Language and Communication Access

The ability to communicate is important in providing and receiving health care. Segments of the population who seek health care services experience challenges in their ability to communicate with caregivers. Some patients are deaf or hard of hearing, others may have limited English proficiency and still others may have challenges with health literacy. Health literacy is the ability of patients to understand basic health information so they can make decisions about their care. Health literacy, patient safety, and informed consent, as well as customer service, all contribute to the importance of being able to communicate to ensure a positive health care experience for all people.

There are several pieces of legislation that help organizations meet the communication needs of people. The American Disabilities Act provides guidance on providing sign language interpreters for deaf & hard of hearing individuals. Title VI of the Civil Rights Act of 1964 states that “No person in the United States shall, on ground of race, color, or national origin, be excluded from participation in, be denied the benefits of, or be subjected to discrimination under any program or activity receiving Federal financial assistance.” The goal is to provide trained interpreters to facilitate communication between providers and patients and their families. Interpretation can be provided in a variety of formats, face to face, telephone and video.

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Action Steps

Develop a Communication Access Plan and use it to determine what information should be translated into languages commonly found in your community.

Post signs in public places that inform people of the availability of interpreters at no cost to patients.

Adopt policies that require trained interpreters.

Assess your patients for health literacy.

Olson, A. M., & Swabey, L. (2017). Communication access for deaf people in healthcare settings: Understanding the work of American Sign Language interpreters. Journal for Healthcare Quality, 39(4), 191-199.

Schwei, R. J., Del Pozo, S., Agger-Gupta, N., Alvarado-Little, W., Bagchi, A., Chen, A. H., … & Jacobs, E. A. (2016). Changes in research on language barriers in health care since 2003: a cross-sectional review study. International journal of nursing studies, 54, 36-44.


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