Second National Conference on
Quality Health Care for Culturally Diverse Populations:
Strategy and Action for Communities, Providers, and a Changing Health System

IV-B: Improving Organizational Cultural Competence: Assessment and Services Planning

Many health care organizations are becoming aware of need to address the increasing ethnic/cultural diversity of their communities and their clients. This awareness is occurring due not only to population shifts, but to changes in the competitive environment and economy that make such diversity more financially attractive. At the same time, increased these organizations are facing a new and uncertain time where federal and state governments are issuing guidelines or regulations intended to improve access and quality of care for all racial and ethnic groups. As a result, many health care providers are seeking ways to reexamine their programs and policies so that they may both conform with emerging government actions, better their competitive position and lead to more cost-effective care.

This session will offer attendees the opportunity to examine the efficacy and value of applying a method to assess cultural competence in their health care setting. It will present a specific design by which health care organizations can evaluate their efforts to date in addressing cultural diversity and improving cultural competence. It will present the specific review tool, "The Cultural Competence Self -Assessment Protocol”, which was developed by Dennis Andrulis, Tom Delbanco and Laura Avakian with support from the Robert Wood Johnson Foundation. It will identify how undertaking a review or "audit” of cultural diversity activities by applying the protocol will provide these organizations with a structured approach to determining strengths and areas needing further development. It will also describe its objectives, components, method of application and scoring of results. As part of this presentation, attendees will have the opportunity to review and consider relevance of protocol questions, to walk through the process and to interpret results.

As part of this profile and review of the protocol, we will also discuss its application and value generally and with the CEO of Cambridge Health Alliance organization that conducted it. John O'Brien will outline the process his organization undertook, staff involvement and results. He will also identify how the information is being applied to address the needs of his community.

Dennis P. Andrulis is a research professor at the State University of New York Health Sciences Center at Brooklyn. He is responsible for creating, developing and conducting policy relevant research related to national and New York State health issues. In his current work and preceding tenure as Director, Office of Urban Populations at the New York Academy of Medicine in New York City, he has created and overseen the development of projects, prepared major reports and published on a wide range of issues affecting hospitals and safety net providers, vulnerable populations and their communities. Dr. Andrulis has served as Principal Investigator for an investigative report, published by Jossey-Bass, entitled Managed Care in the Inner City: the Uncertain Promise for Providers, Plans and Communities. He has led projects concerning cultural diversity in health care including creation of a cultural competence self-assessment tool for health care organizations, and a national conference, Quality Health Care for Culturally Diverse Populations: Provider and Community Collaboration in a Competitive Marketplace. His focus on urban issues led to the creation a compendium and analysis of information on the social and health characteristics of the nation's major urban areas, published by The American Hospital Association Press, entitled The Social and Health Landscape of Urban and Suburban America.

In his ten year tenure as President of the National Public Health and Hospital Institute, Dr. Andrulis instituted a research and education agenda concerning public hospital systems and the safety net, including national surveys on hospital HIV care, teaching hospitals and their adaptation to managed care, patient-centered care and health care professional training on policy. He holds a Ph.D. in Educational-Community Psychology from the University of Texas at Austin and a Masters of Public Health from the University of North Carolina at Chapel Hill.

Dennis P. Andrulis, PhD, MPH
Research Professor
Department of Preventive Medicine and Community Health
SUNY Downstate Medical Center
450 Clarkson Avenue, Box 1240
Brooklyn, NY 11203
Phone: (718) 270-7726
Fax: (718) 270-7565
Email: dandrulis@netmail.hscbklyn.edu

John O'Brien commenced his health care career at The Cambridge Hospital in 1976, worked his way through the ranks to become Chief Financial Officer in 1984 and finally to Chief Executive Officer in 1986. During Mr. O'Brien's tenure as CEO, The Cambridge Hospital has undergone a dramatic transformation. Saddled with a $10 million deficit in 1987, the Hospital has reinvented itself by forming a unique partnership with its community, has restored its financial health and has become a model for building healthier communities. In 1991, The Cambridge Hospital achieved a break even position and has been in the black ever since.

In August 1993, Mr. O'Brien accepted on behalf of the staff of the Hospital, The Foster G. McGaw Prize at the American Hospital's Association annual convention in Orlando, Florida. This coveted award is given by the American Hospital Association and the Baxter Foundation to a single hospital in the United States each year which displays its utmost commitment to improving the health status of its community through a myriad of programs. In April, 1994, Mr. O'Brien received the 1994 CEO Award from the American Hospital Association's Society for Healthcare Planning and Marketing. This award is presented annually to one CEO in the United States who demonstrates excellence in the development and support of an effective strategic planning and marketing function, and who consistently communicates the mission, vision, and strategic plan to all levels of the organization.

Currently, Mr. O'Brien serves as the Chief Executive Officer of a recently created public authority known as the Cambridge Health Alliance, which is comprised of two acute care hospitals (The Cambridge Hospital and Somerville Hospital), a skilled nursing facility (Neville Manor), the City of Cambridge Public Health Department and over twenty primary care sites. He also serves as the Commissioner of Public Health for the City of Cambridge.

Mr. O'Brien is a graduate of Harvard College and received his Masters degree in Business Administration at Boston University.

Mr. O'Brien is the Chair-Elect of the National Association of Public Hospitals, and is the Past-Chairman of the Board of Trustees of the Massachusetts Hospital Association.

John O'Brien
Chief Executive Officer
Cambridge Health Alliance
1493 Cambridge Street
Cambridge, MA 02139
Phone: (617) 665-1001
Fax: (617) 498-1003
Email: Jo'brien@challiance.org

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