Diversity and Cultural Competence in Health Care – A Systems Approach

<p>Figures and Tables ix</p>
<p>Preface xi</p>
<p>Acknowledgments xv</p>
<p>The Authors xvii</p>
<p>PART ONE THE DIVERSITY IMPERATIVE 1</p>
<p>Chapter 1 Systems Approach to Cultural Competence 3</p>
<p>Dimensions of Diversity 7</p>
<p>Health Care Diversity Challenges 19</p>
<p>Health Care Disparities in the United States 20</p>
<p>Changing the US Health Care System 21</p>
<p>Systems Approach in the Health Care</p>
<p>Delivery Organization 26</p>
<p>The Importance of Leadership 27</p>
<p>Summary 28</p>
<p>Review Questions and Activities 29</p>
<p>Chapter 2 Systematic Attention to Health Care Disparities 35</p>
<p>What Are Health Care Disparities? 36</p>
<p>Race and Ethnic Disparities in Health Status 37</p>
<p>Disparities Across Other Diversity Dimensions: Gender, Sexual Orientation, the Elderly 49</p>
<p>Stakeholder Attention to Health Care Disparities 56</p>
<p>Systematic Strategies for Reducing Health Care Disparities 60</p>
<p>Summary 65</p>
<p>Review Questions and Activities 66</p>
<p>Chapter 3 Workforce Demographics 75</p>
<p>Trends in the US Labor Force 76</p>
<p>Diversity and the Health Professions 81</p>
<p>Drivers of Disparities in the Health Professions 83</p>
<p>Checklist of Recommended Organizational–Level Actions 90</p>
<p>Workforce Diversity Challenges 96</p>
<p>Summary 100</p>
<p>Review Questions and Activities 101</p>
<p>PART TWO THE DEVELOPMENT OF CULTURAL COMPETENCE 105</p>
<p>Chapter 4 Foundations for Cultural Competence in Health Care 107</p>
<p>What Is Cultural Competence in Health Care? 109</p>
<p>Long Journey Toward Cultural Competence 119</p>
<p>Cultural Competence and the Health Care Provider Organization 126</p>
<p>Cultural Competence and the Multicultural Health Care Workforce 133</p>
<p>Summary 138</p>
<p>Review Questions and Activities 139</p>
<p>Chapter 5 Hallmarks of Cultural Competence in Health Care Professionals 143</p>
<p>Personal Journey of Cultural Competence 145</p>
<p>Framework for Role Development 153</p>
<p>Journey of Self–Discovery 156</p>
<p>Summary 167</p>
<p>Review Questions and Activities 168</p>
<p>Chapter 6 Training for Knowledge and Skills in Culturally Competent Care for Diverse Populations 171</p>
<p>Eight Principles for Knowledge and Skills Training 173</p>
<p>Cultural Competence Knowledge and Skills for Administrators and Directors 177</p>
<p>Cultural Competence Training for Health Care Professionals in Direct Patient Care 183</p>
<p>Cultural Competence Training for Support Staff 207</p>
<p>The Role of Assessment in Cultural Competence Training 208</p>
<p>Summary 211</p>
<p>Review Questions and Activities 212</p>
<p>PART THREE CULTURAL COMPETENCE AND HEALTH CARE DELIVERY 219</p>
<p>Chapter 7 Cultural Competence in Health Care Encounters 221</p>
<p>Models from Transcultural Nursing 225</p>
<p>Giger–Davidhizar Transcultural Assessment Model (GDTAM) 238</p>
<p>Being Culturally Responsive 251</p>
<p>Summary 253</p>
<p>Review Questions and Activities 254</p>
<p>Chapter 8 Language Access Services and Crosscultural Communication 259</p>
<p>Language Use in the United States 261</p>
<p>Language Differences in Health Care Encounters 262</p>
<p>Attitudes Toward Limited–English Speakers 266</p>
<p>Changing Responses to Language Barriers in Health Care 268</p>
<p>An Expanding Profession: The Health Care Interpreter 278</p>
<p>Translation in Written Health Care Communication 284</p>
<p>Communication Is More Than Words 286</p>
<p>Summary 290</p>
<p>Review Questions and Activities 291</p>
<p>Chapter 9 Group Identity Development and Health Care Delivery 299</p>
<p>Research Highlights 301</p>
<p>Minority Status Group Identity Development 305</p>
<p>Majority Status Group Identity Development 313</p>
<p>Using the Models 325</p>
<p>Summary 328</p>
<p>Review Questions and Activities 329</p>
<p>PART FOUR CULTURAL COMPETENCE AND THE HEALTH CARE ORGANIZATION 333</p>
<p>Chapter 10 The Centrality of Organizational Behavior 335</p>
<p>The Science of Organizational Behavior 338</p>
<p>Organizations as Contexts for Behavior 339</p>
<p>OB Research Highlights 341</p>
<p>Can Culturally Competent Health Care Professionals Go It Alone ? 350</p>
<p>Summary 356</p>
<p>Review Questions and Activities 357</p>
<p>Chapter 11 The Business Case and Best Demonstrated Practices 361</p>
<p>Evolution of the Business Case 363</p>
<p>The Business Case for Cultural Competence in Health Care 364</p>
<p>Workforce, HRM, and the Business Case 373</p>
<p>Best Demonstrated Practices 376</p>
<p>Assessment and the Systems Approach 386</p>
<p>Benchmarking 389</p>
<p>Role of Metrics in the Systems Approach 390</p>
<p>Summary 397</p>
<p>Review Questions and Activities 399</p>
<p>Chapter 12 The Future of Diversity and Cultural Competence in Health Care 405</p>
<p>Trends That Support Widespread Adoption of the Systems Approach 406</p>
<p>The Sustainability Movement and the Systems Approach 419</p>
<p>Change Management and Force Field Analysis: Tools to Envision and Shape the Future 420</p>
<p>Summary 425</p>
<p>Review Questions and Activities 426</p>
<p>Glossary 429</p>
<p>Index 439</p>