Dear Colleagues:

Last week, at the fifth National Conference on Quality Health Care for Culturally Diverse Populations, held in Seattle, The Commonwealth Fund released a series of reports exploring the role of cultural competency in improving quality and outcomes for patients, reducing disparities, and helping patients become more active and engaged in their care.

Medical professionals who are culturally competent consider a patient's race and ethnicity, cultural background, primary language, health practices, and value systems when recommending treatment and providing care.


The reports include:

The Role and Relationship of Cultural Competence and Patient-Centeredness in Health Care Quality Mary Catherine Beach, M.D., M.P.H., Somnath Saha, M.D., M.P.H., and Lisa A. Cooper, M.D., M.P.H. The authors consider the intersection of patient-centered care and cultural competency. Both are promoted as approaches to improving the quality of health care, and they overlap in many ways. Beach and colleagues recommend that the two principles remain distinct but that efforts are aligned to elevate the quality of health care for all patients.

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Improving Quality and Achieving Equity: The Role of Cultural Competence in Reducing Racial and Ethnic Disparities in Health Care Joseph R. Betancourt, M.D., M.P.H. Focusing on the Institute of Medicine's six principles for designing a high-quality health care system, Betancourt identifies areas where cultural competence could be used to reduce disparities and achieve high performance health care.

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The Evidence Base for Cultural and Linguistic Competency in Health Care Tawara D. Goode, M.A., M. Clare Dunne, M.S.W., and Suzanne M. Bronheim, Ph.D. Promising research indicates cultural and linguistic competence improves health outcomes and patient well-being, the authors find in their study. But more work is needed, they say, to establish a solid "business case" for providing such care.

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Cultural Competency and Quality of Care: Obtaining the Patient's Perspective Quyen Ngo-Metzger, M.D., M.P.H., Joseph Telfair, Dr.P.H., M.P.H., M.S.W., Dara H. Sorkin, Ph.D., Beverly Weidmer, M.A., Robert Weech-Maldonado, M.B.A., Ph.D., Margarita Hurtado, Ph.D., M.H.S., and Ron D. Hays, Ph.D. The researchers identify the five domains of culturally competent care that can best be assessed through the patient's perspectives. Incorporating patients' perspectives on cultural competence into existing measures of health care quality, they say, will create opportunities for providers and health plans to make improvements.

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Taking Cultural Competency from Theory to Action Ellen Wu, M.P.H., and Martin Martinez, M.P.P. Using case studies of organizations that have implemented cultural competency initiatives, the authors, who are based at the California Pan-Ethnic Health Network, recommend ways to put cultural competency into practice. They discuss best practices in the field and the principles of successful implementation, such as engaging members of local communities and ensuring that changes under consideration are manageable and measurable.

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Expert Commentaries

The Fund also invited two experts in the field for their perspective on the papers and the important issues they raise. In her commentary, Robyn Y. Nishimi, Ph.D., chief operating officer of the National Quality Forum, says it's time to move the cultural competency agenda forward--and that the best way to do that is through measurement and public reporting of performance on this dimension of quality.

In his commentary, Paul M. Schyve, M.D., senior vice president of the Joint Commission on Accreditation of Healthcare Organizations, says that effective models of culturally competent, patient-centered care must reflect the value-based goals of all major stakeholder groups, and he calls for continued funding of efforts to validate these models.