As most healthcare organizations are aware, the Joint Commission is an independent, not-for-profit organization that accredits and certifies healthcare organizations and programs in the United States. Accreditation and certification by the Joint Commission is recognized nationwide as a symbol of quality that reflects an organization’s commitment to meeting performance standards. Their mission is to continuously improve healthcare for the public, in collaboration with other stakeholders, by evaluating healthcare organizations and inspiring them to excel in providing safe and effective care of the highest quality and value.
Addressing the unique needs of each patient can be a challenge. In addition to medical concerns, patients also have non-clinical needs that can impact their healthcare encounter. There is growing research demonstrating that a variety of patient populations experience less safe, lower quality care or poorer health outcomes associated with language, culture, race, ethnicity or disability. In particular, language or cultural differences can create disparities in care due to impaired communication with caregivers or limited access to care.
Studies Demonstrating Disparities in Care for Limited English Proficient Patients
A study by the Health Research and Educational Trust, Do Professional Interpreters Improve Clinical Care for Patients with Limited English Proficiency (LEP), examines whether or not professional medical interpreters have a positive impact on clinical care for LEP patients. According to the research, “in all four areas examined, the use of professional interpreters is associated with improved clinical care more than the use of ad hoc interpreters, and professional interpreters appear to raise the quality of clinical care for LEP patients to approach or equal that for patients without language barriers.” The findings report that the benefits of using professional interpreters for communication includes utilization, clinical outcomes and satisfaction with care.
Another study published by The Joint Commission, Language proficiency and adverse events in U.S. hospitals: a pilot study, examined the differences in the characteristics of adverse events between English speaking patients and LEP patients in U.S. hospitals. According to the study results, nearly 50% of LEP patient adverse events involved some physical harm whereas only 29.5% of adverse events for patients who speak English resulted in physical harm. “Of those adverse events resulting in physical harm, 46.8% of the LEP patient adverse events had a level of harm ranging from moderate temporary harm to death, compared with 24.4% of English speaking patient adverse events. The adverse events that occurred to LEP patients were also more likely to be the result of communication errors (52.4%) than adverse events for English speaking patients (35.9%).” The study concluded that language barriers do, in fact, increase the risk to patient safety, recommending patients with language barriers have immediate access to competent language services. The study also recommends that providers collect reliable language data at the point-of-care, and documenting those services provided during a patient-provider encounter.
It’s not uncommon for healthcare providers to use an untrained bilingual employee or a family member of the patient who speaks the patient’s language for interpreting. However, in addition to an increased liability for the healthcare organization and potential HIPAA violations, this can also create a challenge in accurately communicating important information to patients. As providers, it is essential that patients clearly understand such things as their condition, treatment plan, medication needs and discharge instructions. The Joint Commission has established guidelines to improve the overall safety and quality of care provided within healthcare organizations nationwide.
The Joint Commission Standards for Communication
The Joint Commission recently released a set of revised standards for patient-centered communication to advance the issues of effective communication, cultural competence, and patient-and family-centered care. These standards were designed to improve patient safety and quality of care, and to inspire hospitals to adopt practices promoting better communication and patient engagement.
The Joint Commission requires medical language interpreters and translators to be “qualified,” meaning they have passed language proficiency assessments, education, training and have relevant experience. The standards also stress the importance of two-way communication between patients and providers and identifying and addressing a patient’s preferred oral and written communication needs prior to discussing care. In addition, clinicians should be collecting patient-level data and preferred language, race and ethnicity information. According to the standards, healthcare systems have the option to determine the best language service modality to meet the needs of each patient such as video remote interpreters (VRI), on-site interpreters or over-the-phone interpreters.
How InDemand Can Help
At InDemand, we have a vision to ensure every patient receives the highest quality healthcare, regardless of language, cultural background or disability, and we partner with healthcare organizations nationwide to bridge the communication gap between LEP, Deaf and hard of hearing patients and their clinicians. We immediately connect clinicians to medically qualified interpreters in more than 200 languages, including American Sign Language (ASL), and Certified Deaf Interpreters (CDIs).