You are the Director of Nursing, and you are performing an annual evaluation of the Manager of the Medical-Surgical Units at the VA hospital. You meet with the manager to discuss their annual leadership performance. Overall, the manager is performing well; however, one area of leadership that is a concern is related to the results from an analysis of the patient satisfaction surveys. The current results for the ACSI index of inpatients recently discharged from the VA acute medical center holds at a 76 on a 0-100 scale. This is four points lower than the industry average. The VA outpatient score of 79 is within one point of the industry average. As a nursing leader, the manager is held responsible for increasing the ACSI Index. You are aware that managers and healthcare professionals who understand their patient's culture, environment, food, customs, religious views, etc. can provide their patients with improved care