Cultural and Linguistic Competency: Overview

The ability to connect with and understand patients is key to caring for them. As the U.S. population grows increasingly diverse in terms of race, ethnicity and language spoken, hospitals are working harder than ever to ensure patient care is culturally and linguistically appropriate. Cultural and linguistic competency has been defined as “a set of congruent behaviors, attitudes, and policies that come together in a system, agency, or among professionals that enables effective work in cross-cultural situations.” (Health Resources and Services Administration, Bureau of Primary Health Care, Office of Women and Minority Health).

Hospital strategies for serving limited English proficient (LEP) patients have evolved as communities have become increasingly diverse and as guidance from regulatory bodies has clarified the role hospitals should play in providing language access services. Striving to achieve cultural and linguistic competency has led many hospitals that encounter LEP patients on a daily basis to create full-time staff positions filled by employees trained to provide interpretive services. Some hospitals contract with agencies that provide professionally trained interpreters who speak a variety of languages. Aside from in-person interpretation, some hospitals access interpretive services via contracts with companies that provide interpretive services exclusively over the telephone or by using videoconferencing equipment.

Recognizing that interactions among patients and providers are mediated by cultural factors has also led many healthcare providers to develop cultural and linguistic competency training programs for their staff. In the future, responding to the changing demographics in the community will present new opportunities for providers to effectively and sensitively serve different patient populations, which will be key hospitals’ ability to compete in the changing marketplace. Several provisions in the recently passed federal health reform legislation are expected to boost healthcare providers’ ability to provide culturally and linguistically appropriate care including the development and dissemination of model cultural competence training and education curricula. 

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