From 1993 to 1998, staff from National Public Health and Hospital Institute assessed the status and progress of urban hospitals in addressing sociocultural barriers to health care access.
Specifically, project staff conducted six case studies of US public and private urban hospitals. Subsequently, it transformed the questionnaire it had created to examine the hospitals into a self-administered tool.
The case studies generally revealed a lack of cross-cultural initiatives at the hospitals studied and showed common elements that constrain action:
- Limited resources to deal with the problem.
- No compelling balance sheet rationale for action.
- A scarcity of models of successful action within the hospital industry and in the literature.
- A tendency among public hospitals to take their cultural competence for granted.
Project staff transformed its hospital questionnaire into a self-administered tool, The Cultural Competence Self-Assessment Protocol, which allows hospitals and other health organizations to assess their own cultural competence.