Organizational Barriers to Cultural Competence in Hospice

Am J Hosp Palliat Care. 2015 Nov;32(7):685-94. doi: 10.1177/1049909113520614. Epub 2014 Mar 12.


This national mixed method study with directors of 207 hospices identified major barriers to cultural competence, including (1) lack of funding for additional staff for community outreach or development of culturally competent programs, (2) lack of applications from diverse professionals, and (3) lack of knowledge about diverse cultures and what cultural groups in the community are not being served. Qualitative results indicated that elements of an organizational culture, which create barriers to access included (1) failure to prioritize cultural competence, (2) failure to budget for culturally competent services, and (3) a staff that does not value awareness of cultural differences, is uncomfortable with diversity, and stereotypes diverse individuals. In phase 2, an interactive session with a 100-symposium audience provided strategies to address the barriers.

Keywords: access to hospice; community outreach; cultural competence; diversity; hospice.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Attitude to Death
  • Communication Barriers
  • Community-Institutional Relations
  • Cultural Competency*
  • Cultural Diversity*
  • Hospice Care / organization & administration*
  • Hospices / standards*
  • Humans
  • Organizational Objectives