Patient Centeredness, Cultural Competence and Healthcare Quality

Portland VA Medical Center, Portland, OR 97239, USA.
Journal of the National Medical Association (Impact Factor: 0.96). 12/2008; 100(11):1275-85. DOI: 10.1016/S0027-9684(15)31505-4
Source: PubMed


Cultural competence and patient centeredness are approaches to improving healthcare quality that have been promoted extensively in recent years. In this paper, we explore the historical evolution of both cultural competence and patient centeredness. In doing so, we demonstrate that early conceptual models of cultural competence and patient centeredness focused on how healthcare providers and patients might interact at the interpersonal level and that later conceptual models were expanded to consider how patients might be treated by the healthcare system as a whole. We then compare conceptual models for both cultural competence and patient centeredness at both the interpersonal and healthcare system levels to demonstrate similarities and differences. We conclude that, although the concepts have had different histories and foci, many of the core features of cultural competence and patient centeredness are the same. Each approach holds promise for improving the quality of healthcare for individual patients, communities and populations.

Download full-text


Available from: Lisa A Cooper, Nov 21, 2014
    • "Significant differences were found in proficiency between paediatricians and nurses as to the use of behavioural management strategies, guidance in parenting techniques, and addressing family conflicts. Similar findings were shown in other studies where practitioners commonly expressed low proficiency and confidence in their ability to help patients change behaviours[16,32,33]. However, better and more consistent assessment of obesity could increase awareness of the extent of the obesity problem, provide a basis for monitoring individuals and populations, and provide early prevention and treatment efforts. "

    No preview · Article · Jan 2016 · Current Pediatric Research
  • Source
    • "Centered Care, which was initiated in 1987[8]. Picker-Commonwealth derived its categories from patient focus groups and emphasized their importance within an ethical context, noting that " respecting patients' individuality is the foundation of humane medical care "[2]. "

    Full-text · Article · Jan 2016
  • Source
    • "On closer examination, this seems to be mainly a question of how factors are labeled: in CLAS, for example, differences in socioeconomic or legal status are regarded as 'cultural' ones. In the European approaches the focus is on individual characteristics, which brings EQS close to the approach known as 'patient centered care'[29](Saha, Beach, and Cooper have discussed the relation between 'patient centered' and 'culturally competent' care[30]). A possible shortcoming of this individualistic perspective is that the social position that characterizes members of certain groups (e.g. "
    [Show abstract] [Hide abstract]
    ABSTRACT: Background: Health care organizations need to be responsive to the needs of increasingly diverse patient populations. We compared the contents of six publicly available approaches to organizational responsiveness to diversity. The central questions addressed in this paper are: what are the most consistently recommended issues for health care organizations to address in order to be responsive to the needs of diverse groups that differ from the majority population? How much consensus is there between various approaches? Methods: We purposively sampled six approaches from the US, Australia and Europe and used qualitative textual analysis to categorize the content of each approach into domains (conceptually distinct topic areas) and, within each domain, into dimensions (operationalizations). The resulting classification framework was used for comparative analysis of the content of the six approaches. Results: We identified seven domains that were represented in most or all approaches: organizational commitment, empirical evidence on inequalities and needs, a competent and diverse workforce, ensuring access for all users, ensuring responsiveness in care provision, fostering patient and community participation, and actively promoting responsiveness. Variations in the operationalization of these domains related to different scopes, contexts and types of diversity. For example, approaches that focus on ethnic diversity mostly provide recommendations to handle cultural and language differences; approaches that take an intersectional approach and broaden their target population to vulnerable groups in a more general sense also pay attention to factors such as socio-economic status and gender. Conclusions: Despite differences in labeling, there is a broad consensus about what health care organizations need to do in order to be responsive to patient diversity. This opens the way to full scale implementation of organizational responsiveness in healthcare and structured evaluation of its effectiveness in improving patient outcomes.
    Full-text · Article · Nov 2015 · BMC Health Services Research
Show more