What is known about this topic• A number of conceptual models have been developed to describe cultural competence elements.• There is no consensus regarding the components of cultural competence.• Scholars believe that cultural competence can improve patient outcomes. What this paper adds• Three major elements of cultural competence -cultural awareness, AbstractIt has been widely suggested that cultural competence is an individual's core requirement for working effectively with culturally diverse people. However, there is no consensus regarding the definition or the components of this concept and there is a dearth of empirical proof indicating the benefits of cultural competence. Therefore, a systematic review was conducted to identify the most common cultural competence dimensions proposed in recent publications and to identify whether sufficient evidence exists regarding the efficacy of cultural competence in the healthcare context. A total of 1204 citations were identified through an electronic search of databases, of which 18 publications included cultural competence frameworks, and 13 studies contained empirical data on cultural competence outcomes. The overarching themes of the review were centred around the challenges faced by the healthcare sector in many countries due to growing cultural diversity, but lack of cultural competence, leading to predicaments that arise during intercultural interactions between patients and clinicians. This review will benefit researchers exploring cultural competence as one of the research variables impacting research outcomes.Keywords: cultural competence, healthcare quality, patient outcome, systematic review cultural knowledge and cultural skills -have been replicated across cultural competence models. This review also highlights additional dimensions of cultural competence that have been found in some conceptual models.• The review finds that many of the proposed conceptual models have not been empirically tested.• The review finds that there is a scarcity of patient-rating tools for measuring cultural competence.

PurposeThis paper reviews the literature on internationalization barriers of small and medium enterprises (SMEs) from developing countries. The purposes of the study are: (1) to explicitly point out specific factors influencing the growth and internationalization of SMEs from developing countries and (2) to identify the research gaps to provide lucid and succinct directions for future research in this area.Design/methodology/approachThe authors selected relevant papers from journals listed on Web of Science and Scopus databases.FindingsIt was found that there are large number of questions remain unanswered regarding the internationalization of SMEs from developing countries regarding the factors determining their growth and internationalization.Originality/valueThis review distinctively accentuates previous studies on such barriers influencing the growth of SMEs from developing countries and systematically synthesize the issues faced by those SMEs. Thus, the authors seek to provide a comprehensible platform for researchers working in this area.

Purpose -The purpose of this paper is to focus on one strategy known as "The Balanced Scorecard", discussing the growing importance of balanced scorecard performance systems, exploring issues that organizations face in building and implementing scorecard systems, and sharing lessons learned from Australian organizations that have taken the balanced scorecard journey. Design/methodology/approach -The approach taken is the case study methodology to depict the real world examples of organisations that have confidence in the "Balanced scorecard performance system" so that other organisations can follow suit. Findings -The paper concludes that the balanced scorecard approach may require some substantial changes in culture within the organization.. The balanced scorecard requires understanding, commitment and support from the very top of the business down. The balanced scorecard will evolve. As culture changes and develops to accept the new approach and members of the organisation mature within the new culture, the organisation will find new things to measure, new goals in different areas, to make the balanced scorecard even more balanced and effective in supporting a living, growing, viable organisation. Different organisations have quite different needs, market areas, people, products and services, and will end up with significantly different balanced scorecards. Research limitations/implications -The outcomes were based on two multinational corporations and may differ with small and medium enterprises. Practical implications -The balanced scorecard is balanced in another dimension -not just a balance of measures of essential areas of the business, but also a balance of goals versus accountability. If people do not accept accountability for achievement of the balanced measures and goals of the balanced scorecard, there is no balanced scorecard. The people of the organisation are the key to the success of the balanced scorecard system. Originality/value -The paper specifically looks at the implementation of the "Balanced Score Card Performance Management System" in Australian corporations.

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