COA360

The COA360 is a suite of validated, web-based cultural competency assessment tools that evaluate the readiness of organizations, rather than individuals, to meet the needs of a rapidly diversifying U.S. population. The COA360 received the 2008 Innovation Award from the National Institutes of Health, National Center on Minority Health and Health Disparities. The COA360u underwent substantial revision and was launched at the DiversityRx Conference on Health Care for Culturally Diverse Populations in October 2010. The hospital version (COA360h) was launched at the DiversityRx Conference on Health Care for Culturally Diverse Populations in March 2013. The Hopkins Center for Health Disparities Solutions worked closely with the Substance Abuse and Mental Health Services Administration, Office of Behavioral Health, Cultural Competence and Eliminating Disparities Workgroup to modify the hospital tool specifically for behavioral health and social services settings (COA360b).

Although originally designed for use in hospital sub-units, such as clinical departments (Emergency Department), hospital inpatient service units (Labor and Delivery), or outpatient units (Radiation Oncology), the COA360 can be used to assess health, healthcare, behavioral health, and human and social services organizations.

The tools provide a 360-degree view of the organizations from the perspective of administrators, clinical/service providers, administrative/clerical or non-clinical staff, and patients/clients. The tools, which assess cultural competency, health literacy, and patient/client experience/satisfaction, enable organizations to identify strengths and improvement opportunities, a vital component of the COA360 continuous quality improvement (CQI) cycle.

The cycle consists of:

  • conducting an organizational assessment to establish a baseline of performance;
  • identifying strengths and improvement opportunities;
  • determining tailored interventions/solutions to address the improvement opportunities;
  • allowing for spread and scale; and
  • conducting a re-assessment to determine whether the interventions/solutions resulted in positive change.
The COA360 measures diversity in terms of age, race, ethnicity, language, religion/spirituality, gender identity, sexual orientation, disability, and military status and is based upon the following standards:

  • U.S. Department of Health and Human Services, Office of Minority Health, Enhanced Culturally and Linguistically Appropriate Services (CLAS) Standards (2013)
    • Cultural and Linguistic Competence, and Health Literacy
  • Joint Commission Standards on "Effective Communication, Cultural Competence, and Patient- and Family-Centered Care"
  • Patient/Client Experience (adapted from the Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) patient experience survey, and
  • The Human Rights Campaign (HRC) Foundation Healthcare Equality Index (HEI) Core Four.
The suite of tools includes:

  • COA360b – Created in partnership with the Substance Abuse and Mental Health Services Administration (SAMHSA), Office of Behavioral Health Equity, Cultural Competence and Eliminating Disparities Workgroup for behavioral health organizations
     
  • COA360h – For an entire health or healthcare organization, such as a freestanding community health clinic, hospital, etc.
     
  • COA360o – For human and social services organizations, such as health departments, local, state, and national agencies or departments
     
  • COA360u - For sub-units of a health and healthcare organization, such as an emergency department, inpatient unit, or hospital clinic, etc.

Paper surveys are available for patients/clients to facilitate survey administration. The COA360 underwent a health literacy and plain language review. Patient /client surveys are available in Spanish language.

Participant background questions include:

  • Age
  • Race and ethnicity questions based on the Affordable Care Act, Section 4302 data collection standards
  • Military status
  • Preferred language
  • Educational level
  • Gender identity
  • Sexual orientation
  • Religion/spirituality
  • Disability status
  • Country of birth

After the assessment is completed, an auto-generated PDF report is available immediately. The report provides a score for each CLAS standard as well as the other standards included. Results are then stratified by the participant background questions above.

Note: In all assessments, the term “patient,” can be customized and replaced by whatever term applies to the organization’s service area, e.g. client, customer, consumer, participant, family, etc.
 

Validation Article, "The COA360: A Tool for Assessing the Cultural Competency of Healthcare Organizations"

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Frequently Asked Questions (FAQs)

What is the COA360?
The COA360 is a web-based tool that is an assessment of healthcare organizations, not individuals. By conducting an assessment, a healthcare organization establishes a baseline of performance, which identifies strengths and areas for improvement. The tool is suitable for
any size healthcare organization. The COA360 assesses the unique configuration of diversity in the service area (race/ethnicity/nationality, language, religion/spirituality, and sexual identity).

Is the COA360 a validated assessment tool?
A validation study was published in the Journal of Healthcare Management (italicized the journal title) in July/August 2008.

Has the COA360 received any awards?
The COA360 was awarded the 2008 Innovation Award by the National Institute of Health, National Center on Minority Health and Health Disparities.

On what standards is the COA360 based?
The COA360 is based on the:

  • US Department of Health and Human Services, Office of Minority Health, Culturally and Linguistically Appropriate Services (CLAS) Standards
  • Joint Commission Standards on “Effective Communication, Cultural Competence, and Patient- and Family-Centered Care.”
  • HCAHPS patient experience
  • Human Rights Campaign Foundation Healthcare Equality Index Core Four

What do you mean by a 360-degree perspective?
Unlike other assessments, the COA360 is not just from the perspective of a single administrator. Instead, the COA360 is based on the perspectives of administrators, clinical staff (direct patient care), non-clinical (support staff), and patients.

What is the difference between the two tools—COA360U and COA360H?
The COA360U is for departments or units of a healthcare organization.

The COA360H is for hospitals or healthcare organizations.

What is the COA360/CQC Continuous Quality Improvement Cycle?

The COA360/CQC Continuous Quality Improvement Cycle consists of:

  • Conducting a COA360 assessment to establish a baseline of performance
  • Identifying strengths and improvement opportunities
  • Once the improvement opportunities have been identified, tailoring interventions/solutions to address them
  • Implement the interventions/solutions giving them time to scale and spread
  • Conduct a re-assessment to gauge the success of the interventions/solutions.

What types of surveys are included in the COA360?
There are 5 surveys—Point of Contact, Administrator, Clinical Staff, Non-Clinical Staff, and Patient.

Does the COA360 need to be completed in one sitting?
Once assigned a username and password, participants can log into the system as many times as necessary to complete the survey before the end of the assessment period.

How long does it take to complete the COA360U and the COA360H?
The COA360U takes about 10-15 minutes to complete and the COA360H takes about 15-25 minutes to complete.

How long are the surveys open and available to complete?
The assessing organization decides how long the surveys remain open. However, the typical assessment period lasts from 2-6 weeks.

How long does it take to receive the assessment results?
Once the assessment period has ended, a .pdf report is generated and available for download.

What is included in the COA360 report?
The COA360 report consists of 3 sections:

  • Organizational Diversity and Representativeness Summary based on the responses to the Point of Contact survey
  • Respondent and Patient Background Summary based upon the responses from the Staff and Patient surveys
  • Performance Domain Summary which provides the scores on each of the domains and reported out by each of the survey groups—employee average, administrators, clinical staff, non-clinical staff, and patients.
  • For benchmarking purposes, the report provides feedback on how the unit or healthcare organization compares to peers. In addition, the report provides suggestions on how to improve performance in each domain.
  • Certain domains, specifically the language access domains, patient satisfaction, discrimination/bias, patient trust, Healthcare Equality Index Core Four, and HCAHPS are stratified by race/ethnicity, language, religion/spirituality, and sexual identity.

What should I do after I receive my COA360 results?
Share the results with senior leadership, the staff who completed the survey, and the surrounding community. Create an action plan to address the improvement opportunities.

Considering working with one of the COA360 Certified Consultants.

Clear Vision in Dynamic Times

Healthcare leaders need an objective resource for informed counsel on performance improvement and regulatory compliance. Now more than ever, rely on Clearview360’s experienced consulting team to assist you. Our team of consultants understand today’s most compelling quality and cultural competency issues and can provide practical, targeted solutions to your challenges. Our consulting team has perfected methodologies to uncover problems and suggest achievable solutions quickly and effectively.

Contact one of our COA360 consultants to see how you can transform your organization.

COA360 Consultants


LaVonna Blair Lewis, PhD, MPH

Teaching Professor
USC Sol Price School of Public Policy
650 Childs Way RGL 309
Los Angeles, CA 90089-0626
(213) 740-4280 Office
(213) 740-6555 Fax
(323) 791-6150 Cell
Email: llewis@usc.edu


Yolanda Robles
CulturaLink, Inc.
(888) 844-1414 x14 Office
(404) 693-1200 Cell
Email: yrobles@theculturalink.com
http://www.theculturalink.com/


Gabrielle Wanamaker, MA, PhD Candidate

Principal Change Agent
TrustWorks
5501 Wayne Avenue, Suite 306
Philadelphia, PA 19144-3327
(215) 843-8635 Office
(215) 344-3205 Fax
Email: gabrielle@trustworksconsulting.com


Amy Wilson-Stronks, MPP, CPHQ
Advocate, Consultant, Researcher
AWS Wilson-Stronks
(312)­ 671-­1439 Office
Email: amy@wilson-­stronks.com
http://www.wilson-­stronks.com


PCMH Consultant

Audrey Whetsell, MA, CPHIT
CEO, Resource Partners, LLC
Medical Home Development Group, LLC
(843) 554-2533 Office
(843) 412-5548 Cell
(866) 643-9237 Fax
Email: Awhetsell@consultrp.net
Email: Awhetsell@medicalhomegroup.net
http://medicalhomegroup.net/

 

Clear Vision in Dynamic Times

Healthcare leaders need an objective resource for informed counsel on performance improvement and regulatory compliance. Now more than ever, rely on Clearview360’s experienced consulting team to assist you. Our team of consultants understand today’s most compelling quality and cultural competency issues and can provide practical, targeted solutions to your challenges. Our consulting team has perfected methodologies to uncover problems and suggest achievable solutions quickly and effectively.

Contact one of our COA360 consultants to see how you can transform your organization.

COA360 Consultants


LaVonna Blair Lewis, PhD, MPH

Teaching Professor
USC Sol Price School of Public Policy
650 Childs Way RGL 309
Los Angeles, CA 90089-0626
(213) 740-4280 Office
(213) 740-6555 Fax
(323) 791-6150 Cell
Email: llewis@usc.edu


Yolanda Robles
CulturaLink, Inc.
(888) 844-1414 x14 Office
(404) 693-1200 Cell
Email: yrobles@theculturalink.com
http://www.theculturalink.com/


Gabrielle Wanamaker, MA, PhD Candidate

Principal Change Agent
TrustWorks
5501 Wayne Avenue, Suite 306
Philadelphia, PA 19144-3327
(215) 843-8635 Office
(215) 344-3205 Fax
Email: gabrielle@trustworksconsulting.com


Amy Wilson-Stronks, MPP, CPHQ
Advocate, Consultant, Researcher
AWS Wilson-Stronks
(312)­ 671-­1439 Office
Email: amy@wilson-­stronks.com
http://www.wilson-­stronks.com


PCMH Consultant

Audrey Whetsell, MA, CPHIT
CEO, Resource Partners, LLC
Medical Home Development Group, LLC
(843) 554-2533 Office
(843) 412-5548 Cell
(866) 643-9237 Fax
Email: Awhetsell@consultrp.net
Email: Awhetsell@medicalhomegroup.net
http://medicalhomegroup.net/