Cultural Competency Training and Performance Measures to Reduce Racial Disparities in Health Care Quality
Authors: Leonard Pogach
Journal: Annals of Internal Medicine (2010)

Letters18 May 2010Cultural Competency Training and Performance Measures to Reduce Racial Disparities in Health Care QualityLeonard Pogach, MDLeonard Pogach, MDFrom Veterans Affairs New Jersey Health Care System, East Orange, NJ 07018.Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-152-10-201005180-00015 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail TO THE EDITOR:Sequist and colleagues (1) reported that a bundled provider intervention, consisting of cultural competency training and monthly reports of differences in achieving “clinical control targets” for black and white patients, did not reduce disparities after 12 months. Before conclusions are drawn from this study, the validity of the intervention should be reevaluated.There is considerable disagreement over the strength of evidence supporting the clinical control targets chosen. The ACCORD (Action to Control Cardiovascular Risk in Diabetes) trial (2), which was ongoing during this study, permitted hemoglobin A1c levels of 7.0% to 7.9% and systolic blood pressure of ...References1. Sequist TD, Fitzmaurice GM, Marshall R, Shaykevich S, Marston A, Safran DG, et al. Cultural competency training and performance reports to improve diabetes care for black patients: a cluster randomized, controlled trial. Ann Intern Med. 2010;152:40-6. [PMID: 20048271] LinkGoogle Scholar2. Buse JB, Bigger JT, Byington RP, Cooper LS, Cushman WC, Friedewald WT, et al; ACCORD Study Group. Action to Control Cardiovascular Risk in Diabetes (ACCORD) trial: design and methods. Am J Cardiol. 2007;99:21i-33i. [PMID: 17599422] CrossrefMedlineGoogle Scholar3. Aron D, Pogach L. Transparency standards for diabetes performance measures. JAMA. 2009;301:210-2. [PMID: 19141769] CrossrefMedlineGoogle Scholar4. Snow V, Aronson MD, Hornbake ER, Mottur-Pilson C, Weiss KB; Clinical Efficacy Assessment Subcommittee of the American College of Physicians. Lipid control in the management of type 2 diabetes mellitus: a clinical practice guideline from the American College of Physicians. Ann Intern Med. 2004;140:644-9. [PMID: 15096336] LinkGoogle Scholar5. Hofer TP, Hayward RA, Greenfield S, Wagner EH, Kaplan SH, Manning WG. The unreliability of individual physician “report cards” for assessing the costs and quality of care of a chronic disease. JAMA. 1999;281:2098-105. [PMID: 10367820] CrossrefMedlineGoogle Scholar Author, Article, and Disclosure InformationAffiliations: From Veterans Affairs New Jersey Health Care System, East Orange, NJ 07018.Note: Dr. Pogach has served on the operations committee of the National Diabetes Quality Improvement Alliance and as Chair of the Diabetes Subcommittee of the National Quality Forum.Disclaimer: The views expressed are solely those of the author and do not necessarily represent the opinion of the Department of Veterans Affairs.Disclosures: None disclosed. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetailsSee AlsoLipid Control in the Management of Type 2 Diabetes Mellitus: A Clinical Practice Guideline from the American College of Physicians Vincenza Snow , Mark D. Aronson , E. Rodney Hornbake , Christel Mottur-Pilson , Kevin B. Weiss , and Cultural Competency Training and Performance Reports to Improve Diabetes Care for Black Patients Thomas D. Sequist , Garrett M. Fitzmaurice , Richard Marshall , Shimon Shaykevich , Amy Marston , Dana Gelb Safran , and John Z. Ayanian Cultural Competency Training and Performance Measures to Reduce Racial Disparities in Health Care Quality Thomas D. Sequist , Dana Gelb Safran , and John Z. Ayanian Cultural Competency Training and Performance Measures to Reduce Racial Disparities in Health Care Quality Erik A. Wallace and F. Daniel Duffy Metrics 18 May 2010Volume 152, Issue 10Page: 685-686KeywordsBlood pressureHealth care qualityHealth care quality assessmentHealth disparitiesHemoglobinPerformance measuresQuality improvementStatinsSystolic pressureType 2 diabetes ePublished: 18 May 2010 Issue Published: 18 May 2010 Copyright & PermissionsCopyright © 2010 by American College of Physicians. All Rights Reserved.PDF downloadLoading ...