SOC

1. Chapter 1Chapter 1
Systems Approach to CulturalSystems Approach to Cultural
CompetenceCompetence

2.  To clarify what is meant by a systems approach
 To define key terms including diversity, cultural
competence, disparities, and strategic diversity
management
 To describe the dimensions of diversity that will be
discussed throughout this text
 To gain an understanding of health care disparities in the
United States
 To become familiar with essential systems approaches to
cultural competence and reducing disparities
 To characterize the relationship between strategic
diversity management and culturally competent health
care delivery
Chapter ObjectivesChapter Objectives

4.  A system is a structure of interconnected people, policies,
and practices designed to work in concert to achieve a
common goal
 The systems approach is the process of:
• Considering how different parts of the whole structure influence
and integrate with each other
• Viewing problems in a systems as affecting the system overall
• Understanding components of a system in the context of their
relationships with each other
 In a well functioning system, each part contributes to the
achievement of the goals for which the system was put
into place
Systems ApproachSystems Approach

5.  The goal of the US health care system is a high level of
health for the nation’s population
 The US health care system is an open system-elements
from the environment beyond the system constantly
affect the system
 The system must include feedback mechanisms and
adapt to changes in the external environment
 Diversity and disparities are factors in the external
environment that require adaptation from the US health
care system
 Cultural competence and strategic diversity management
are approaches to successful adaptation
Diversity & Cultural CompetenceDiversity & Cultural Competence
US Health Care SystemUS Health Care System

6.  Defined as differences that make each
person/group unique when compared with
others
 In health care, diversity affects:
• how patient care is structured and delivered
• how the health care workforce is managed
DiversityDiversity

7.  The National Institutes of Health (2000)
defines health care disparities as
“differences in the incidence, prevalence,
mortality, and burden of diseases and
other health conditions that exist among
several populations in the United States”
(p. 4).
DisparitiesDisparities

8. Cultural CompetenceCultural Competence
 National Quality Forum (2008) definition:
“the ongoing capacity of healthcare
systems, organizations, and professionals
to provide for diverse patient populations
high-quality care that is safe, patient and
family centered, evidence based and
equitable” (p. 3).

9.  Strategic diversity management includes a
careful evaluation of the health care
delivery system and its personnel to
ensure that it is actually able to meet the
needs of the community or communities
that make up its catchment area.
Strategic Diversity ManagementStrategic Diversity Management

10. Table 1.1 – The Seven Dimensions of DiversityTable 1.1 – The Seven Dimensions of Diversity
Immutable
Dimensions of
Diversity
•Race & ethnicity
•Gender
•Sexual orientation
Crosscutting
Dimensions of
Diversity
•Age
•Language
•Socioeconomic
status
•Religion

11.  Aging population = greater demand for health
care services
 Generational differences in work style can result
in a shortage of nurses and other professionals
 Educational gaps in health care workers
perpetuate concentration of Asians and non-
Hispanic whites in professional, administrative
and policy making positions
Health Care DiversityHealth Care Diversity
Challenges - 1Challenges - 1

12.  Provider bias and lack of cultural
awareness contribute to disparities in
health care and poorly structured service
delivery
 The high number of limited English
speakers will call for innovative and cost-
effective solutions in language access
Health Care DiversityHealth Care Diversity
Challenges - 2Challenges - 2

13.  Underrepresentation of certain racial and ethnic
groups among physicians, nurses, and the allied
health professions make it difficult to provide
patients with clinicians who share their racial or
ethnic identity
 Growing religious diversity presents health care
organizations with HR policy and patient care
challenges
 Learning to understand, value and adapt to
diversity across multiple dimensions is essential
to a well functioning health care system
Health Care DiversityHealth Care Diversity
Challenges - 3Challenges - 3

14.  Access
 Prevention
 Treatment
 Health care literacy
 Health care outcomes
US Health Care DisparitiesUS Health Care Disparities

15.  Data driven decision making
 Evidence based strategies
 Medical homes
 Patient-centered care
 Interprofessional/multidisciplinary teams
Changing the US HealthChanging the US Health
Care SystemCare System

16. Systems Approach to Diversity and Cultural CompetenceSystems Approach to Diversity and Cultural Competence
for Health Care Delivery Organizationsfor Health Care Delivery Organizations

17.  Leaders set the context for effective or ineffective
system responses to diversity and disparities in
the workforce, patients, and communities served
 Leaders create the culture and climate in which
care is delivered
 Policies, practices, and the workforce operate
within the culture and climate that leaders create
 Leaders are those individuals that others follow
due to their position, expertise, and social
influence within the system
The Importance of LeadershipThe Importance of Leadership

18. THE PRIMARY GOAL OF THIS BOOK IS TO
EQUIP THE READER WITH THE
KNOWLEDGE, SKILLS, AND ABILITIES TO
LEAD EFFECTIVELY IN THE CONTEXT OF
WORKFORCE AND PATIENT DIVERSITY

19. Key TermsKey Terms
• crosscutting
• cultural competence
• culture
• data-driven strategies
• disparities
• diversity
• ethnicity
• evidence-based strategies
• identity groups
• immutable
• inclusion
• interprofessional or
multidisciplinary teams
• medical homes
• patient-centered care
• personalized care
• race
• strategic diversity
management
• system
• systems approach
• worldview