Hca_230_Wk_2

Effective communication with patients is critical to the safety and quality of care. Barriers to this communication include differences in language, cultural differences, and low health literacy. Evidence-based practices that reduce these barriers must be integrated into, rather than just added to, health care work processes. When patients with limited English proficiency are treated by physicians and other health professionals who are proficient only in English, 3 factors converge to create a “triple threat” to effective communication. First, the language differences themselves are a barrier to effective communication. Unfortunately, this language barrier is often not immediately evident. Instances in which patients identified themselves as “reasonably” proficient in English, but were not, have been reported, and a Joint Commission study found physicians and hospital staff who believed themselves to be sufficiently proficient in another language, but were not. Both the patient and the clinician can underestimate the language barrier between them. As a physician’s or other clinician’s office, clinic, hospital, or other health care delivery setting focuses its attention on improving the safety and quality of patient care, these observations generate a set of principles: * Providing safe and high-quality patient care is dependent upon effective communication between health care professionals, patients, and patients’ families. * Effective communication requires the recognition and amelioration of 3 key barriers: language differences, cultural differences, and low health literacy. * There is a growing body of evidence-based practices that address these 3 barriers (and of evidence that certain practices are ineffective or unsafe). * For the implementation of these practices to be effective, reliable, and sustainable, the practices should be incorporated into the redesign of the relevant work processes in the health care delivery site (e.g., physician’s practice, hospital), not just bolted onto the current system. * Changes in the site’s systems and processes are likely to produce unintended consequences; a prospective identification of these potential consequences should be undertaken before implementation, and vigilance for these consequences should follow implementation. These principles will guide its approach to removing communication barriers related to language, cultural differences, and low health literacy, as well as communication barriers arising from physical factors such as hearing, speech, and vision. If the goal of providing safe, high-quality care is to be achieved, the obligation of health care professionals and organizations to address linguistic, cultural and health literacy barriers to patient communication is immediate. Learning to respect each other’s cultural values is an ongoing process in building successful cross-cultural communication and relationships professionally and personally. Refrences Barrier, P. A., Li, J. T. C., & Jensen, N. M. (2003). Two words to improve physician-patient communication: what else' Mayo Clinic Proceedings, 78, 211–214. Cooper, L. A. (2004). Health disparities. Toward a better understanding of primary care patient–physician relationships. Journal of General Internal Medicine, 19, 985–986.