The Third National Conference on
Quality Health Care for Culturally Diverse Populations:
Advancing Effective Health Care through Systems Development, Data, and Measurement

October 2 - 4, 2002, Chicago, IL
Westin Chicago River North Hotel

Conference Proceedings

I. Conference Rationale

II. Conference Design

III. Conference Conclusions

A. Cultural competence must align its objectives with broader quality-of-care initiatives to strengthen its position in the national health care agenda.

B. Reducing health disparities is a matter of civil rights.

C. The National CLAS standards can guide organizational change and assist with the implementation of cultural competence in a host of health care settings.

D. Establishing standards and models for cultural competence training in the health professions will improve the clinical encounter.

E. Health care organizations are using and improving upon a wide variety of approaches to communicating with linguistically diverse populations.

F. Researchers and providers are experimenting with different ways to measure cultural competence and its impact and can offer insight into successful approaches and difficult challenges.

G. Outcomes research on cultural competence is challenging to design and conduct, but researchers are slowly establishing a base that makes a link between cultural competence and improved outcomes.

IV. Overall Conference Conclusions

V. Conference Plenary Presentations

• Keynote Address: Culture and Quality—Joining the Levers
• The Role of Language and Culture in Patient Safety
• The Institute for Culturally Competent Care: Leveraging Kaiser Permanente's Expertise
• Data, Disparities, and Discomfort: Moving the Cultural Competency Agenda
• Need Meets Opportunity: Current and Future Directions in Research, and Innovations in Cultural Competence

Proceedings

Health care organizations and health professionals continue to face the challenge of delivering quality health care to a growing population that is culturally and linguistically diverse. Implementing relevant programs, collecting data, and measuring effectiveness are critical steps in the pursuit of better health outcomes. Toward that end, the “Third National Conference on Quality Health Care for Culturally Diverse Populations: Advancing Effective Health Care through Systems Development, Data, and Measurement” was held October 2-4, 2002, in Chicago, Illinois. By creating a national forum to explore how various measures contribute to improved outcomes, the conference sought to promote the exchange of ideas, experiences, and practices that have proven beneficial to the health of these diverse populations.

The conference was presented by the State University of New York Downstate Medical Center and Resources for Cross Cultural Health Care, in conjunction with the Arthur Ashe Institute for Urban Health, and agencies of the U.S. Department of Health and Human Services: the Office of Minority Health, the Centers for Medicare & Medicaid Services, the Health Resources and Services Administration’s Bureau of Primary Health Care, and the Agency for Healthcare Research and Quality.

These proceedings provide an overview of the conference design and rationale, synthesizing themes and conclusions from conference presentations, summarizing conference plenary presentations, and highlighting model programs in the field of cultural competence. The proceedings are part of a multi-format archive of resources available to the public on cultural competence in health care. The conference Web site, www.DiversityRx.org/ccconf, contains biographies and abstracts for conference presenters from all three conferences, and will be continually updated with information about the Fourth National Conference, slated for September 28-October 1, 2004. Information about audiotapes from the conference series is also available online. Contact information for the 2002 conference presenters is located at the end of the document.

I. Conference Rationale

The series of conferences on quality health care for culturally diverse populations originated from discussions in the mid 1990s with community representatives and members of national and state-based organizations. These stakeholders indicated that national meetings would serve as an important resource for professionals concerned with the growing diversity of the nation and the need to reduce racial and ethnic disparities in health care.

Broad Support. In creating the national conference series, we explicitly determined that our planning group as well as the funding base should be built on a broad representation of organizations whose involvement we deemed critical to success: business, government, foundations, providers, and advocates. We have received financial assistance and in-kind support for all three conferences from more than twenty state and national foundations, pharmaceutical firms, health care associations, federal agencies, and local governments. We complement these sources with representation from culturally diverse communities on our National Advisory Group.

The First and Second National Conferences. The objective of the first national conference was to place health care for culturally diverse populations squarely in the center of business, healthcare, and education, and to draw attention to the need for common investment in culturally competent care that extends across interest groups. By presenting a broad agenda that integrated the perspectives of the patient, provider, organization, community, government, and research, the conference highlighted the complexity of cultural competence and its relevance across disciplines and health care settings. Of equal importance was the fact that the conference provided participants from around the United States and three other countries the opportunity to meet and to create their own networks with others concerned with care to culturally diverse communities.

Attendees of the first national conference voiced a unanimous opinion about the need for a second conference. A review of the conference transcripts revealed that the conference had, in many ways, raised more questions than it had answered, and attendees wanted to reconvene in two years’ time to discuss in greater depth the strategies and models that might be applied in their specific settings.

As the first conference created an opportunity for individuals to learn about contextual issues related to cultural competence, the second national conference highlighted model development and performance results within the framework of a more interactive format. While focusing on national, state, and local initiatives through plenary sessions, the conference featured opportunities for more directed and intensive discussion among participants on cutting edge innovation and research. Participants were particularly enthusiastic about the new roundtable discussions on controversial issues and the special emphasis on networking opportunities in the conference resource center.

The Third National Conference. Evaluation form comments from the second conference, as well as inquiries from several participants about when and where the next conference would take place, indicated that people continued to find this conference series a valuable venue for learning about emerging approaches to improving care for diverse populations. Having set cultural competence in the context of business, policy, and community priorities, and having illuminated the wide range of model programs and practices being developed nationwide (as well as in other countries), the intent of the third national conference was to look at efforts to measure the impact of cultural competence. The call for proposals specifically asked presenters to discuss how their programs approached assessment and data collection, especially in the context of provider and purchaser interest in health and health service outcomes.

II. Conference Design

Nearly 500 people participated in the “Third National Conference on Quality Health Care for Culturally Diverse Populations.” Convening in Chicago allowed the conference to maintain a nationwide focus while facilitating the participation of individuals and programs from the Midwest who had not been able to travel to the first and second conferences. Attendees came from across the country, as well as Canada, Australia, and several European countries, and represented a cross section of professionals in the health care field.

The format of the third conference paralleled that of the first and second meetings. Presentations continued to highlight innovative strategies by reviewing the status of interventions discussed at the first and second conferences and reporting on “next phase” findings. Particular emphasis was placed on interactive presentations and skills-building workshops. Presentations featured information on system strategies, data, measurement, and outcomes. Moderators were asked to guide session discussions to consider implications for measurement. The conference also featured strategies for integrating measurement and assessment components into cultural competency initiatives.

A half-day preconference of five intensive training sessions preceded the two-and-a-half day main conference. At the main conference, more than 100 speakers offered skills-building, informational, and plenary sessions on topics ranging from the appropriate use of bilingual staff and interpreters to designing and assessing cultural competence training programs for health care professionals. Session tracks included organizational cultural competence, linguistic access, measurement and assessment, policy and research, and cultural competence training. The program also included participatory roundtable sessions, resource center exhibitions, poster presentations, networking opportunities, and a film festival.

As in previous years, conference participants were asked to share their observations about the positive aspects of the conference as well as to suggest ways in which it could be improved. More than 350 evaluation forms were submitted, and overall, those who completed evaluation forms were very positive about the conference’s content and its capacity to serve as a forum for creating and strengthening networks of contacts. A summary of key comments is included in the appendix.

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