Advanced Effective Communication, Cultural Competence, and ...
Advanced Effective Communication, Cultural Competence, and ...
Advanced Effective Communication, Cultural Competence, and ...
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A Roadmap for Hospitals<br />
Chapter Three: Treatment<br />
• Speak in plain language <strong>and</strong> avoid using technical<br />
terminology or medical jargon. Include examples <strong>and</strong><br />
stories whenever possible.<br />
• Use visual models, diagrams, or pictures to illustrate a<br />
procedure or condition.<br />
• Help the patient gather basic health information by using<br />
methods such as AskMe3, a strategy for asking <strong>and</strong><br />
answering three questions about the patient’s care [2].<br />
• Use the “teach back” method to assess underst<strong>and</strong>ing.<br />
This involves asking the patient to explain in his or her<br />
own words the information the staff shared or asking<br />
the patient to demonstrate a skill that was taught.<br />
• Refrain from simply asking the patient “Do you<br />
underst<strong>and</strong>?” Regardless of their ability to underst<strong>and</strong><br />
the information, many people who do not underst<strong>and</strong><br />
may still answer “Yes.”<br />
• Encourage the patient to write notes or check off key<br />
information on patient education materials during<br />
discussions.<br />
• Use patient education materials that meet health<br />
literacy needs. Materials should be written at a 5th<br />
grade or lower reading level. Consider revising written<br />
materials to address the health literacy needs of all<br />
patients. Use readability tests, divide complex<br />
information into bullet points, <strong>and</strong> modify document<br />
font, layout, <strong>and</strong> design to improve readability.*<br />
• Use translated patient education materials in the<br />
patent’s language whenever possible. Provide an<br />
interpreter for the patient’s preferred language during<br />
patient education discussions, even if the hospital<br />
provides translated materials, to facilitate patient<br />
communication.<br />
❑ Address patient mobility needs during<br />
treatment.<br />
Many patients with mobility needs have difficulty<br />
physically accessing medical equipment. When specialized<br />
equipment is not available, staff may conduct<br />
examinations <strong>and</strong> tests in a way that can generate<br />
inaccurate results or conceal physical evidence required for<br />
appropriate diagnosis <strong>and</strong> treatment, for example,<br />
conducting x-rays while the patient is seated in a<br />
wheelchair [3]. In addition, patients with unmet mobility<br />
needs due to a recent stroke, changes in health status, or<br />
treatment side effects may be at risk for falls. †<br />
• Assess whether the patient needs mobility assistance,<br />
including the type of <strong>and</strong> circumstances in which<br />
assistance is required.<br />
• Make sure the patient has been assigned to a room that<br />
can accommodate his or her mobility needs.<br />
• Make sure any mobility aid the patient uses (such as a<br />
service animal, cane, or walker) is readily accessible to<br />
the patient.<br />
• Determine whether the patient requires<br />
accommodations (such as adaptive switches or an<br />
intercom call system) to access the nurse call system.<br />
• Make sure appropriate precautions are in place to<br />
prevent falls. Some hospitals post a sign above the<br />
patient’s bed or door, or use special colored socks or<br />
bracelets to identify a patient at risk for falls.<br />
• Note the need for mobility assistance in the medical<br />
record <strong>and</strong> communicate these needs to staff.<br />
❑ Accommodate patient cultural, religious,<br />
or spiritual beliefs <strong>and</strong> practices.<br />
The patient’s beliefs <strong>and</strong> practices can affect the perception of<br />
illness <strong>and</strong> how he or she approaches treatment. Staff should<br />
accommodate the patient’s unique needs whenever possible.<br />
• Communicate any cultural, religious, or spiritual beliefs<br />
or practices staff identified during the admission or<br />
assessment process to the care team.<br />
• Respect the patient’s needs <strong>and</strong> preferences for modesty<br />
by assigning appropriate providers, uncovering only the<br />
parts of the body necessary for examination <strong>and</strong><br />
treatment, providing privacy in toileting <strong>and</strong> washing,<br />
<strong>and</strong> using full gowns or robes for walking <strong>and</strong> transport.<br />
Many cultures <strong>and</strong> religions have restrictions on<br />
touching, distance, <strong>and</strong> modesty, which may be affected<br />
by providers of the opposite sex or staff that are younger<br />
or older than the patient.<br />
• Provide an area or space to accommodate the patient’s<br />
need to pray. In addition, ask the patient if there are specific<br />
times of day to avoid scheduling tests or procedures<br />
to respect the patient’s religious or spiritual practices.<br />
• Work with the patient <strong>and</strong> family to develop mutually<br />
agreed on solutions to patient requests regarding<br />
* See Chapter 6: Organization Readiness: Provision of Care, Treatment, <strong>and</strong> Services (page 42) for additional information on integrating health literacy<br />
strategies into patient education discussions <strong>and</strong> materials.<br />
† See Chapter 6: Organization Readiness: Provision of Care, Treatment, <strong>and</strong> Services (pages 39–40) for more information on making sure that<br />
mobility assistance <strong>and</strong> specialized equipment are available to patients.<br />
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