OAKBROOK TERRACE, Ill. – A new Joint Commission report recommends targeted strategies to address language and cultural issues that increasingly pose challenges to hospitals seeking to deliver safe, effective care to diverse American population.
The recommendations in Joint Commission Web site.
Last month, the Joint Commission released a public policy white paper, “‘What Did the Doctor Say?:’ Improving Health Literacy to Protect Patient Safety,” which frames the existing communications gap between patients and caregivers as a series of challenges involving literacy, language, and culture, and suggests multiple steps that need to be taken to narrow or even close this gap. Far too often, ordinary citizens are placed at risk for unsafe care because important health care information is communicated using medical jargon and unclear language that exceed their literacy skills. A complete copy of this paper is also available at no charge on the Joint Commission website.
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A Joint Commission press release.
![Joint Commission Web site](_blank><i>Hospitals, Language, and Culture: A Snapshot of the Nation</i></a>, result from a study of how 60 hospitals across the country are providing health care to culturally and linguistically diverse patient populations. The project examined the challenges of providing care and services to populations that may not speak the same language or share the same customs; how hospitals are addressing these challenges; and promising practices that can be used by hospitals across the country. </p>
<p>As America becomes more diverse, so do the patient populations served by hospitals. Few studies have systematically explored the provision of culturally and linguistically appropriate health care in a large number of hospitals. With funding from The California Endowment, the <i>Hospitals, Language, and Culture: A Snapshot of the Nation</i> project is closing this gap. </p>
<p>“Linguistically and culturally appropriate care has a direct impact on quality and safety, and is a growing issue that is not going to go away,” says Paul M. Schyve, M.D., senior vice president, The Joint Commission. </p><div class="second_para_all"><div style="font-weight: 400; text-transform: uppercase; color: #888; font-size: 12px; margin-bottom: 0; text-align: center;">——Article Continues Below——</div>
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<p>The study shows inconsistent practices-both in the aggregate and in individual hospitals. In some cases, needed resources or processes are missing; while in other cases, resources and processes are in place, but are not being used. As the report shows, providing care that meets the cultural and linguistic needs of patients is a shared responsibility. The Joint Commission will educate its surveyors to better assess compliance with accreditation standards related to linguistically and culturally appropriate care. For other stakeholders-health care organizations, public policymakers and patient advocates-the recommendations include:</p>
<ul>
<li><b>Leadership</b> – Hospitals serving linguistically and culturally diverse patient populations should consider establishing a centralized program to coordinate services relating to language and culture as a part of the organization’s commitment to quality. Other recommendations for hospital leadership include a visible commitment to culturally and linguistically appropriate care and fostering internal discussions among all disciplines about this issue. Additional research is encouraged to understand what motivates hospital leaders to embrace culturally and linguistically appropriate care.
<li><b>Quality Improvement and Data Use</b> – Hospitals should implement a uniform framework for systematic collection of data on race, ethnicity and language, and should stratify by language, race, and ethnicity, service and technical quality measures such as those reported through the Hospital Quality Alliance. Regulatory and accrediting bodies are urged to require the collection of data on race, ethnicity and primary language, and to require organizations to use these data as part of ongoing quality improvement efforts. Other recommendations are to integrate data on race, ethnicity and primary language into hospital information systems, and for researchers to form partnerships with hospitals to use measurement data to identify and address disparities.
<li><b>Workforce</b> – Hospitals should work with their staff to find ways to meet the needs of diverse populations, and should provide ongoing training to staff on how and when to access language services. Accrediting bodies should require continuing education and training that supports the provision of culturally and linguistically appropriate care. The report also advocates more research to measure and understand the benefits of increased racial, ethnic and linguistic concordance of hospital workforces and their patient populations, and to develop measures that address the impact of cultural competency training programs for hospital staff on patient care.
<li><b>Patient Safety and Provision of Care</b> – Hospitals should formalize their processes for translating patient education materials, such as patient rights and informed consent documents, into languages other than English and should use health care interpreters and cultural brokers to facilitate communication and education. Other recommendations include sensitizing caregivers and staff about the tendency to make unwarranted assumptions about patients (stereotyping); greater discussion of issues related to culture and language that can impact patient safety; expansion of a Joint Commission National Patient Safety Goal to specifically address diverse populations, particularly those with language and communication barriers; and use of adverse event data to examine language, race and ethnicity in patient safety.
<li><b>Language Services</b> – Hospitals should establish written policies regarding language services, including a prohibition on the use of family members and children as interpreters except in the case of an emergency. The report also suggests that hospitals should require training and proficiency testing for all interpreters and incorporate language service programs into safety and quality efforts. Policymakers are asked to consider a national certification program for health care interpreters in health care.
<li><b>Community Engagement</b> – Hospitals should work with community members from diverse cultures and language groups through formal boards and in hospital planning processes, as well as consider partnerships with local ethnic media to promote better understanding of available hospital services and appropriate routes for accessing care.
</ul>
<p>Copies of <i>Hospitals, Language, and Culture: A Snapshot of the Nation, A Report of Findings</i>, is available at no cost at the <a href=http://www.jointcommission.org target=){kind=link}