Healthcare Disparities and Cultural Competency Measures
use the Consumer Assessment of HealthcareProviders and Systems (CAHPS®) Item Set forAddressing Health Literacy to evaluate providercommunications, disease self-management, andcommunication about medicines, test results,and forms. Finally, RAND’s cultural competencyimplementation measure is designed to helphealthcare organizations identify how well theyprovide culturally competent care, serve theneeds of diverse populations, and adhere to 12out of 45 NQF-endorsed cultural competencypractices. All of these measures will be helpful toproviders working to improve care for all patients.
These measures are designed for use by a rangeof clinical settings and providers, physiciano
ces, ambulatory centers, health plans andhospitals.
Eliminating healthcare disparities and improvingcultural competency are integral to advancingquality improvement e
orts throughout thehealthcare system. These new measures areeven more signiﬁcant in that the majority ofthem evaluate patient experience, an increasinglyimportant concern in quality measurementand improvement. When providers directlyengage with patients – whether by holdingconversations in a native language, ensuringpatients understand medication adherence, orestablishing a level of trust throughout treatment– they are better able to deliver high-quality careto vulnerable populations.Throughout the project, NQF identiﬁed severalimportant concepts beyond race, ethnicity, andlanguage that future disparities-related measuredevelopment will need to address. These include:
Leadership and accountability
Addressing other populations withknown disparities, such as gender, lowsocioeconomic status, and persons withdisabilities
Health-related quality of life
Inclusion of socioeconomic status variableswithin measure concepts, such as educationlevel or income – particularly as proxies forhealth literacy/beliefs
Tracking the ﬂow of information speciﬁcto disparities and culture within healthcarethrough accountable care organizations
Identifying the number of bilingual/biculturalproviders and tracking the number ofqualiﬁed/certiﬁed medical interpreters andtranslators
Measures using comparative analyses with areference population (ex. percent adherenceof a given measure with the targetedpopulation as a numerator and the referenceor majority population as the denominatorwith serial assessments to demonstrateimprovement to unity)
Measurement of the e
ectiveness of servicesprovided to the patient
Measures related to e
ective engagement ofdiverse communities
1888: Workforce development measure derivedfrom the workforce development domain of theCommunication Climate Assessment Toolkit(CCAT) (American Medical Association)
Site score on the measure domain of“Workforce Development” of the CommunicationClimate Assessment Toolkit (C-CAT), 0-100.
1901: Performance evaluation measure derivedfrom the performance evaluation domain of theCommunication Climate Assessment Toolkit(CCAT) (American Medical Association)
Site score on domain of“performance evaluation” of the CommunicationClimate Assessment Toolkit (C-CAT), 0-100.
1905 Leadership commitment measure derivedfrom the leadership commitment domain of theCommunication Climate Assessment Toolkit(CCAT) (American Medical Association)
Site score on the measure derivedfrom the domain of “Leadership Commitment” ofthe Communication Climate Assessment Toolkit(C-CAT), 0-100.