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Hopkins Center for Health Disparities Solutions Projects

Clearview Organizational Assessments-360 (COA360)

The COA360 is an evidence-based, web-based cultural competency tool that evaluates the readiness of a healthcare organization or clinical unit to meet the needs of a rapidly diversifying U.S. population. The COA360 is designed to assess the cultural competency of healthcare organizations, rather than individuals.

Originally designed for use in hospital organizational sub-units, such as clinical departments, hospital inpatient service units, or outpatient units, the COA360 can be used to assess an entire hospital or healthcare organization. The tool, which provides a 360-degree view from the perspective of administrators, clinical/service providers, administrative/clerical staff, and patients/clients, should be used as part of a continuous quality improvement cycle:

  • Assess
  • Identify strengths/improvement opportunities
  • Develop tailored interventions and solutions
  • Implement and allow time to scale and spread
  • Re-assess

The COA360 measures diversity in terms of race, ethnicity, language, religion/spirituality, and sexual identity 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),
  • Joint Commission Standards on "Effective Communication, Cultural Competence, and Patient- and Family-Centered Care,"
  •  Patient/Client Attitudes:
    •  Patient/Client Satisfaction
    •  Discrimination/Bias
    •  Trust
  • Cultural and Linguistic Competence, and Health Literacy
  • 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 COA360 is a validated organizational cultural competency tool with a study published in a peer-reviewed journal. The COA360 received the 2008 Innovation Award from the National Institutes of Health, National Center on Minority Health and Health Disparities. The COA360 underwent substantial revision and was launched at the DiversityRx Conference on Health Care for Culturally Diverse Populations in October 2010. The hospital version was launched at the DiversityRx Conference on Health Care for Culturally Diverse Populations in March 2013.

Two versions are currently available—the COA360U designed for departments or units of a healthcare organization (such as the Emergency Department, Labor and Delivery, Ambulatory Surgery Center, etc.) and the COA360H for hospitals or healthcare organizations.

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

Sample participant background questions include:

  • Race and ethnicity based upon the Affordable Care Act, Section 4302 data collection standards (Office of Minority Health)
  • Preferred language
  • Educational level
  • Sexual identity
  • Religion/spirituality
  • Country born in

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 reported by race/ethnicity, language, religion/spirituality, and sexual identity.


For additional information on the COA360, please contact Cheri Wilson, MA, MHS, CPHQ, the COA360 Program Director, at: or 443-287-0305 or visit the COA360 website at: