Cultural Competency Assessment Tool for Hospitals (CCATH): Survey Field Data from California Hospitals

Cultural competence has been defined as an “ongoing commitment or institutionalization of appropriate practices and policies for diverse populations” (Brach and Fraser, 2000). The national standards for culturally and linguistically appropriate services (CLAS), set forth by the Department of Health and Human Services' Office of Minority Health, provide guidelines on policies and practices aimed at developing culturally competent systems of care. The 14 CLAS standards are categorized into three themes: Culturally Competent Care (Standards 1-3), Language Access Services (Standards 4-7), and Organizational Supports for Cultural Competence (Standards 8-14). The Cultural Competency Assessment Tool for Hospitals (CCATH) is a survey instrument that was developed to assess hospital's performance with respect to the CLAS standards.

In this study we describe the development process of the CCATH, which included a comprehensive review of available cultural competence assessment tools, obtaining input from managers and researchers in the field, pilot testing the initial draft of the instrument, and qualitative testing (focus groups and cognitive interviews) of a revised version of the survey. In addition, we present the survey results of the CCATH field test in California from October 2006- February 2007. The sampling frame for the CCATH mail survey consisted of all acute care hospitals in California, approximately 370 hospitals. Descriptive statistics (means and standard deviations) are used to examine the adherence of California hospitals to each of the CLAS standards. Analysis of variance (ANOVA) is used to examine differences in adherence to the CLAS standard by ownership (for-profit, not-for-profit, and government).