Comparing cultural competence in healthcare delivery to library & information science environments
For the following comparison, the two frameworks shall be referred to by their acronyms. Culturally & Linguistically Appropriate Services Standards will be shortened to CLAS. Library and Information Services will also be shortened to LIS.
The goal of each of these frameworks is essentially the same, minus one small detail. The principle standard of CLAS effectively calls for "quality care and services"1 while the LIS framework's goal is twofold, improving services as well as increasing library use by diverse groups.2 This small detail can be amplified however and become a major difference between the two in terms of outcome. In health care delivery, not following the CLAS guidelines can lead not only communication ineffectiveness, but to things as serious as the wrong or inappropriate care. In the LIS realm, the goal of the framework being to increase library use is less consequential to the customer. In a library or information services setting, a lack of cultural competence is not likely to endanger the health of the patron.
A very obvious similarity between the two frameworks is the need for education and training. In order to maintain a culturally appropriate environment in any workplace, ongoing training is required. The fourth point of the CLAS framework clearly lays out that this training starts at the top with governance and leadership and continues to be reflected in the knowledge of cultural policies and activities. Similarly, the LIS document calls out the need to build cultural knowledge in a formal setting, not limited to professional development training for those already working in an information services environment, but also course development for students enrolled in LIS degree programs. 2
Although this is a similarity, it clearly displays how much farther ahead the health care world is when compared with LIS in terms of not only standards, but the educational and continuous training aspect called for in the CLAS standards. I am also evidence of the lack of formality in the training for members of my own industry. As a programmer, my cultural competence training is right here, in this class, Client Diversity in Health Sciences.
Another concept found in both frameworks is that partnering with the community. Formal education is a start, but cultural understanding is learned in large part by communicating with those that either use the service provided, or those who an increase in participation is the desired outcome. In the case of the CLAS guidelines, point 13 describes a partnership with the community in which the design and implementation of services are appropriate to the community served. The guideline just prior also states that regular assessments are needed to ensure that the planning of services truly reflects the cultural and linguistic needs of those served. The LIS framework takes this "within the community" 2 idea to another level, separating the concept into two sections, the interpersonal domain, and the environmental domain. In terms of partnering with the community, the LIS framework suggests that planning and implementing culturally appropriate services has to address both. Competency in the interpersonal domain, where one recognizes both their own level of cultural appreciation, ethics and level of cultural interaction leads directly to an environment of cultural appropriateness. For Library and Information Science professionals, having collections in multiple languages, or providing services via an interpreter is only the tip of the iceberg. The leadership and staff's cultural competency is reflected in the environment where they work.
The conclusion that I will make after reading these two frameworks looking for similarities and differences is this: in health care delivery, cultural competency is and has been an important part of the training and skills of those in that realm. In LIS and other technical fields, cultural awareness is a more recent phenomenon. The availability of information on this topic for health care is much, much higher than it is for any other industry. Having a framework like the one provided in the article by Overall is a good starting place for a lot of catching up.
Bibliography
1.
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The national CLAS
standards. Office of Minority Health - U.S. Dept of Health and Human
Services. November 21, 2016. Available at: http://minorityhealth.hhs.gov/omh/browse.aspx?lvl=2&lvlid=53.
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Overall M. Cultural
competence: a conceptual framework for library and information science
professionals. The Library Quarterly. April 2009;79(2):175-204. Accessed here:
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