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Collaborative aimed at hospital communication
Important means of reducing care disparities
A new program from the Department of Health and Human Services (HHS) called "Effective Communication in Hospitals" is designed to aid hospitals in meeting the communication needs of individuals who do not speak English as their primary language, or who are deaf or hard of hearing.
The program will have both national and state-based components; the state-based initiative involves collaboration between HHS' Office for Civil Rights (OCR) and state hospital associations. At present, hospital associations in Kentucky, Missouri, New Jersey, New York, Oklahoma, Pennsylvania, Rhode Island, Utah, and Washington are slated to participate.
According to HHS, state-based efforts will be tackling such issues as:
One of the 'chosen'
One of the participating organizations, the Kentucky Hospital Association (KHA), was actually enlisted by the OCR, explains Pam Mullaney, KHA's director of membership services.
"The OCR and AHA [American Hospital Association] brought it to us," she recalls, explains that there are 10 OCR offices in the country, with Kentucky falling within the jurisdiction of Atlanta's office.
Kentucky is unique in a number of ways, Mullaney continues. First, all 126 hospitals in the state belong to the KHA, which, she says, is unique. "Most states have more than one organization that represents its hospitals," she asserts. This means that in Kentucky, every hospital will be exposed to the program. KHA, adds Mullaney, "represents and facilitates collaborative efforts among Kentucky hospitals and is the source for strategic information about the constantly changing health care environment."
In addition, says Mullaney, "Because more than half our hospitals have fewer than 100 beds, we are considered a rural state. Urban hospitals probably are going to have programs in place already."
The program is important, she says, because "Patient care starts with communication; it's number one. Once you have a program in place that can assist these populations, you are on your way to delivering quality care."
So many of these people don't know how to find their way through the health care system, she explains. "In a lot of other countries, health care is provided by the government; they do not understand that we provide care for the indigent. They also do not understand, however, that this care should not start in the ED, but with a primary care doctor."
Starting pilot project
The KHA will begin its effort with a pilot program, says Mullaney, and it may even "go after" some grant dollars.
"Our idea currently is to come up with something like they've done in Illinois," she says. This involves the use of an oversized laminated board that employs dry erase markers, covered with many different symbols.
"So, if a person [who did not know English or who could not speak] came in and had a broken arm, they could point to it," Mullaney explains.
The board, she says, will have "maybe 100 different pictures, as well as the letters of the alphabet to spell out words." This will be done for the top five languages used in the state: Spanish, Somali, Russian, Arabic, and Vietnamese.
If KHA gets its grant dollars, it will investigate the different language line companies that could provide interpreters. "If a Vietnamese patient comes in, for example, you can call the phone line using two phones — one for the patient and one for the physician — and they can converse back and forth using an interpreter," she explains.
KHA will do due diligence on the top companies. "Since our endorsement could mean all the hospitals in the state would use this vendor, we could get a discounted rate," she suggests.
The OCR is doing a lot of population analysis for KHA "so we'll have a lot more arrows in our quiver when we go to grant writing," says Mullaney, adding that this collaborative "is all about patient care and patient safety," as opposed to a government-mandated activity.
"The nice thing about working with OCR," she continues, "is that they are not claiming to come to us with the answers. They recognized that we know your hospitals and our state, and they want to listen to us for guidance as to what would be of value in each hospital in each setting."
Still, she notes, one program will not be a cure-all. "I think this is a monumental problem, and we will not be able solve it with this one collaborative effort," she concedes. "But it is a step in the right direction; we'll try to give our hospitals a mechanism [for addressing the problem], and then spread the word from there."
[Editor's note: For more information, contact: Pam Mullaney, Director, Membership Services, Kentucky Hospital Association, 2501 Nelson Miller Parkway, Louisville, KY 40253. Phone: (502) 992-4363. Fax (502) 814-0363. E-mail: email@example.com.]