April is National Minority Health Month, a federal initiative to confront healthcare disparities that exist as a result of race, ethnicity, socioeconomic factors, disability status and more. Of course, not all minorities are limited English proficient (LEP). But when language barriers do exist in minority populations, language access can play a significant role in supporting better outcomes.
One of the most effective ways to improve LEP minority health outcomes is to increase health literacy, or the degree to which patients understand health information and make appropriate decisions. People with poor health literacy are up to three times more likely to have adverse medical outcomes, according to the National Institute on Minority Health Disparities.
The National Standards for Culturally and Linguistically Appropriate Services (CLAS) offer guidelines for improving health literacy and minority health outcomes by improving communication, among other strategies. Here are five important recommendations healthcare leaders should consider following:
Assess Language Needs
Before they can begin to address language and cultural barriers, healthcare organizations must first understand the community around them. Conducting a community survey can be a helpful way to gauge the community and determine priorities.
A survey can also help to assess your staff’s experience and level of knowledge in working with diverse populations.
Train Staff to Provide Culturally and Linguistically Appropriate Care
A diverse and well-trained workforce sets the foundation for providing quality care to all. Staff should be educated in the various customs and cultural norms of the patients they serve and how these factors may impact their care. For instance, patients who are accustomed to using traditional remedies such as herbs, acupuncture, or healing rituals may be more reluctant to use certain forms of Western medicine.
However, it is important to treat patients as individuals above all else, recognizing that their culture or country of origin is just one of many factors that may influence them.
Training staff to use patient-centered interviewing strategies, such as the LEARN Model, can help them avoid stereotyping.
The LEARN Model
- Listen with sympathy and understanding to the patient’s perception of the problem.
- Explain your perceptions of the problem.
- Acknowledge and discuss the differences and similarities.
(Source: Berlin & Fowkes, 1983)
Use Professional Interpreters
Hospitals often rely on family members or friends to interpret for patients. This puts the patient at an increased risk for misdiagnosis or medical errors. A 2015 study in the journal Medical Care assessed the accuracy of medical interpretation during 32 primary care visits. It found errors were twice as likely to occur when physicians used untrained interpreters compared to professional interpreters. Nearly 7 percent of those errors could have had significant medical consequences, such as giving an incorrect drug dosage or inaccurately describing the patient’s symptoms.
Using professionals interpreters reduces the risk to patients and enhances their health literacy, which in turn empowers patients to be proactive and experience better outcomes.
Provide Health Information in Multiple Languages
The law already requires hospitals to translate vital medical documents such as informed consent, intake forms with clinical consequences, discharge instructions, and complaint forms. Hospitals also must translate notices of free language services and eligibility criteria for those services.
The CLAS standards also offer guidance in this area, recommending hospitals provide print and multimedia materials and signage in the languages most commonly used in the community.
Strive For Continuous Improvement
Providing language access is an ongoing commitment, not a “fix it and forget it” solution. Hospital leaders should establish goals and policies for removing language barriers and hold their organizations accountable for meeting them. They should also regularly assess their needs and be prepared to add new language services when necessary.
CLAS standards outline a number of recommendations for ensuring continuous improvement, including:
- Collecting “accurate and reliable demographic data to monitor the impact of CLAS on health equity and outcomes and to inform service delivery”
- Partnering with the community to develop services that are culturally and linguistically appropriate
- Creating a process for complaints to be filed and addressed
- Communicating the organization’s progress to key stakeholders and the general public
For hospitals and healthcare organizations, ensuring language access is the law. It’s also the right thing to do. Breaking down language barriers and improving communication between providers and patients is one of the first and most critical steps to improving outcomes. It’s not an easy task, but working with a provider who offers comprehensive language services makes it more manageable.
Need help selecting the right one? Download this helpful guide to selecting a language services provider.