Advanced Effective Communication, Cultural Competence, and ...

A Roadmap for Hospitals
Chapter One: Admission
• Contact the Speech Language Pathology Department,
if possible, to provide the appropriate AAC resources
needed to help a patient who has a communication
impairment due to a current medical condition.*
• Note the sensory or communication need and mention
any personal aids or devices, auxiliary aids or resources,
or AAC resources in the medical record and
communicate these needs to staff.
❑ Determine whether the patient needs
assistance completing admission forms.
Over 40% of adults have significant literacy challenges,
and 88% of adults have less than “proficient” health
literacy skills [3]. Recognizing that a patient needs help
reading or completing admission forms can be a sensitive
issue and staff should obtain necessary information
without embarrassing the patient.
• Pay attention to clues to identify a patient with limited
or low literacy (for example, statements like, “I forgot
my glasses,” “My spouse usually keeps all this
information at home,” or “Can I take this home to fill
out and bring it back later?”) and respond with
appropriate help.
• Ask the patient, “Would you prefer to have someone
help you fill out the forms?”
• Offer the patient an opportunity to complete
admission forms alongside a staff member.
❑ Collect patient race and ethnicity data in
the medical record.
Hospitals must collect patient-level demographic data on
race and ethnicity to identify the needs of individual
patients and to eliminate disparities in the patient
population. These critical data provide hospitals with
information on the potential cultural needs of each
patient, as well as an opportunity to monitor and analyze
health disparities at the population level. †
• Ensure that the patient understands why race and
ethnicity data are being collected. The Health Research
and Educational Trust recommends that staff explain
to the patient, “We want to make sure that all our
patients get the best care possible, regardless of their
race or ethnic background. We would like you to tell
us your race or ethnic background so that we can
review the treatment that all patients receive and make
sure that everyone gets the highest quality of care” [4].
• Allow the patient to self-report race and ethnicity
information.
• Respect the patient’s choice to decline to provide race
and ethnicity information.
• Refer to hospital policies and procedures for collecting
patient demographic data.
❑ Identify if the patient uses any assistive
devices.
A patient may arrive at the hospital with any of a number
of devices that he or she uses to assist with activities of
daily living and/or mobility. It is important for the
hospital to make accommodations and make sure that the
patient has access to these devices during care.
• Make sure that any needed assistive device (such as a
service animal, cane, walker, wheelchair, or another
mobility device) is available to the patient throughout
the continuum of care.
• Identify whether specialized equipment should be used
during the care of any patient with mobility needs.
❑ Ask the patient if there are any additional
needs that may affect his or her care.
Although many of the preceding points have addressed the
identification of patient needs, there may be additional
issues (such as cultural, religious or spiritual, mobility, or
other needs) that would require staff to coordinate
services, incorporate specialized equipment, or record
supplementary information in the patient’s medical
record. ‡
• Ask a general question, “Is there anything else the
hospital should be aware of to improve your care
experience?”
• Identify whether the patient has cultural- or religionbased
modesty issues regarding care provided by staff
of the opposite sex.
• Determine if there are certain garments or religiously
important items that need to be worn.
* See Chapter 6: Organization Readiness: Provision of Care, Treatment, and Services (page 41) for additional information on providing
augmentative and alternative resources.
† See Chapter 6: Organization Readiness: Data Collection and Use (page 36) for more information on the collection of patient race and ethnicity data.
‡ See Chapter 6: Organization Readiness: Data Collection and Use (page 37) for more information on the collection of additional patient data.
11