In today’s health care environment, cultural competence is key to the delivery of quality care to culturally and linguistically diverse communities. As the nation’s leading provider of healthcare services, HCA is comprised of locally-managed facilities that includes 163 hospitals and 109 freestanding surgery centers in 20 states and England that employ approximately 199,000 people. Today, four to five percent of all inpatient care delivered in the country is provided by HCA facilities. In 2010, HCA’s diversity council provided a clear directive—focus on cultural competence. As a result, the C3 (Culturally Competent Care) Initiative was established to support the dissemination of resources and tools to facilitate culturally competent care within HCA’s healthcare network.

According to Sherri Neal, HCA’s diversity officer, “I felt the first thing we needed was an internal roadmap that would establish a comprehensive framework for implementing cultural competence initiatives across the enterprise and position HCA as a leader in the delivery of culturally competent patient-and family-centered care.”

The C3 Resource Guide, developed in September 2011, provides direction to improve communications within the workforce, better serve patients, and enhance communities. It includes helpful cultural competence background information, steps for implementation, cross-walks with Joint Commission patient-centered communication standards, Office of Minority Health CLAS Standards, and other recommended strategies.

The HCA C3 Resource Guide was first designed as an electronic book accessible to employees via the intranet. The footnotes in the document were hyperlinks that enabled users to easily access ancillary information relevant to key areas. This eco-friendly innovation is also easy to update as new input and feedback are collected. Employee reactions to this online innovation have been extremely positive. As a result of the ease of use and quality and value of the content, HCA received several requests for print copies and now have created a print version for distribution.

The purpose of the C3 Resource Guide was to provide HCA affiliates with the necessary tools to guide the implementation of culturally and linguistically appropriate strategies and services. There are multiple external resources that provide recommended practices for creating a more culturally competent and inclusive organization, but the C3 Resource Guide is the internal roadmap. It is built on strong “patients first” philosophy, but is also aligned with regulatory and other standards that relate to cultural competence.

The most important benefit of this document is that HCA has an internal roadmap for how cultural competence and inclusion should be driven through the organization. The guide is designed to help assess, adapt, and apply new approaches and techniques as a long-term effort that will last many years.