Cultural Competence is a Strategy II

I doubt that strategy and struggle have a common Latin root.

What I don't doubt is that they go hand in hand if success is desired.

With any change process, there is resistance. In many instances the resistance can even exist amongst those who want to actually see the change move forward. They may fundamentally believe in the idea of transforming the way their organization gets healthcare (or whatever their business is) done; nonetheless, something they cannot fully understand about their thinking or approach leaves them with results that are less than desired.

Why does this happen? It happens because CHANGE DOESN'T WORK.

Let me explain using a device that I found quite fascinating when I first came across the ad that read: "Drop 2-3 dress sizes in less than 10 minutes." When I first read it and then saw the pictures and read the testimonials on the postcard that was left on my car one day, I began to wonder how long this 2-3 size drop lasted. I was compelled to learn more because I have read about a lot of diets from The Zone to the Master Cleanser, and none of them promised results in such a short period of time.

As some of you who watch Oprah probably know (of course it was on Oprah!), this device is not actually a diet. It is in fact a very efficient body compression, girdle-type device that apparently allows one to wrap themselves up thus compressing 2-3 sizes worth of "love handles or other handles" that one has, leaving them visibly thinner under their clothing.

I am not discounting this device, it has its place. It creates change and from the outside, if you saw a person with one of these compression devices on, you would naturally perceive them to appear a certain way. They may appreciate your perception as their intention was to present themselves in a particular light.

Now, the person wearing this device changed, but how long did that change actually last? What will be required to sustain that change?

The answer: it cannot be sustained. It can be repeated and it can be replicated, but it cannot be sustained because CHANGE DOESN'T WORK. It doesn't fail because we are not sincere about our desire to see lasting results. It doesn't fail because the intention is not sincere or carefully considered. Change doesn't work because as long as it is viewed as change it will be resisted and it will be changed again. Change is a tactic. Some tactics have longer-term success than others but in and of themselves, they fall short of creating results that are sustainable.

So, change is like the love handle compression device shared above. It is a tactic that creates the appearance of a desired result, but it is not the desired result because its not possible for it to be sustained. 10 minutes to decrease 2-3 dress sizes is akin to doing a 2 hr, 4hr, or two-day "diversity" or "cultural competency" training and expecting that the learning will be sustained and put into practice. I am not saying that it doesn't have a positive effect and given that we deliver training as one of our services, I recommend it. However, I am very clear that it is a tactic in an overall strategy that takes more time and more struggle.

Cultural Competence is a Strategy--it is an organizational development strategy. If it is framed as such (and aligned with your overall organizational quality strategy) it can be a transformational strategy. Transformation is sustainable as it implies that the process leads to a place where what your organization is doing tactically transcends the moment of implementation and speaks to practices becoming part of what I call your "Organizational Being". This is in contrast to "Organizational Doing" which speaks to something temporary and consciously or unconsciously viewed as marginal to success.

A solid cultural competence strategy takes struggling with current mindsets, norms, and a variety of other conversations that we have become accustomed to that require a shift of perspective to create quality healthcare delivered in a patient-centered, culturally competent manner.

Next time I will speak briefly on leading your cultural competence efforts strategically.

Make it a great day!