Standard 5 of culturally and linguistically appropriate services in health care

The enhanced National CLAS Standards and The Blueprint, their accompanying guidance document, are now available.

Comment:

The enhanced National CLAS Standards and The Blueprint, their accompanying guidance document, are now available online. A launch event was held April 24, 2013 ,at the The Henry J. Kaiser Foundation's Barbara Jordan Conference Center.

The National Standards for Culturally and Linguistically Appropriate Services in Health and Health Care (known as the National CLAS Standards) are intended to advance health equity, improve quality and help eliminate health care disparities by establishing a blueprint for organizations to deliver effective, understandable and respectful services at every point of patient contact. Adoption of the National CLAS Standards will help advance better health and health care in the United States.

A Blueprint for Advancing and Sustaining CLAS Policy and Practice (The Blueprint) is a new guidance document for the National CLAS Standards available exclusively on the Think Cultural Health website. The Blueprint describes each Standard's purpose and components. In addition, it provides basic strategies for implementation and a list of resources that provide additional information and guidance.

Comment:

Culturally and linguistically appropriate services (CLAS) are respectful of and responsive to the health beliefs, practices and needs of diverse patients. AHRQ has tools, training, and reports to help health systems deliver CLAS so that all patients receive high quality care and achieve good health outcomes.

Tools to Promote CLAS

Re-Engineered Discharge Toolkit

The Re-Engineered Discharge (RED) Toolkit helps hospitals re-design their discharge processes to reduce readmissions and post-hospital emergency department visits. Geared particularly hospitals that serve diverse populations, delivering CLAS is addressed throughout the RED Toolkit, and is the focus of Tool 4: How To Deliver the Re-Engineered Discharge to Diverse Populations.

AHRQ Health Literacy Universal Precautions Toolkit, 2nd edition

The AHRQ Health Literacy Universal Precautions Toolkit, 2nd edition and companion implementation guide help adult and pediatric practices reduce the complexity of healthcare, increase patient understanding of health information, and enhance support for patients of all health literacy levels. Two tools specifically address CLAS: Address Language Differences (Tool #9) and Consider Culture, Customs, and Beliefs (Tool #10).

CAHPS Ambulatory Care Improvement Guide

The CAHPS Ambulatory Care Improvement Guide is a comprehensive resource for health plans, medical groups, and other providers seeking to improve their performance in the domains of patient experience measured by CAHPS surveys of ambulatory care. Its chapter on Cultivating Cultural Competence  describes strategies available to help reduce linguistic and cultural barriers.

Tips on Writing a Quality Report

TalkingQuality offers guidance on producing comparative information on healthcare quality that's understandable and useful to consumers. Tip 5: Make a Health Care Quality Report Culturally Appropriate helps readers feel like the report was written for them. It fits with their cultural traditions and beliefs, making them feel respected and understood.

CLAS-Related Training Resources

The SHARE Approach

The SHARE Approach, a train-the-trainer curriculum, supports the training of healthcare professionals on how to engage patients in healthcare decisionmaking. Taking Steps Toward Cultural Competence provides guidance for how to consider cultural differences to build effective relationships with patients during shared decisionmaking.

TeamSTEPPS® Limited English Proficiency Module

The TeamSTEPPS® Limited English Proficiency Module train-the-trainer curriculum includes everything you need to train clinicians and interpreters to work as a team. The publication Improving Patient Safety Systems for Patients With Limited English Proficiency: A Guide for Hospitals focuses on how hospitals can better identify, report, monitor, and prevent medical errors in patients with limited English proficiency, including preparing to implement the TeamSTEPPS limited English proficiency module.

Reports

Cultural Competency in Making Healthcare Safer III

Cultural competency is one of 47 safety practices reviewed in AHRQ’s 2020 report Making Healthcare Safer III. To access the summary of the evidence published from 2008 onward on cultural competency as a patient safety practice, go to Cross-Cutting Patient Safety Topics/Practices (PDF, 1.7 MB) and scroll down page 17-41, where the Cultural Competency section (17.4) begins.

Improving Cultural Competence to Reduce Health Disparities for Priority Populations

The systematic literature review Improving Cultural Competence to Reduce Health Disparities for Priority Populations considers the effect of diversity and cultural competence interventions on three populations with varying degrees of cultural identification and visibility: LGBTQI adolescents and adults, children and adults aging with disabilities, and racial/ethnic minority children and adults.

Race, Ethnicity, and Language Data: Standardization for Health Care Quality Improvement

Collecting healthcare quality information stratified by race, ethnicity and language data is critical for targeting disparity reduction strategies. AHRQ commissioned a report from the Institute of Medicine to identify standardized categories for the variables of race, ethnicity, and language that can be used to facilitate the sharing, compilation, and comparison of quality data stratified by the standard categories.

Cultural Competence and Patient Safety

The brief Cultural Competence and Patient Safety discusses CLAS in relation to medical errors and strategies that have the potential to decrease patient safety disparities. In the companion piece, Cultural Competence and Patient Safety: Interview with Cindy Brach, AHRQ’s lead for cultural competence discusses the relationship between CLAS and health literacy, as well as AHRQ tools and training to promote CLAS.

HHS Resources

Think Cultural Health is a program of the U.S. Health and Human Services Office of Minority Health that provides health and healthcare professionals with information, continuing education opportunities, resources, and more to learn about CLAS. Resources include:

• Culturally and Linguistically Appropriate Services (CLAS) in Maternal Health Care
• National CLAS Standards
• The Guide to Providing Effective Communication and Language Assistance Services
• Improving Cultural Competency for Behavioral Health Professionals
• A Physician’s Practical Guide to Culturally Competent Care
• Culturally Competent Nursing Care: A Cornerstone of Caring

Originally developed by the Health Resources and Services Administration, and updated by the Centers for Disease Prevention and Control CDC, Effective Communication For Healthcare Teams: Addressing Health Literacy, Limited English Proficiency and Cultural Differences is a three-part course that can be taken for continuing education credit.

LEP.gov is a federal interagency site providing wide ranging resources for providing ensuring that people with limited English proficiency have equal access to federally-funded services.

What are culturally and linguistically appropriate services?

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