Hospitals, Language and Culture: A Snapshot of the Nation (HLC) is a cross-sectional qualitative study of how 60 hospitals across the country provide health care to culturally and linguistically diverse patient populations. The study is conducted by The Joint Commission with funding from The California Endowment. Specifically, the study aims to answer the following questions:
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What challenges do hospitals face when providing care and services to culturally and linguistically diverse populations?
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How are hospitals addressing these challenges?
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Are there any promising practices that may be helpful and can be replicated in other hospitals?
Published reports
Exploring Cultural and Linguistic Services in the Nation’s Hospitals: A Report of Findings, was released in March 2007. The report recommends targeted strategies to address language and cultural needs that currently pose challenges to hospitals seeking to deliver safe, effective care to the diverse American population. Key findings of the report:
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Hospitals face a variety of challenges in meeting the cultural and language needs of their patient populations.
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Efforts to address language are more concrete than those to address culture.
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There are a wide range of practices for meeting the cultural and language needs of patients. There also exists varied interpretation of “good” versus “poor” practice.
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There is a gap between current practice and desired practice, particularly related to the provision of language services. This may be attributable to missing resources or, in some cases, the resources are available but are not being used or processes are not being followed.
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Collection of patient demographic data collection is inconsistent across and within hospitals, and few hospitals use these data to improve services for diverse patients.
One Size Does Not Fit All: Meeting the Health Care Needs of Diverse Populations, was released in April 2008. This report provides a thematic framework that was derived from current practices that hospitals are employing to provide care and services to diverse patients. As the range of practices mentioned in the report illustrates, there is no “one size fits all” solution, and the road map to cultural competence is unique for each organization. However, based on data gathered from the HLC study, this report recommends that organizations:
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Identify the needs of the patient population being served and assess how well these needs are being met through current systems.
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Bring people across the organization together to explore cultural and language issue by sharing experiences, evaluating current practices, discussing barriers, and identifying gaps.
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Make assessment, monitoring, and evaluation of cultural and language needs and services a continuous process.
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This report includes a self-assessment tool that organizations can use to initiate discussions about the needs, resources, and goals for providing the highest quality care to every patient served.
These reports are available free for download at http://www.jointcommission.org/PatientSafety/HLC/.
Other HLC projects
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From the Perspective of the CEO: What Drives Hospitals to Provide Culturally and Linguistically Appropriate Care? This HLC study, in collaboration with Sunita Mutha, M.D., at the University of California, San Francisco, looks at CEO perspectives on providing health care to culturally and linguistically diverse patient populations. The study explores what drives some to embrace cultural and language services as “the right thing to do” while others see it as a “burden” on an already taxed health system.
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Juan Lopez: One Limited English Proficient Man’s Experience at 60 Hospitals. This HLC study, in collaboration with Elizabeth Jacobs, M.D., MPP, at John Stroger Cook County Hospital and Rush Medical College, examines the experience of Juan Lopez, a hypothetical limited-English proficient (LEP) patient, as he navigates the health system at 60 hospitals across the country. This project promises unique insight into how a typical LEP patient is treated at different organizations, whether his treatment varies with hospital characteristics, and the hospitals’ orientation towards the provision of culturally competent care.
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Developing Hospital Standards for Culturally Competent Patient-Centered Care. The Joint Commission, with funding from The Commonwealth Fund, is developing accreditation standards for hospitals that will promote, facilitate, and advance the provision of culturally competent patient-centered care. The development process will build upon evidence from the current literature and previous studies and will explore how diversity, culture, language and health literacy issues can be better incorporated into current Joint Commission standards or drafted into new requirements. Additionally, in collaboration with the National Health Law Program, The Joint Commission will design an implementation guide to prepare Joint Commission surveyors and accredited hospitals for the release of these new standards.
Background
The Joint Commission works to continuously improve the safety and quality of care provided to the public through the provision of health care accreditation and related services that support performance improvement in health care organizations. As quality health care and patient safety are dependent upon effective communication, The Joint Commission encourages health care organizations to address the cultural and linguistic needs of our nation’s rapidly growing and diverse population. The Joint Commission has developed recognition among those working in the area of cultural competence for its Hospitals, Language, and Culture study and its ongoing related work.
For more information
Visit http://www.jointcommission.org/PatientSafety/HLC/ or contact Amy Wilson-Stronks, principal investigator, at awilson-stronks@jointcommission.org or (630) 792-5954.
2/09
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