Advancing Effective Communication, Cultural Competence, and Patient- and Family-Centered Care A Roadmap for Hospitals Quality Safety Equity A Roadmap for Hospitals Project Staff Amy Wilson-Stronks, M.P.P., Project Director, Health Disparities, Division of Quality Measurement and Research, The Joint Commission. Paul Schyve, M.D., Senior Vice President, The Joint Commission Christina L. Cordero, Ph.D., M.P.H., Associate Project Director, Division of Standards and Survey Methods, The Joint Commission Isa Rodriguez, Project Coordinator, Division of Quality Measurement and Research, The Joint Commission Mara Youdelman, J.D., L.L.M., Senior Attorney, National Health Law Program Project Advisors Maureen Carr, M.B.A., Project Director, Division of Standards and Survey Methods, The Joint Commission Amy Panagopoulos, R.N., M.B.A., Director, Division of Standards and Survey Methods, The Joint Commission Robert Wise, M.D., Vice President, Division of Standards and Survey Methods, The Joint Commission Joint Commission Mission The mission of The Joint Commission is to continuously improve health care for the public, in collaboration with other stake- holders, by evaluating health care organizations and inspiring them to excel in providing safe and effective care of the highest quality and value. The inclusion of an organization name, product, or service in a Joint Commission publication should not be construed as an en- dorsement of such organization, product, or services, nor is failure to include an organization name, product, or service to be construed as disapproval. © 2010 by The Joint Commission Permission to reproduce this guide for noncommercial, educational purposes with display of attribution is granted. For other requests regarding permission to reprint, please call (630) 792-5954. Suggested Citation The Joint Commission: Advancing Effective Communication, Cultural Competence, and Patient- and Family-Centered Care: A Roadmap for Hospitals. Oakbrook Terrace, IL: The Joint Commission, 2010. For more information about The Joint Commission, please visit http://www.jointcommission.org. ii Table of Contents Acknowledgements ............................................................................................vii Introduction ..........................................................................................................1 Terminology ........................................................................................................................................................................................1 A Roadmap to the Future....................................................................................................................................................................3 How the Roadmap Is Organized ........................................................................................................................................................3 Checklist of Recommended Issues to Address ..............................................................................................................................4 Joint Commission Requirements....................................................................................................................................................4 Laws and Regulations....................................................................................................................................................................4 Resource Guide ............................................................................................................................................................................4 Suggested Ways to Use the Roadmap for Hospitals ..........................................................................................................................4 To Improve Performance................................................................................................................................................................4 To Train Staff ..................................................................................................................................................................................4 To Help Inform Policy ....................................................................................................................................................................4 To Evaluate Compliance with Relevant Laws, Regulations, and Standards..................................................................................6 Chapter 1: Admission............................................................................................9 Recommended Issues and Related Practice Examples to Address During Admission ......................................................................9 Inform patients of their rights..........................................................................................................................................................9 Identify the patient’s preferred language for discussing health care ............................................................................................10 Identify whether the patient has a sensory or communication need ............................................................................................10 Determine whether the patient needs assistance completing admission forms ..........................................................................11 Collect patient race and ethnicity data in the medical record ......................................................................................................11 Identify if the patient uses any assistive devices..........................................................................................................................11 Ask the patient if there are any additional needs that may affect his or her care ........................................................................11 Communicate information about unique patient needs to the care team ....................................................................................12 Chapter 2: Assessment ......................................................................................13 Recommended Issues and Related Practice Examples to Address During Assessment ................................................................13 Identify and address patient communication needs during assessment......................................................................................13 Begin the patient–provider relationship with an introduction........................................................................................................14 Support the patient’s ability to understand and act on health information....................................................................................14 Identify and address patient mobility needs during assessment..................................................................................................14 Identify patient cultural, religious, or spiritual beliefs and practices that influence care ..............................................................15 Identify patient dietary needs or restrictions that affect care ........................................................................................................16 Ask the patient to identify a support person ................................................................................................................................16 Communicate information about unique patient needs to the care team ....................................................................................16 iii A Roadmap for Hospitals Chapter 3: Treatment..........................................................................................17 Recommended Issues and Related Practice Examples to Address During Treatment ..................................................................17 Address patient communication needs during treatment ............................................................................................................19 Monitor changes in the patient’s communication status ..............................................................................................................19 Involve patients and families in the care process ........................................................................................................................19 Tailor the informed consent process to meet patient needs ........................................................................................................19 Provide patient education that meets patient needs ....................................................................................................................20 Address patient mobility needs during treatment ........................................................................................................................21 Accommodate patient cultural, religious, or spiritual beliefs and practices ..................................................................................21 Monitor changes in dietary needs or restrictions that may impact the patient’s care ..................................................................22 Ask the patient to choose a support person if one is not already identified ................................................................................22 Communicate information about unique patient needs to the care team ....................................................................................22