Nurses who have been following the progress of the federal Office of Minority Health (OMH)’s landmark project to develop a set of comprehensive national standards for culturally and linguistically appropriate services (CLAS) in health care know that the final version of the standards was officially published in the Federal Register in December 2000. But did you know that OMH has also produced a Final Report on the standards in a handy paperback book format that makes an excellent desktop resource for nurses in clinical practice who want to help their health care institutions implement the CLAS guidelines?

The 14 standards–some of which are voluntary recommendations while others are mandates under Title VI of the Civil Rights Act for any health care organization that receives federal funds—cover such areas as recruiting and retaining a culturally diverse staff, training staff to deliver culturally and linguistically competent services, and providing patients who have limited English language proficiency with competent language assistance services.

The Final Report not only summarizes the CLAS standards but also contains a wealth of information to help nurses in clinical settings understand them, interpret them and apply them to their practice and to their facility’s particular cultural competency needs. The book includes a history of the project, an in-depth discussion of each standard and the issues involved, examples of strategies for implementing the standards, a bibliography, a glossary and more.

“I don’t want to go out on a limb and say it’s ‘everything you want to know about cultural competence,’” the CLAS project’s principal investigator, consultant Julia Puebla Fortier, founder of Resources for Cross-Cultural Health Care in Silver Spring, Md., told Minority Nurse. “But an awful lot of what you want to know about cultural competence is contained in this report.”

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Fortier, who is of Mexican American and Native American descent, offers this advice for how nurses can best use the Final Report—which, at 180 pages, may seem a little weighty and intimidating at first glance. “The standards themselves, which are published at the very beginning of the report, are obviously the first place to start. It’s really helpful to get a sense of the overall framework the standards are trying to describe, because in a way, they are describing an ideal culturally competent institution.

“Implementing the standards must be a step-by-step process,” she continues. “Depending on what is already going on in the organization, what the strongest needs are, clinicians on the front lines can look at the condensed form of the standards and say, ‘Where do we want to focus our energies first? Do we want to start out by doing an assessment, or by instituting data collection practices? Do we want to tackle interpreter issues?’ You can take a couple of things that you want to focus on and then go to the report’s discussion section.”

That section, says Fortier, is “very useful for helping you understand the depth of the implementation issues, such as what some of the model programs are and what is involved in their execution. It’s not a step-by-step guideline, but it lays out all of the most important issues, both from the perspective of what can be achieved and what possible complications could be encountered. As for the section on the background and purpose of the CLAS project, it’s a very useful tool for nurses who are trying to make the case for their institution to pursue cultural competence in general.”

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For a free copy of the CLAS Final Report, contact the Office of Minority Health Resource Center (OMHRC) at (800) 444-6472. If you are interested in simply reading the final CLAS standards without any of the supplemental information contained in the report, the OMHRC Web site has a direct link to the Federal Register version.

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