few have addressed how health plans can improve their cultural competency to reduce disparities. This commentary summarizes the importance of culturally competent communication across several levels of the healthcare system and details concrete steps that managed care organizations can take to maximize their ability to provide culturally competent communication and care

Promoting culturally competent communication at the provider, care institution, health plan, and national levels is likely to contribute to success in reducing racial and ethnic disparities in the receipt of high quality care. Although some health plans recently have shown interest in addressing racial and ethnic disparities in care, very few have addressed how health plans can improve their cultural competency to reduce disparities. This commentary summarizes the importance of culturally competent communication across several levels of the healthcare system and details concrete steps that managed care organizations can take to maximize their ability to provide culturally competent communication and care.The importance of effective patient-provider communication in delivering high-quality care is well accepted. Good patient-provider communication is associated with better patient satisfaction, better adherence to treatment recommendations, and improved health outcomes. It is assumed, but not proven, that the components of communication that acknowledge and take into account differences between providers and patients–particularly with regard to culture, ethnicity, and beliefs–play an important role in efforts to reduce racial and ethnic disparities in the quality of care. Culturally competent communication refers to communicating with awareness and knowledge of healthcare disparities and understanding that sociocultural factors have important effects on health beliefs and behaviors, as well as having the skills to manage these factors appropriately. This issue is so important that the Institute of Medicine, in its seminal report , identified cross-cultural training as a key recommendation for reducing healthcare disparities. Numerous other organizations have addressed the need to incorporate culture in the training of health professionals.

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In these complex situations, patients and clinicians both need to be involved for optimal care. Clinicians supply information and advice based on their scientific expertise in treatment and intervention options, along with potential outcomes

Patients, their families, and other caregivers bring personal knowledge on the suitability—or lack thereof—of different treatments for the patient's circumstances and preferences. Information from both sources is needed to select the right care option. It is important to note that patient-centered care does not mean simply agreeing to every patient request. Rather, it entails meaningful engagement on the options available in order to understand the patient and establish a dialogue between patient and clinician on the evidence and the decisions in play (Epstein et al., 2010; Fowler et al., 2011). The provision of patient-centered care can be complex and time-consuming, and requires broad involvement of the patient, the family, and the care team to consider all of the issues affecting the patient's care. This chapter explores the ways in which a learning health care system can fill some of the gaps in orienting and coordinating the U.S. health care system around people's needs. First, the chapter considers what is currently known about focusing the health care system on people's needs and preferences, sets forth a vision for how the system could be improved in this regard, and summarizes the benefits of moving toward that vision. The chapter then investigates how this knowledge can be applied at different levels of the health care system, from the patient care experience to the broader system. Next is a discussion of communities of care and how they can incorporate those stakeholders not normally included in the health care system. The chapter concludes with recommendations for realizing the vision of a health care system that engages patients, families, and communities. Throughout, the discussion highlights ways in which a learning health care system can better incorporate patients, families, and the public in managing health and health care.

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Given these points, more rigorous research yielding higher levels of evidence is needed in the field of culturally competent patient–provider communication in the management of cancer

Most of the available literature was classified as non-research evidence. The themes that emerged do, however, provide some insight into how culturally competent patient–provider communication may be delivered in order to improve treatment outcomes in patients diagnosed with cancerPatient–provider communication in cancer care as well as cross-cultural clinical settings is known to be challenging. This article provides information on how healthcare providers can deliver culturally competent care to cancer patients when working in cross-cultural clinical settings. The integrative literature review was performed to explore existing evidence and revealed that more rigorous research yielding higher levels of evidence is needed in the field of culturally competent patient–provider communication with cancer patients.

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Epstein RM, Fiscella K, Lesser CS, Stange KC. Health Affairs (Millwood). 8. Vol. 29. 2010. Why the nation needs a policy push on patient-centered health care; pp. 1489–1495.

Fowler FJ Jr, Levin CA, Sepucha KR. Health Affairs (Millwood). 4. Vol. 30. 2011. Informing and involving patients to improve the quality of medical decisions; pp. 699–706.

HHS (U.S. Department of Health and Human Services). Multiple chronic conditions—a strategic framework: Optimum health and quality of life for individuals with multiple chronic conditions. Washington, DC: HHS; 2010.

Hibbard JH. Health Affairs (Millwood). Suppl. Variation. 2004. Moving toward a more patient-centered health care delivery system; pp. VAR133–135.

Hibbard JH, Stockard J, Mahoney ER, Tusler M. Health Services Research. 4, Pt. 1. Vol. 39. 2004. Development of the Patient Activation Measure (PAM): Conceptualizing and measuring activation in patients and consumers; pp. 1005–1026

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