Ensuring that individuals and families feel welcomed and affirmed, and are able to trust their providers, requires not only that providers and staff are culturally competent as individuals, but that the competencies of health care organizations and systems are continuously assessed and improved.
Institutional leadership should publicize trainings available to providers and staff, and strongly encourage if not require attendance. Moreover, attendance by key leadership can send an important signal to others about the organization’s commitment.
Providing accessible, welcoming, and competent health care to persons of all sexual orientations, genders, differences in sex development, races and ethnicities, includes a focus on the policies and practices, infrastructure, and the physical environment. Moreover, cultural competence training of providers and staff at a given organization will be much more effective if there is commitment to inclusivity and accountability for change at all levels of the institution, including its leadership.
ADDRESSING HEALTH INEQUALITIES
Cultural competence training should address the fact that health inequities affecting people result not only from an inequitable healthcare system, and implicit and explicit biases of healthcare providers, staff, and management, but also from lack of family support that many people experience; discrimination in employment, education, housing, and public programs; stigmatizing messages conveyed by media, educational and religious institutions, public officials, and government policies.
INDICATORS OF COMMITTMENT
Cultural competence training programs should secure commitments from institutional leadership to assess and improve organizational policy, protocols and culture. Indicators of level of commitment can include: an institution’s mission statement; job descriptions; board of directors’ mandates; and performance reporting requirements for senior leadership. The institution’s standing in the Human Rights Campaign’s Healthcare Equality Index or HEI can also be consulted. Institutional leadership should publicize trainings available to providers and staff, and strongly encourage if not require attendance. Moreover, attendance by key leadership can send an important signal to others about the organization’s commitment.