A LISTING OF CULTURAL COMPETENCE ASSESSMENT TOOLS Examples from the Field A collection of sample tools, this document is a work-in-progress informally compiled by Marjory Bancroft, MA mbancroft@cultureandlanguage.net 410-750-0365 Most of the text below is excerpted or adapted from commentary by the authors of the tools or from promotional materials and does not reflect the opinions or recommendations of Marjory Bancroft. 1. American Medical Association (AMA) Organizational assessment toolkit: “Improving communication—improving care”: the AMA Ethical Force program toolkit. For information: www.EthicalForce.org: For information on cost/ordering: https://catalog.amaassn.org/Catalog/product/product_detail.jsp?productId=prod1180003?checkXwho=done Intended to help health care organizations meet the needs of a diverse patient population. Assesses how effectively the organization communicates Can help organizations improve communication with all patient Questions focus on common communication problems, such as culture, language and health literacy gaps. The toolkit includes the assessment instruments (surveys) and protocols, analysis guide and data tools, and ideas for how to improve performance based on specific results—to be a catalyst for productive organizational change. The toolkit's surveys are available for viewing online. Anyone may download and use the surveys for research purposes at no cost and without a license. To use the surveys for organizational assessment, AMA requests that organizations purchase the toolkit and license. 2. Andrulis, Denis et al Conducting a Cultural Competence Self-Assessment Available at no charge at http://erc.msh.org/provider/andrulis.pdf Authored by: Dennis Andrulis, SUNY/Downstate Medical Center, Brooklyn, NY, in collaboration with Thomas Delbanco, Beth Israel Deaconess Medical Center, Boston, MA, Laura Avakian, Massachusetts Institute of Technology, Boston, MA, Yoku Shaw-Taylor, Public Health Foundation, Washington, DC 2 A tool for an organizational audit of cultural competence in health care Helps validate organizational understanding of the ethnic and cultural composition of its patient and employee populations May hope to ensure access to appropriate treatment and effective communication May reveal opportunities for the organization to make itself more attractive to diverse populations Can demonstrate that the organization values diversity 3. Annie E. Casey Foundation Race Matters: Organizational Self-Assessment A one-page questionnaire on staff competencies and organizational operations that purports to offer a racial equity score followed by a “next steps” analysis. It also suggests tools for improvement. http://www.jdaihelpdesk.org/Docs/Documents/JDAI%20InterSite%20Conference%202006/organization_self_assessment.pdf 4. American Speech Language Hearing Association Self-Assessment for Cultural Competence Available at no charge at http://www.asha.org/about/leadershipprojects/multicultural/self.htm#ccc Involves an interactive web-based tool designed to help evaluate cultural competence. Includes cultural competence checklists, a cultural competence awareness assessment and a questionnaire about “How Does Your Caseload Compare?” Addresses personal reflection, policies and procedures and service delivery Assesses demographic and caseload changes related to culturally/linguistically diverse (CLD) populations. Is intended to help organizations to increase and improve service delivery 5. Association of University Centers on Disabilities Assessment of Organizational Cultural Competence No longer online. Formerly available at http://www.aucd.org/councils/multicultural/Cultural_Competence_Survey.htm. Contact Marjory Bancroft at mbancroft@cultureandlangauge.net for a copy. 3 A survey intended to assess organizational cultural competence for university centers on disabilities. 6. Vancouver, B.C. Ministry for Children and Families Cultural Competency Assessment Tool No longer online. Formerly available at; http://www.mcf.gov.bc.ca/publications/cultural_competency/assessment_tool/tool_index1.htm Contact Marjory Bancroft at mbancroft@cultureandlangauge.net for a copy. This was a 7-page tool intended to assist the Vancouver region of the Ministry for Children and Families and community based agencies of all sizes in the Vancouver area in becoming more culturally competent. The goal was to enhance services and programs to ethnocultural communities, including newcomers. http://erc.msh.org/mainpage.cfm?file=9.1g.htm&module=provider&language=English 7. Andrulis et al The Cultural Competence Self Assessment Protocol for Health Care Organizations and Systems http://erc.msh.org/mainpage.cfm?file=9.1g.htm&module=provider&language=English Developed by Dennis Andrulis, Thomas Delbanco, Laura Avakian and Yoku Shaw-Taylor, this is an innovative approach to assessing organizational cultural competence. The protocol builds upon the Georgetown University Child Development Center's Continuum of Cultural Competency. Intended for use by health care providers, including hospitals and clinics, to conduct organizational assessments of their cultural competence. Particularly useful for services involving racially and ethnically diverse populations Questions are organized according to four cornerstones of cultural competence: a) health care organization's relationship with its community; b) the administration and management's relationship with staff; c) inter-staff relationships at all levels; d) the patient/enrollee-provider encounter. The protocol allows organizations to score responses and then place themselves on a five point spectrum of cultural competence, ranging from inaction to a fully realized "learning" organization. The protocol can serve as a formal organization-wide review tool or as a department- or clinic-specific assessment instrument. 8. Outcomes Management Group and Ohio Department of Mental Health Consolidated Culturalogical Assessment Tool Kit (C-CAT) http://www.ccattoolkit.org/ The toolkit for organizational assessment in mental health includes training materials, promotional materials, a facilitator’s guide, user workbook, assessment tools and a database. It 4 can be used by a variety of shareholders. The toolkit must be purchased at a cost of $750 or higher, depending on the number of licenses purchased. 9. Hasnain-Wynia, R., Pierce, D., Haque, A., Hedges Greising, C., Prince, V., Reiter, J. (2007) Health Research and Educational Trust Disparities Toolkit. http://www.hretdisparities.org/ The HRET toolkit is a web-based tool that provides hospitals, health systems, clinics, and health plans information and resources for systematically collecting race, ethnicity, and primary language data from patients. Registration is free. Development of the toolkit included input from a National Advisory Panel. By using this Toolkit, health care organizations can assess their organizational capacity to collect this information and implement a systematic framework designed specifically for obtaining race, ethnicity, and primary language data directly from patients/enrollees or their caregivers in an efficient, effective, and respectful manner. 10. Carr, W. and Willis, J (2002) for U.S. Department of Health and Human Services, Health Resources and Services Administration Group (2002), Indicators of Cultural Competence in Health Care Delivery Organizations: An Organizational Cultural Competence Assessment Profile This detailed, practical assessment tool was created to contribute to the methodology of cultural competence assessment. The product - An Organizational Cultural Competence Assessment Profile - builds upon previous work in the field, such as the National Standards for Culturally and Linguistically Appropriate Services (CLAS) , and advances the conceptualization and practical understanding of how to assess cultural competence at the organizational level. The specific objectives of this project were to: 1) develop an analytic framework for assessing cultural competence in health care delivery organizations; 2) identify specific indicators that can be used in connection with this framework; and 3) assess the utility, feasibility and practical application of the framework and its indicators. The project was implemented through a contract with The Lewin Group, Inc. HRSA's Office of Minority Health and Office of Planning and Evaluation provided both oversight and substantive input to the project. 11. Wilson-Stronks, A. et al (2008 for The Joint Commission. One Size Does Not Fit All: Meeting the Needs of a Diverse Health Care Population. http://www.jointcommission.org/PatientSafety/HLC/one_size_meeting_need_of_diverse_popula tions.htm Both a tool (Chapter 8) and a report on a tool, this detailed report provides It provides a framework and self-assessment tool for hospitals to develop and employ practices for meeting diverse patient needs. The report recommends that organizations: Identify the needs of the patient population being served and assess how well these needs are being met through current systems 5 Bring people across the organization together to explore cultural and language issues by sharing experiences, evaluating current practices, discussing barriers, and identifying gaps Make assessment, monitoring, and evaluation of cultural and language needs and services a continuous process Implement a range of practices spanning all four themes in a systemic manner aligned with patient needs and organizational 12. Mason, J.L. (1995) Cultural Competence Self-Assessment Questionnaire: A Manual for Users. http://eric.ed.gov/ERICWebPortal/custom/portlets/recordDetails/detailmini.jsp?_nfpb=true&_& ERICExtSearch_SearchValue_0=ED399684&ERICExtSearch_SearchType_0=no&accno=ED39 9684 This manual contains the Cultural Competence Self-Assessment Questionnaire (CCSAQ), a measure designed to assist service agencies working with children with disabilities and their families in self-evaluation of their cross-cultural competence. The measure is based on the Child and Adolescent Service System Program Cultural Competence Model. This model describes cultural competency in terms of four dimensions: attitude, practice, policy, and structure. The manual provides information on the application and administration of the measure, its outcomes, its reliability, its content validity, the scoring guide, and presentation of resulting data in a comprehensible format. Appendices include two different versions of the questionnaire--one for direct service providers and one for administrative staff. Also included is a scale for collecting demographic information. 13. National Center for Cultural Competence Cultural Competence Health Practitioner Assessment http://gucchd.georgetown.edu/nccc/pa.html The Cultural Competence Health Practitioner Assessment (CCHPA) was developed at the request of the Bureau of Primary Health Care (BPHC), Health Resources and Services Administration (HRSA), U.S. Department of Health and Human Service (DHHS). The CCHPA captures a wide range of data in its six subscales including: /Values & Belief Systems, Cultural Aspects of Epidemiology, Clinical Decision-Making, Life Cycle Events, Cross-Cultural Communication and Empowerment/Health Management/. Assessment of practitioners is only one aspect of examining cultural and linguistic competence within an organization, and should not be used in isolation. For more information about self-assessment tools & processes see: http://gucchd.georgetown.edu/nccc/selfassessment.html 14. National Center for Cultural Competence (2006) Cultural and Linguistic Competence Policy Assessment (CLCPA) http://www.clcpa.info/ The Cultural and Linguistic Competence Policy Assessment (CLCPA) was developed by the National Center for Cultural Competence (NCCC) at the request of the Bureau of Primary Health 6 Care (BPHC), Health Resources and Services Administration (HRSA), U.S. Department of Health and Human Service (DHHS) to assist community health centers to advance and sustain cultural and linguistic competence. The CLCPA is intended to support health care organizations to: improve health care access and utilization enhance the quality of services within culturally diverse and underserved communities promote cultural and linguistic competence as essential approaches in the elimination of health disparities. The NCCC has also developed a companion Guide for Using the Cultural and Linguistic Competence Policy Assessment Instrument that provides step-by-step instructions on how to conduct an organizational self-assessment process. 15. Robert Wood Johnson Foundation, Speaking Together, National Language Services Network Measures http://www.speakingtogether.org/measures/measures The George Washington University Department of Health released the language services performance measures being piloted and tested in its learning collaborative. The measures, developed at the request of the Robert Wood Johnson Foundation, allow hospitals to examine how they communicate with non-English-speaking patients, and focus attention on how hospital staff can better structure and manage language services programs to have effective, efficient and timely communications with patients with limited English proficiency (LEP).