Facts about patient-centered communications

Effective communication is critical to the successful delivery of health care services. For several years, The Joint Commission has supported a number of efforts promoting better health literacy between health care professionals and patients. It’s been estimated that more than 90 million Americans have low health literacy, meaning they don’t have the means to either obtain or understand the health information they need to make good decisions about their health. The Joint Commission’s health literacy efforts include:

• “One Size Does Not Fit All:  Meeting the Health Care Needs of Diverse Populations”—Published in April 2008, this report urges health care organizations to assess their capacity to meet patients’ unique cultural and language needs. Based on successful practices being used in hospitals, the report underscores the need to move away from a “one size fits all” approach that negatively affects the quality and safety of care for diverse patients. The report includes a self-assessment tool that can help health care organizations tailor their initiatives to meet the needs of diverse populations. The tool addresses the main issues found in the report and provides a framework for discussing needs, resources and goals for providing the highest quality care to every patient served. The report is the result of an ongoing multi-year research study, “Hospitals, Language, and Culture: A Snapshot of the Nation,” supported by funding from The California Endowment (see below for more information on the study). The report is available at http://www.jointcommission.org/PatientSafety/HLC/.
  
  
• “Hospitals, Language and Culture:  A Snapshot of the Nation”—Issued in March 2007, this report recommends targeted strategies to address language and cultural issues that increasingly pose challenges to hospitals seeking to deliver safe, effective care to diverse American populations. The recommendations in the report are the result of a study of how 60 hospitals across the country are providing health care to culturally and linguistically diverse patient populations. Few studies have systematically explored the provision of culturally and linguistically appropriate health care in a large number of hospitals. With funding from The California Endowment, this project is closing this gap. More information about this project and copies of the report are available at http://www.jointcommission.org/PatientSafety/HLC/
  
  
• “What Did the Doctor Say?:”  Improving Health Literacy to Protect Patient Safety—Published in February 2007, this white paper is the result of the Health Literacy and Patient Safety Roundtable, part of The Joint Commission’s Public Policy Initiative. This roundtable met in May and September 2005 and was charged with framing the issues related to low health literacy and its impact on patient safety. The white paper describes interventions to improve the ability of patients to understand complex medication information and provides recommendations for a broad range of health care stakeholders and policymakers to mitigate the risks to patients with low health literacy or low English proficiency. For more information, visit http://www.jointcommission.org/PublicPolicy/.
  
  
• “Understanding Adverse Events in Minority Patients with Limited English Proficiency”—Completed in January 2006, this study was funded by the Commonwealth Fund and examined the characteristics (impact, type, causes) of adverse events for Limited English Proficiency and English-speaking patients. Among the important findings of the study were the differences in impact adverse events had on the LEP vs. the English-speaking patients. The comprehensive study results are currently awaiting publication.
  
  
• Joint Commission accreditation standards—The Joint Commission standards set performance expectations for activities that affect the safety and quality of patient care. Within these standards are many requirements that promote effective communication between patient and caregiver. This issue must be addressed and embedded within all of the functions of the organization, as is reflected in the standards. The Joint Commission develops its standards in consultation with health care experts, providers, measurement experts, purchasers, and consumers. In particular, standard IM 6.20 requires that medical records include the patient’s language and communication needs.
  
  
• Health Care Services Certification—The Joint Commission’s Health Care Services Certification Program, to be launched in 2008, is a new evaluation program for health care services which are provided to patients in a wide variety of health care settings and play an important role in the management of direct patient care. The program incorporates the underlying concepts of clinical microsystems, studied extensively at Dartmouth College, which emphasize the importance of patient-centered care and teamwork in focusing on the front line of service delivery. A microsystem is a small group of people who work together on a regular basis ― or an as-needed basis ― to provide care to a discrete sub-population of patients. The microsystem also includes the patients receiving care.
  
  
• Speak Up program—In March 2002, The Joint Commission launched a national campaign to urge patients to take a role in preventing health care errors by becoming active, involved and informed participants on the health care team. The program features brochures, posters and buttons on a variety of patient safety topics. All brochures are either at a lower reading level or a lower reading level is available. Speak Up is intended to involve the public in their health care, raise their knowledge about health care issues, and enable them to make good decisions about their health. Speak Up™ brochures are available on the topics of surgical safety, living organ donation, infection prevention, preventing medication mistakes, follow-up care, preventing medical test mistakes, and patient rights. Speak Up materials are available at http://www.jointcommission.org/PatientSafety/SpeakUp/.
  
  
• “You:  The Smart Patient: An Insider’s Handbook For Getting The Best Treatment”—published by Free Press, a division of Simon and Schuster, and sold at bookstores nationwide, this book uses humor and illustrations to provide concrete guidance to patients in navigating the health care system. It also urges patients to get involved in their health care, and showcases the importance of Joint Commission accreditation. The book was written by best-selling authors Michael F. Roizen, M.D., and Mehmet C. Oz, M.D., in collaboration with Joint Commission Resources, The Joint Commission's not-for-profit affiliate.

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