Hospital Cultural Competency and Attributes of Patient Safety Culture: A Study of US Hospitals

Document Type

Conference Proceeding

Publication Date


Publication Title

Academy of Management Proceedings 2019 (1), 13015


American Society of Civil Engineer (ASCE)






Given the increase in racial and ethnic diversity in the U.S., hospitals face a challenge in terms of providing safe and high quality care to minority patients. Cultural competency can be used as a resourceful strategy to provide safe care and improve patient safety culture. In particular, becoming culturally competent can influence employee behaviors through training and education on diversity. This paper aims to examine if cultural competency impacts employee’s perceptions of attributes of safety culture. A longitudinal study design was used with 283 unique hospital observations from 2014-2016. The dependent variables were percent composite scores for four attributes of perceived safety culture: 1) management support for patient safety, 2) non-punitive response to error, 3) teamwork across units, and 4) communication openness. The independent variable was cultural competency considered in 3 categories: 1) robust, 2) medium, and 3) low. Hospital characteristics, market characteristics, and % diversity were controlled for. Lagged effects of cultural competency score on patient safety culture data were used. Ordinal logistic regressions were used for analyses. Results indicate that hospitals that have a robust cultural competency have a 0.05% higher perceptions of management support for safety, 0.04% higher perceptions of non-punitive response, and a 0.03 % higher perceptions of teamwork across units as compared to hospitals that have a low cultural competency (p<0.05). In general, culturally competent hospitals have better safety culture than their counterparts. Cultural competency is an important resource to build safety culture so that safe care for patients from minority and diverse backgrounds can be delivered.


Medicine and Health Sciences | Public Health



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