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The Joint Commission

Health Literacy and Patient Safety

The Health Literacy and Patient Safety Roundtable met in May and September of 2005. The Roundtable was charged with framing the issues related to low health literacy and its impact on patient safety. The Roundtable discussions culminated in the publication of a white paper, which describes interventions to improve the ability of patients to understand complex medical information, and provide recommendations for a broad range of health care stakeholders and policymakers to mitigate the risks to patients with low health literacy and/or low English proficiency. The Joint Commission and Joint Commission Resources hosted a national symposium on health literacy and patient safety in June of 2006. Information gained from the symposium contributed to the content of the white paper,  "What Did the Doctor Say?: Improving Health Literacy to Protect Patient Safety".

http://www.mmia.org/uploads/docs/improving_health_literacy.pdf

 A Snapshot of a Nation

A new report from the Joint Commission recommends strategies to address the language and cultural issues that challenge hospitals as they strive to deliver safe, effective care to diverse patient populations. For example, the report recommends that hospitals serving diverse populations establish a centralized program to coordinate services relating to language and culture; implement a uniform framework for systematic collection of data on race, ethnicity and language; and provide ongoing training to staff on how and when to access language services. The recommendations are based on a study of how 60 hospitals are providing health care to culturally and linguistically diverse patient populations. "These findings cannot be generalized to all hospitals, but they provide detailed information about many ways that culture and language issues are being addressed in hospitals," the authors say.

http://www.jointcommission.org/NR/rdonlyres/E64E5E89-5734-4D1D-BB4D-C4ACD4BF8BD3/0/hlc_paper.pdf

Hospitals, Language, and Culture Project Update - October 2007 

Hospitals, Language, and Culture Project Update for October 2007 from The Joint Commission. To download please go to: http://www.jointcommission.org/NR/rdonlyres/E46ED01D-EA80-4A7E-BB7D-DA543AD3DFEC/0/hlc_update.pdf  

The New Joint Commission Standards for Patient-Centered Communication
Hospitals Remain Unprepared As The Joint Commission Standards Go Into Effect

by Oscar Arocha, MM and Deborah Yvette Moore
http://languageline.com/main/files/wp_joint_commission_022211.pdf

Video: Improving Patient-Provider Communication:  Joint Commission Standards and Federal Laws
The Joint Commission collaborated with the US Department of Health & Human Services (HHS) to support language access in health care organizations and developed a free video, "Improving Patient-Provider Communication:  Joint Commission Standards and Federal Laws."  The video highlights what is required by Joint Commission standards as well as Federal civil rights laws with respect to patients who are deaf/hard of hearing or limited English proficient.   You can download it here: http://www.jointcommission.org/multimedia/improving-patient-provider-communication---part-1-of-4/

The Joint Commission Standards for interpreti‚Äčng in healthcare
Improving Patient-Provider Communication: Joint Commission Standards and Federal Laws regarding LEP

Video series:
Part 1
http://www.youtube.com/watch?v=5mR0Vk2zHqs

Part 2
http://www.youtube.com/watch?v=JJc6NQ4PzyM

Part 3
http://www.youtube.com/watch?v=W7Labgs2GFw

Part 4
http://www.youtube.com/watch?v=NFSwdUB88lU
 


Results of National Survey on Hospital Language Services for LEP patients:

Hospital Language Services for Patients with Limited English Proficiency:  Results from a National Study, October 2006. Funded by The California Endowment, this report was written by the Health Research and Educational Trust/AHA (HRET) in collaboration with the National Health Law Program (NHeLP). The report describes current practices, common barriers, and the specific resources and tools needed to provide language services to patients with LEP. The results of the survey will inform federal policymakers, practitioners,
providers, and others of the issues and potential solutions facing hospitals as they work to improve language services for all patients with LEP.

Providing Language Services in State and Local Health-Related Benefits Offices: Examples from the Field

Having appropriate language services available for patients with limited English proficiency (LEP) can greatly improve health care experiences. State and local benefits offices that administer Medicaid, the State Children's Health Insurance Program (SCHIP), and other benefit programs are especially important, since they are often the first point of contact for LEP clients. The new Commonwealth Fund report, Providing Language Services in State and Local Health-Related Benefits Offices: Examples from the Field, outlines an eight-step approach to helping benefits offices develop language strategies tailored to their clients' specific needs. Mara Youdelman, Jane Perkins, Jamie D. Brooks, and Deborah Reid, at the National Health Law Program, illustrate each step
with promising practices in place throughout the country. [The Commonwealth Fund, January 2007]

Joint Commission Report recommends strategies for addressing language, cultural challenges

A new report from the Joint Commission recommends strategies to address the language and cultural issues that challenge hospitals as they strive to deliver safe, effective care to diverse patient populations. For example, the report recommends that hospitals serving diverse populations establish a centralized program to coordinate services relating to language and culture; implement a uniform framework for systematic collection of data on race, ethnicity and language; and provide ongoing training to staff on how and when to access language services. The recommendations are based on a study of how 60 hospitals are providing health care to culturally and linguistically diverse patient populations. "These findings cannot be generalized to all hospitals, but they provide detailed information about many ways that culture and language issues are being addressed in hospitals," the authors say.

What did the Doctor say?

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, according to a call to action released today by The Joint Commission in its newest public policy white paper, What Did the Doctor Say?: Improving Health Literacy to Protect Patient Safety. The paper 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. Effective communication is a cornerstone of patient safety, says Dennis S. O'Leary, M.D., president, The Joint Commission. If patients lack basic understanding of their conditions and the whats and whys of the treatments prescribed, therapeutic goals can never be realized, and patients may instead be placed in harm's way . The Joint Commission report on strategies for addressing health literacy and protecting patient safety contains 35 specific recommendations that cover a wide range of important improvement opportunities including, among others: The sensitization, education and training of clinicians and health care organization leaders and staff regarding health literacy issues and patient-centered communications. The development of patient-friendly navigational aids in health care facilities. The enhanced training and use of interpreters for patients. The re-design of informed consent forms and the informed consent process

Hospitals, Language, and Culture: A Snapshot of the Nation 

Hospitals, Language, and Culture is a qualitative cross-sectional study designed to provide a snapshot of how sixty hospitals across the country are providing health care to culturally and linguistically diverse patient populations. This project sought to answer the following questions:
- What challenges do hospitals face when providing care and services to culturally and linguistically diverse populations?
- How are hospitals addressing these challenges?
- Are there promising practices that may be helpful to and can be replicated in other hospitals?

The project findings will be presented in multiple reports. This report highlights findings regarding the first two research questions. A purposive sampling approach was used to select sixty hospitals for this study. Two methods used were judgment sampling (hand-selection) and stratified sampling (demographically-driven). Study data were collected through two mechanisms a 26-question Pre-Visit Questionnaire completed by each hospital, and one-day site visits conducted at each hospital by a trained project researcher and a note-taker. Site visits were completed between September 2005 and March 2006. Each site visit consisted of a combination ofadministrative and clinical interviews that focused on six research domains:
- Leadership
- Quality Improvement and Data Use
- Workforce
- Patient Safety and Provision of Care
- Language Services
- Community Engagement
The findings provide unique insight into the challenges, activities, and perspectives of sixty hospitals across the nation and a snapshot of their current situation. These findings cannot be generalized to all hospitals, but they provide detailed information about many ways that culture and language issues are being addressed in hospitals. Hospitals in this study had generally progressed further in their efforts to address language issues than they had in their efforts to address cultural issues.



Straight Talk: Model Policies and Procedures on Language Access

Straight Talk: Model Hospital Policies and Procedures on Language Access is the result of the joint efforts of the California Health Care Safety Net Institute (SNI), which serves as the educational and research affiliate of the California Association of Public Hospitals and Health Systems (CAPH), and Melinda Paras, Principal at Paras and Associates. The adoption of hospital policies and procedures is the essential mechanism to making a significant change in the operational actions of the U.S. hospital industry, and has been used throughout the history of this industry as a mechanism to change practice and establish expectations on a challenging issue. For example, the creation and
widespread distribution of model policies on issues ranging from sexual assault to organ donation have created universal standards through which the hospital industry navigates such issues of social importance. This document is designed to offer American hospitals a set of tools to utilize in updating their own internal Policy and Procedure Manuals. (Language Access Policies and Procedures are typically found in the Administrative Manuals required in every accredited U.S. hospital.)The Safety Net Institute published, Straight Talk: Model Policies and Procedures on Language Access, drawing on best practices in California's public hospitals and beyond.
http://www.safetynetinstitute.org/publications/documents/StraightTalkFinal.pdf 

 National Services Resource Guide for Health Care Providers

by Alyssa Sampson, MLIS, Cross Cultural Health Care Program -This guide, developed with input from the coalition, gathers basic information about providing language services in one document. Information includes interpreter and translator associations and agencies, training programs, assessment tools, and other materials. This guide will aid health care providers, administrators, interpreters, translators, and others in improving language access and improving health care for their clients and patients.

Video: Improving Patient-Provider Communication:  Joint Commission Standards and Federal Laws 

The Joint Commission collaborated with the US Department of Health & Human Services (HHS) to support language access in health care organizations and developed a free video, "Improving Patient-Provider Communication:  Joint Commission Standards and Federal Laws."  The video highlights what is required by Joint Commission standards as well as Federal civil rights laws with respect to patients who are deaf/hard of hearing or limited English proficient.   You can download it here: http://www.jointcommission.org/multimedia/improving-patient-provider-communication---part-1-of-4/

 

Additional Documents

>Patient-Centered Communication Standards 2010

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