Organisational Systems’ Approaches to Improving Cultural Competence in Healthcare: A Systematic Scoping Review of the Literature

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Healthcare organisations serve clients from diverse Indigenous and other ethnic and racial groups on a daily basis, and require appropriate client-centered systems and services for provision of optimal healthcare. Despite advocacy for systems-level approaches to cultural competence, the primary focus in the literature remains on competency strategies aimed at health promotion initiatives, workforce development, and student education. This paper aims to bridge the gap in available evidence about systems approaches to cultural competence by systematically mapping key concepts, types of evidence, and gaps in research. Outcomes were found for organisational systems, the client/practitioner encounter, health, and at national policy level. Authors could not determine the overall effectiveness of systems-level interventions to reform health systems because interventions were context-specific, there were too few comparative studies and studies did not use the same outcome measures. However, examined together, the intervention and measurement principles, strategies and outcomes provide a preliminary framework for implementation and evaluation of systems-level interventions to improve cultural competence.

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McCalman, J., Jongen, C., & Bainbridge, R. (2017). Organisational systems’ approaches to improving cultural competence in healthcare: a systematic scoping review of the literature.  International Journal for Equity in Health,  16(1), 78.

About This Study:

Outcome(s): Cultural Competence
Intervention(s): Cultural Competence Training
Intervention Duration: Varies by study
Relevant ORR Program: Children's Services, Ethnic Community Self-Help Program, Medical Screening, Preferred Communities, Refugee Health Promotion
Study Type: Systematic review
Full Text Availability: Free
Direction of Evidence: Inconclusive or mixed impact
Strength of Evidence: Strong
Population(s): Refugees
Gender(s) of Participants: All
Age(s) of Participants: Multiple Age Groups
Region(s) of Origin of Participants: Multiple Regions

Relevant Evidence Summaries:

The evidence was reviewed and included in the following summaries: