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Dying in America – Cultural Competence

By Helen McNeal, Executive Director, CSU Shiley Institute for Palliative Care

The Institute of Medicine (IOM) in their recent Dying in America report recognized that research shows a “general pattern in minority populations” of a greater preference for more intensive treatments coupled with lower access to hospice.

To those of us in palliative care who are aware of the disparities in access to care, this was not surprising. But, more importantly, the IOM states, “It is vital, therefore, that clinicians be aware of common differences in perception among racial, ethnic, and cultural groups so that at the very least, they can ask the right probing questions and have a firmer basis for individualized understanding of patients and their families.” [i]

Emphasizing the need for greater cultural competence in healthcare, including palliative care, isn’t new. However with the ever-growing population of culturally and ethnically diverse older adults in the US, there is great urgency than ever before.

One of the criteria for meeting Guideline 6.2 of the Clinical Practice Guidelines for Quality Palliative Care is education to help staff “increase their cross-cultural knowledge and skills.”[ii] This is echoed in the IOM report, which states:

It is vital, therefore, that clinicians be aware of common differences in perception among racial, ethnic, and cultural groups so that at the very least, they can ask the right probing questions and have a firmer basis for individualized understanding of patients and their families.

Improving the quality of care provided requires more than just a commitment to cultural competency, it requires ongoing education to ensure your entire team – staff and clinicians alike – have, at the very least — an understanding of those common differences, cultural norms and potential barriers to accessing quality care… for everyone but most especially for those who are more challenged to access that care.

A diverse group of medical professionalsHow Does Your Cultural Competency Impact Your Bottom Line?

Ineffective communication due to cultural misperceptions is not just uncomfortable, it has an economic cost. A deeper understanding of your organization’s cultural competence can help you achieve your goals and better meet the needs of a diverse community. This 4-week faculty led online course can help. Starts: May 13. Learn more.

[i] IOM (Institute of Medicine). Dying in America: Improving quality and honoring individual preferences near the end of life. (2015). Washington, DC: The National Academies Press.

[ii] Clinical Practice Guidelines for Quality Palliative Care. (2013). Pittsburgh: National Consensus Project for Quality Palliative Care. doi:978-1-934654-35-4

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