In the changing demographics the significance of cultural competence and diversity in health care settings the growing need for cultural transformation. So that as a cultural transformation leader in the opportunity to influence the lives of millions of people through building relationships, ensuring effective education and reporting, and through promoting a culture of learning. For sustained change to occur, it has to come from the inside out and from the top down (Stockamp, 2004). In understanding how health-care changing demographic impact the workforce, as transformation in population size, age, race and ethnicity affect the health-care resources needed, the cost of care provided, and the conditions associated with each population group
