Swedish, who sat on a special Joint Commission committee that created the patient-centered communication standards, says hospitals can start with a "planning construct" to more effectively analyze a community's demographic needs.
"We now have a model to follow with respect to guidance on assessing community needs," he says. "It puts the method and expectation in place that gets us started creating more 'knowns' regarding our community. That maps over to training and education, recruitment, and clinical services. The exemplary organizations of the future are going to be highly sensitized to the needs and then develop programs, initiatives, services, that are very aligned with the mosaic of the community."
Wilson-Stronks says it's difficult to predict what new demands will be placed on staff, or how many new staff members may be needed.
"It's going to vary from hospital to hospital. There is a cost associated with it, and hospitals will have to weigh what their population is," Wilson-Stronks says. "The intent is not that there is an on-site staff interpreter in every language you could imagine. That is totally unrealistic, and it's not what the law requires."
Instead, Wilson-Stronks says, each hospital will have to examine the communities it serves. For example, if 10% of a hospital's patient demographic speaks a particular foreign language, that hospital would be well served by hiring healthcare workers or qualified interpreters who speak that language.
"We are not requiring any sort of certification for interpreters, but we are requiring that they are competent," Wilson-Stronks says. "Just because someone is certified does not necessarily mean they are performing well. We are trying to raise awareness that there are competency and professional practice standards that interpreters should follow and it's not OK to just pull somebody from the waiting room or rely on a family member."
Swedish says that "clearly there will be personnel required" to achieve certification. "At Trinity Health we have a very significant focus on diversity and inclusion and that has created within our 47 hospitals a diversity leader, and efforts that come from that leader to go through the analytics and the development programs that advance the cause of diversity and inclusion."
Swedish acknowledges that, "Yes, there will be some added costs." But, he notes, "On the flip side you are going to be able to demonstrate higher quality, improved service, and I would argue that those opportunities will offset the expense."