This is the first post in a multi-part series about the new Joint Commission standards on language access requirements for limited English proficient patients.
When the Joint Commission's new standards for hospital accreditation based on language access take full effect a year from now, many hospitals might not make the cut and could lose critical funding. That's because to qualify for public funds, Medicaid, Medicare and other government-financed programs, healthcare organizations must comply with federal and state regulations that mandate the provision of language services.
Until now, the regulations have often been loosely followed, leading the Joint Commission to implement, new, more formalized standards. A year-long pilot started in January 2011, and full implementation is scheduled for January 1, 2012. The Joint Commission is an independent, non-profit organization that surveys and accredits hospitals and other healthcare institutions across the country via unscheduled accreditation surveys.
A crucial first step in meeting the new standards and providing safe, quality patient-centered care is identifying the patient's "preferred language" for discussing his/her healthcare needs. Healthcare organizations must develop a systematic approach to consistently collect patients' language preferences in order to provide effective communication for non-English speaking patients, as well as those with limited English proficiency. Identifying the preferred language of every patient should occur at the entry point of the organization.
This requires healthcare facilities to train the intake staff on how to enter the preferred language information into patient record systems. All systems should have the preferred language question as a required field. This way, intake representatives will always be prompted to ask the question instead of by-passing this section.
Both preferred language and dialect must be recorded in the patient record database. And, if the patient is deaf or hard of hearing and does not use American Sign Language (ASL) to communicate, this too should be noted as there will be a need for two interpreters to communicate with this patient -- a Certified Deaf Interpreter (CDI) for hand gestures, lip reading, etc., and an ASL interpreter who will capture what the CDI interpreter is signing and interpret that into English.
In the healthcare industry, effective language programs are a matter of patient safety, and sometimes, life and death. Identifying communication barriers improves patient care, ensures they will not have to repeat their information at every service point in the care continuum, improves accuracy, reduces safety issues and increases continuity of care. All of which also is good for reducing medical costs for us all.
More than 50 million people in the United States speak a language other than English at home, according to the most recent U.S. Census Bureau survey. The Joint Commission has decided that it's time for healthcare institutions throughout the country to get serious about listening to patients in their native language. Identifying which language to listen in is just the first of many steps.
Oscar Arocha is a 25-year industry veteran, former director of the largest interpreter services department in the nation at Boston Medical Center and currently Senior Executive, Global Strategic Initiatives at Language Line Services. Deborah Yvette Moore served 32 years as manager of the Parkland Health and Hospital System and is a lifelong advocate of patients' rights. Download their report, "The New Joint Commission Standards for Patient-Centered Communication."