Hospitals, Language, and Culture:  A Snapshot of the Nation, Compiled List of Resources

The resources listed below represent a compilation of websites, reports, guidelines, training tools and other information that addresses issues of culture, language, and diversity.  These are resources that the Hospitals, Language, and Culture staff have become aware of, but it is not an exhaustive list.  We hope you find it useful as your organization works to improve its efforts to provide safe, quality health care to all patients.

Tooklkits

• Addressing Language Access Issues in Your Practice:  A Toolkit for Physicians and Their Staff Members, California Academy of Family Physicians and CAFP Foundation, funded by The California Endowment, 2005.  This report presents a systems approach to redesigning medical office practices to provide the highest quality care possible to patients who speak limited English. 
  
• HRET Disparities Toolkit, A Toolkit for Collecting Race, Ethnicity, and Primary Language Information from Patients, The Health Research and Educational Trust, February 2005.  This toolkit is designed to assist in the collection of race, ethnicity, and primary language information in health care organizations in a manner that is both effective for the organization and respectful of the patient.
  
• Language Services Action Kit – Interpreter Services in Health Care Settings for People with Limited English Proficiency, National Health Law Program and The Access Project, February 2004.  This toolkit is designed to support advocates and others working to ensure that people with limited English proficiency in their state receive appropriate language assistance services in health care settings.
  
• Making Public Programs Work for Communities of Color:  An Action Kit for Community Leaders, Minority Health Initiatives Department, Families USA, January 2006.  The purpose of this Action Kit is to provide community leaders with the information, tools, and resources necessary to engage in health advocacy and improve the health and well-being of their communities.
  
• Patient-Centered Communication for Vulnerable Populations, the Ethical Force Program, an AMA-sponsored program.  Through this initiative, the Ethical Force Program is preparing to develop a set of measures for health care organizations that will address patient-centered communication for vulnerable populations, with a special focus on evaluating the use of these measures to help reduce health disparities.

Guidelines/Standards

• A National Code of Ethics for Interpreters in Health Care, the National Council on Interpreting in Health Care (NCIHC), July 2004.  
  
  
• Crosswalk, the Office of Minority Health (OMH) National Culturally and Linguistically Appropriate Services (CLAS) Standards crosswalked to the Joint Commission 2006 Standards for Hospitals, Ambulatory, Behavioral Health, Long Term Care, and Home Care.
  
  
• Guidance to Federal Financial Assistance Recipients Regarding Title VI Prohibition Against National Origin Discrimination Affecting Limited English Proficient Persons, U.S. Department of Health & Human Services, Office of Civil Rights, last revised November 20, 2003.   
  
  
• Hablamos Juntos
  • Affordable Language Services:  Implications for Health Care Organizations (Language Services Issue Brief), September 2005.
  • Developing Better Non-English Materials:  Understanding the Limits of Translation (Non-English Materials Issue Brief), September 2005.
  • Symbol Usage in Health Care Settings for People with Limited English Proficiency, April 2003.
    
• Improving Cultural Competency in Children’s Health Care – Expanding Perspectives, National Initiative for Children’s Healthcare Quality (NICHQ), July 2005.  This issue describes the NICHQ’s community care model for child health. 
  
  
• Improving Patient Safety Through Informed Consent for Patients with Limited Health Literacy, National Quality Forum (NQF), September 2005.  This report presents the results of an NQF study that examined implementation of Safe Practice 10, which focused on informed consent and patient safety.  Lessons learned through four case studies are reviewed, as well as the perspectives of organizations that have not adopted the practice.  Based on these findings, a separate User’s Guide also was developed to assist providers in implementing Safe Practice 10.
  
  
• Joint Commission 2006 Requirements Related to the Provision of Culturally and Linguistically Appropriate Health Care, Joint Commission on Accreditation of Healthcare Organizations, 2006.
  
  
• National Health Law Program (NHELP)
  • HIPAA and Language Services in Health Care, report funded by The California Endowment.
  • Language Access in Health Care Statement of Principles, March 16, 2005.
  • Summary of State Law Requirements Addressing Language Needs in Health Care, updated January 2006
    
• National Standards for Culturally and Linguistically Appropriate Services in Health Care (Final Report), U.S. Department of Health and Human Services, Office of Minority Health, March 2001.
  
  
• National Standards of Practice for Interpreters in Health Care, National Council for Interpreting in Health Care (NCIHC), September 2005.
  
  
• New Requirement at Standard IM.6.20 for the Collection of Information on Language and Communication Needs, Joint Commission on Accreditation of Healthcare Organizations, January 2006.  
  
  
• Principles and Recommended Standards for Cultural Competence Education of Health Care Professionals, The California Endowment, 2003.  This report provides guidance on content, training methods and modalities, evaluation and qualifications of teachers and trainers.
  
  
• Serving Diverse Communities in Hospitals and Health Systems from the Experience of Public Hospitals and Health Systems, National Public Health and Hospital Institute (NPHHI), funded by the U.S. Dept. of Health and Human Services, Office of Minority Health, June 2004.  This report presents the most significant and applicable strategies from the various programs and approaches currently underway in NAPH hospitals and health systems by presenting findings and lessons learned from case studies and a focus group and the development of a toolkit. 

General Resources

• Diversity Health Institute Clearinghouse, funded by the New South Wales Government.  This website is a central access point for Australian multicultural health services, resources, research, training, and events. 
  
  
• English in the Hospital – Point to Talk, Massachusetts General Hospital, 2002.  These American Hospital Association award-winning booklets were developed to aid Limited English Proficient patients in communicating with their caregivers.  Using a booklet, patients point to the words depicting what they would like to say in their language and the English translation can be read directly underneath.
  
  
• Health Translations Directory, State Government of Victoria, Australia, Department of Human Services, Victorian Government Health Information, June 2005.  Health practitioners who work with culturally and linguistically diverse communities can use this directory to find reliable translated health information.
  
  
• In The Right Words:  Addressing Language and Culture in Providing Health Care, Grantmakers in Health, August 2003.  This issue brief is based on an issue dialogue focusing on the challenges and opportunities involved with ensuring language access for the growing number of people who require it.
  
  
• Medicare Quality Improvement Community (MedQIC).  This website has a link to information related to Underserved Populations including tools, literature, stories, links, resources, and presentations.
  
• National Networks of Libraries of Medicine (NN/LM).  This website has a section with links devoted to Cultural Competence Resources
  
  
• Providing Language Services in Small Health Care Provider Settings:  Examples from the Field, National Health Law Program, funded by the Commonwealth Fund, April 2005.  This report includes an eight-step plan to help providers develop a strategy to meet the needs of their LEP patients and the community. 
  
  
• Straight Talk:  Model Hospital Policies and Procedures on Language Access, California Health Care Safety Net Institute and California Association of Public Hospitals and Health Systems, funded by The California Endowment, 2005.  This report examines both new and innovative operational procedures that can streamline hospital systems and processes for patients with limited-English skills.
  • http://www.calendow.org
  • http://www.calendow.org/reference/publications/pdf/cultural/SNI%20CAPH%20Model%20Hospital%20Policies%20and%20Procedures.pdf
    
    
• The Fifth National Conference on Quality Health Care for Culturally Diverse Populations, jointly presented by the Drexel University Center for Health Equality, Resources for Cross Cultural Health Care, et al., Seattle, WA, October 17-20, 2006.  The focus of this year’s conference is Building the Essential Link Between Quality, Cultural Competence, and Disparities Reduction.  The objective of the conference is to identify and highlight leading work in the areas of health care quality, cultural competence and disparities reduction, and to provide a forum for cross-discipline exchange that promotes integration of these fields in health care practice and policy. 
  • http://www.diversityRx.org/ccconf
    
    
• The Interpreter’s World Tour:  An Environmental Scan of Standards of Practice for Interpreters, prepared for the National Council on Interpreting in Health Care, funded by The California Endowment, March 2005.  This report summarizes standards of practice in the areas of general interpreting, healthcare/medical interpreting, court and legal interpreting, community and liaison interpreting, and conference interpreting.
  • http://data.memberclicks.com/site/ncihc/NCIHC%20Environmental%20Scan.pdf
    
    
• What a Difference an Interpreter Can Make – Health Care Experiences of Uninsured with Limited English Proficiency, The Access Project, April 2002.  This report compares the perceptions and experiences of adults who needed and easily got an interpreter with those who needed and did not get an interpreter (or had difficulty getting one), and with other uninsured who did not need an interpreter.
  • http://www.accessproject.org

TRAINING RESOURCES

• A Family Physician’s Practical Guide to Culturally Competent Care, U. S. Dept. of Health and Human Services, Office of Minority Health, December 2004.  This program offers continuing medical education (CME) credit and equips family physicians with awareness, knowledge, and skills to better treat the increasingly diverse U.S. population they serve.  Through a self-directed training course, these modules will equip family physicians with competencies that will enable them to better treat the increasingly diverse U.S. population. 
  • https://cccm.thinkculturalhealth.org
    
    
• Communicating Through Health Care Interpreters, Rush University Medical Center, May 2005.  This is a series of online courses to train doctors on how to work with professional interpreters, how to guide an untrained interpreter, and how to work with a telephone interpreter.  The training is offered through The Virtual Lecture Hall sponsored for CME credit by Rush University Medical Center. 
  • http://www.vlh.com
    
    
• Fanlight Productions, Sandy St. Louis, Distribution Director.  This production company offers cultural competency-related training videos.
  • Worlds Apart is a video and study guide used as a training tool for raising awareness about the role socio-cultural barriers play in patient-provider communication and healthcare for culturally and ethnically diverse patients.
  • The Culture of Emotions is an award-winning program designed to introduce cultural competence and diversity skills to all mental health clinicians and students available on video and also on DVD with a facilitator’s guide.
  • Community Voices is a video and study guide that helps to integrate cultural awareness and skill-building into training programs for all health professionals.
    • http://www.fanlight.com
      
      
• Quality Interactions, A Patient-Based Approach to Cross Cultural Care, Manhattan Cross Cultural Group.  This e-learning program, based on nationally-recognized cross-cultural curriculum published in the Annals of Internal Medicine, provides CME-accredited cultural competency training for physicians, nurses, and healthcare professionals.
  • http://www.qualityinteractions.org
    
    
• The Medical Interpreter Project for Children’s Hospitals, Phoenix Children’s Hospital, funded by Ronald McDonald House Charities, Inc., July 2005.  The national Medical Interpreter Project prepares instructors to teach interpreter skills to bilingual hospital employees.  Using a curriculum and organizational design that was developed and tested in Arizona, this project provides training and support to children’s hospitals that have a substantial need for language services in English and Spanish.  For information on the project, contact Juanita Francis (602) 481-3853 or email at mip@phoenixchildrens.com.