PM2082: Measuring Cultural Competence of the Medical & Non-medical Providers to Promote Diversity & Inclusion at Our Children’s Hospital

Background: In 2020, our children’s hospital was established as a free-standing hospital. It is the only one of its kind in the rural state serving a diverse group of children from various ethnicities, race, religious beliefs, sexual orientations, and socio-economic backgrounds. There is a need to assess the cultural competence among medical- and non-medical providers at the children’s hospital so we can provide appropriate care to children of diverse background.

Aim: To evaluate what drives respondent perceptions of the children’s hospital cultural competence.

Methods: This is a 3-month cross-sectional survey focusing on organizational cultural competence factor (4-item, CCF) to understand how the children’s hospital operationalizes inclusion. This survey was administered by email through the department list-serves with survey link (QR code) using RedCap. Respondent’s anonymity was maintained. Three monthly email reminders were sent and the survey was open for response from March-May, 2021. All categorical data were presented as counts and relative frequencies as percentages and the differences among the levels were tested using Chi-Squared test or Permutation Chi-Squared test for cell counts ≤5. A multiple logistic regression was performed and variables with a p-value < 0.30 in the unadjusted analyses were included in the model. As an effect measure, adjusted odds ratio (aOR) was calculated and reported with 95% confidence interval (95%CI). As a measure of internal consistency, Cronbach’s alpha was calculated. A two sided p-value < 0.05 was considered significant. Institutional IRB approved the study protocol.

Results: From an available pool of 1,600 staff members of the children’s hospital, 22% or 349 responded. The mean (standard deviation, SD) of the CCF score was 15.9 (SD, 3.3) and the median (interquartile, IQR) was 19 (IQR, 4), with at least 58% of the respondents (n=349) characterizing cultural competence of the children’s hospital above the mean. The Cronbach’s α for the CCF measure was 0.87 (95%CI: 0.84-0.90) with significant correlation between the four-item questions. There was significant unadjusted associations between some examined covariates (race/ethnicity, p< 0.001 & belief system, p< 0.001) and ranking the CCF score below the mean. (Table 1) In adjusted analyses, respondents self-identifying as non-Hispanic black (aOR=0.23, 95%CI: 0.12-0.43, p< 0.001) versus various race/ethnicities, other belief system (aOR=0.21, 95%CI: 0.09-0.48, p< 0.001) versus various religions, and advanced practice providers (aOR=0.28, 95%CI 0.08-0.88, p=0.04) versus various positions of providers were significantly less likely to rank the cultural competence of the children’s hospital above average. (Figure 1)

Conclusion: The children’s hospital survey data showed that more than half of respondents (58%) scored its cultural competence above average. However, minorities and advanced practice providers were less likely to rank the children’s hospital as culturally competent. Other children’s hospital should measure their cultural competence which are essential in making changes to local workforce and educational policies.