Advanced Effective Communication, Cultural Competence, and ...

A Roadmap for Hospitals
Chapter Six: Organization Readiness
Table 6-3. Categorization of
Patient-Level Language Data
Categories of English Proficiency*
• Very well
• Well
• Not well
• Not at all
Preferred Spoken Language for Health Care
• Locally relevant choices from standardized
national set
• “Other, please specify:_____”
• Sign language
Preferred Written Language
• Locally relevant choices from standardized
national set
• Braille
* The Institute of Medicine recommends hospitals collect information
on an individual’s assessment of his or her proficiency with English
and the patient’s preferred spoken and written language for health
care discussions and education. Limited English proficiency is
defined as anything less than “very well”.
Source: Adapted from Table 4-1. Summary of Question
Types and Categories in Ulmer C., McFadden B., Nerenz D.:
Race, Ethnicity, and Language Data: Standardization for
Health Care Quality Improvement. Washington, DC: The
National Academies Press, 2009.
• Support training and career development activities to
help culturally and linguistically diverse nonclinical staff
advance to a patient care position.
• Develop relationships with local community colleges
that offer health care career training to develop volunteer,
work-study, and internship programs.
• Encourage the transition of English as a second language
(ESL) students into health care careers by partnering
with community-based organizations that offer ESL
courses, such as technical colleges, community colleges,
adult literacy programs, or workforce development
programs.
❑ Ensure the competency of individuals
providing language services.
Language services that meet patient communication needs
promote quality and safety. Hospitals must ensure the
competency of their language interpreters and translators.*
• Define qualifications for language interpreters and
translators to comprise a combination of language
proficiency assessment, education, training, and
experience.
• Consider including certification by the Registry of
Interpreters for the Deaf or the National Association of
the Deaf as a qualification for sign language interpreters. †
• Conduct an assessment of language proficiency in both
English and the target language for language interpreters
and translators, or contact an external vendor to perform
language proficiency assessments for these individuals.
• Promote ongoing training and educational opportunities
for language interpreters and translators.
• Find out the qualifications of the language interpreters
and translators provided by an external vendor for
contracted language services.
• Refrain from relying on untrained individuals, including
a patient’s family members or friends, to provide
language services.
• Consult resources from the National Council on
Interpreting in Health Care (http://www.ncihc.org)
and the American Translators Association
(http://www.atanet.org) for additional guidance on
the qualifications and competencies to expect of
language interpreters and translators. ‡
❑ Incorporate the issues of effective
communication, cultural competence, and
patient- and family-centered care into new
or existing staff training curricula.
Staff training should provide information and guidance
about the hospital’s efforts to address unique patient cultural,
religious, spiritual, mobility, or other needs. Address with
staff all relevant policies, services, and programs for effective
communication, cultural competence, and patient- and
family-centered care.
* See Chapter 6: Organization Readiness: Provision of Care, Treatment, and Services (page 40) for additional information on developing a
system to provide language services.
† See Appendix E: Resource Guide (page 82) for further information on interpreter qualifications.
‡ See Appendix E: Resource Guide (page 82) for additional resources on training and qualifications for language interpreters and translators.
38