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MONTEREY, CA – Hospitals are falling short of the Joint Commission's language access requirements for patients with limited English, according to a new report.
"The New Joint Commission Standards for Patient-Centered Care," co-authored by two former language-expert hospital administrators in conjunction with Language Line Services, comes as the new communication regulations from the Joint Commission enter a year-long pilot phase.
Hospitals that don't comply with the new regulations will face damage to their reputations and untold expenses, the report says.
"Poor communication leads to poor care," said Oscar Arocha, a 25-year industry veteran and former director of the largest interpreter services department in the nation at Boston Medical Center. "The problem is that few hospitals have taken the necessary steps to comply."
According to the report, some hospitals don't see the link between language services, patient rights and patient safety, while others think they're compliant because they have bilingual staff, contract interpreters and over-the-phone or video interpreters.
In addition, Aricha said, hospitals understand the urgency to adopt the new standards but don't know how to get started or where to turn for help.
Communication breakdowns are responsible for nearly 3,000 unexpected deaths each year, according to the Joint Commission. The majority of these breakdowns involve people with limited command of English. More than 50 million people – or approximately one in six residents – speak a language other than English at home, and today's ethnic minority is projected to become the majority by 2042.
"Ineffective communication between patients and providers can result in misdiagnosis, inappropriate treatment or medication errors," said Amy Wilson-Stronks, project director in the Division of Standards and Survey Methods at The Joint Commission. "When a provider cannot communicate effectively about a disease or treatment, or when a patient cannot describe their illness, they lack the basic connection needed to result in appropriate care."
The aim of the revised Joint Commission regulations, announced in 2009, is to improve patient-provider communication and ensure patient safety, Arocha said. The standards were put in place on January 1, but won't impact accreditation during the year-long pilot phase. The regulations require proof of interpreter training and fluency competence for interpreters in spoken languages as well as American Sign Language for deaf and hard-of-hearing patients.
"The Joint Commission expects hospitals to demonstrate a greater commitment to language services and cultural competency for all its limited English-proficient and deaf patients, and it is giving hospitals one year to prepare," said Deborah Yvette Moore, who co-authored the report and has spent 32 years as manager of the Parkland Health and Hospital System. "Relying on bilingual staff, family members or untrained interpreters whose misunderstandings, omissions, biases and impatience often get in the way is a risky way to bridge the language gap."