Study finds hospitals aren't complying with communication requirements

A new report has found that hospitals are falling short of the Joint Commission's language access requirements for patients with limited English.

"The New Joint Commission Standards for Patient-Centered Care," co-authored by two former language-expert hospital administrators in conjunction with Language Line Services, comes as the new communication regulations from the Joint Commission enter a year-long pilot phase.

Hospitals that don't comply with the new regulations will face damage to their reputations and untold expenses, the report says.

"Poor communication leads to poor care," said Oscar Arocha, a 25-year industry veteran and former director of the largest interpreter services department in the nation at Boston Medical Center. "The problem is that few hospitals have taken the necessary steps to comply."

According to the report, some hospitals still don’t see the link between language services, patient rights and patient safety. Other healthcare facilities may believe they are compliant because they already have bilingual staff, contract interpreters and over-the-phone or video interpreters, Arocha said. In addition, there are many hospitals that genuinely appreciate the urgency to adopt the new standards but simply don’t know how to get started and don’t know where to turn for help, he added.

According to the report, communication breakdowns are responsible for nearly 3,000 unexpected deaths each year, according to the Joint Commission. The majority of these breakdowns involve people with limited command of English. More than 50 million people – or approximately one in six residents – speak a language other than English at home, and today's ethnic minority is projected to become the majority by 2042.

[The HHS Office of Civil Rights is going after hospitals that do not communicate effectively with hearing disabled patients. Read more.]

The aim of the revised Joint Commission regulations, announced in 2009, is to improve patient-provider communication and ensure patient safety, Arocha said. The standards were put in place on January 1, but won't impact accreditation during the year-long pilot phase. The regulations require proof of interpreter training and fluency competence for interpreters in spoken languages as well as American Sign Language  for deaf and hard-of-hearing patients.

"The Joint Commission expects hospitals to demonstrate a greater commitment to language services and cultural competency for all its limited English-proficient and deaf patients, and it is giving hospitals one year to prepare," said Deborah Yvette Moore, who co-authored the report, spent 32 years as manager of the Parkland Health and Hospital System and is a lifelong advocate of patients' rights. "Relying on bilingual staff, family members or untrained interpreters whose misunderstandings, omissions, biases and impatience often get in the way is a risky way to bridge the language gap."

[See more on what the Joint Commission expects hospitals to do for non-English proficient patients.]

"The New Joint Commission Standards for Patient-Centered Care" can be found here.