Advanced Effective Communication, Cultural Competence, and ...

A Roadmap for Hospitals
ChapterTwo: Assessment
❑ Identify patient dietary needs or
restrictions that affect care.
Dietary needs and restrictions can arise from cultural,
religious, or spiritual practices, or they may be related to
the patient’s medical condition. Some medications use
animal byproducts as binders and fillers, and staff should
be aware of the patient’s dietary restrictions in order to
select alternative medications where possible.
• Ask the patient “Is there anything your providers
should be aware of regarding your diet?”
• Identify whether the patient’s religious or spiritual beliefs
or customs require or forbid eating certain foods.
• Determine if the patient routinely or periodically
observes fasting practices (for example, on religious
holidays).
• Note the dietary needs or restrictions in the medical
record and communicate them to staff.
• Make sure the hospital’s food service accommodates
the patient’s needs.
❑ Ask the patient to identify a support
person.
A patient support person should provide emotional
support, give comfort, and alleviate fear during the course
of the patient’s hospital stay. Patients should have access to
their chosen support person at all times.
• Explain the purpose of the patient’s support person,
including limitations if the presence of the individual
infringes on others’ rights, compromises safety, or is
medically or therapeutically contraindicated.
References:
1. HealthCare Chaplaincy: A Dictionary of Patients’ Spiritual and
Cultural Values for Health Care Professionals. New York:
HealthCare Chaplaincy, Updated Sept. 2009. Available at
http://www.healthcarechaplaincy.org/userimages/doc/
Cultural%20Dictionary.pdf. (Accessed March 1, 2010.)
• Make staff aware that the patient has chosen a support
person to be present with him or her during the course
of stay.
• Allow the patient access to the support person at all
times.*
• Ask if the patient would like to involve the chosen
support person during rounds, patient education, and
other crucial decision-making and care processes. The
support person may or may not be the patient’s
designated surrogate decision-maker.
• Note information about the patient’s support person
in the medical record and communicate the selection
to staff.
❑ Communicate information about unique
patient needs to the care team.
Any information about patient needs should be easily
accessible at all points of care and in other appropriate
departments to help staff provide the necessary services
and arrangements to meet patient needs.
• Note all relevant data in the patient’s medical record.
• Create a process to identify any patients with unique
needs (for example, color code the patient’s chart, add
flags or stickers to the chart, or use patient armbands
to denote different patient needs). Consider posting
signs on doors or above the patient’s bed, or using the
whiteboard in the patient’s room to communicate,
with the patient’s permission, information to staff.
• Inform staff of patient needs at specific transfer points,
including transports for procedures, tests, or transfers
to different care units or services.
3. National Council on Disability: The Current State of Health Care
for People with Disabilities. Washington, DC: National Council on
Disability, 2009. Available at http://www.ncd.gov/newsroom/
publications/2009/pdf/HealthCare.pdf. (Accessed March 1, 2010.)
2. Partnership for Clear Health Communication: Ask Me 3: What
Can Providers Do? Boston: National Patient Safety Foundation,
2009. Available at http://www.npsf.org/askme3/\PCHC/
what_can_provid.php. (Accessed March 1, 2010.)
* On April 15, 2010, President Obama released a presidential memorandum for the secretary of the Department of Health and Human Services
respecting the rights of hospital patients to receive visitors and to designate surrogate decision-makers for medical emergencies regardless of their
status of legally recognized immediate family members (available at http://www.whitehouse.gov/the-press-office/presidential-memorandumhospital-visitation).
(Accessed on July 22, 2010.)
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