If you’re in healthcare, you already know about The Joint Commission, formerly the Joint Commission on Accreditation of Healthcare Organizations (JCAHO). Chances are pretty good that an impending visit has even caused you to break out in a sweat. Well, get out your ShamWow, because The Joint Commission is proposing new standards that, if rolled out in 2011 as predicted, will have administrators in healthcare settings hopping.
The Joint Commission will be enacting new standards to evaluate employers’ “cultural competence.” This is about more than hiring a diverse workforce. The Joint Commission defines cultural competence as “the ability of health care providers and organizations to understand and respond effectively to the cultural and language needs brought by the patient to the health care encounter.” With 17 standards/points to meet, the addition of cultural competence to the audits will require more objective reviews of your organization’s policies and practices, more strategic planning, more employee training and education, more documentation, and quite possibly, more hires.
From the head honcho charged with evaluating (or possibly creating?) your organization’s cultural competence policy — preferably a highly experienced HR or healthcare professional with a specific, successful background in diversity and inclusion — to the interpreters you’ll need to communicate with patients and their families (I really wish I had taken more than two years of Spanish in high school…), cultural competence is the buzz phrase that is sure to have you busting your butt to ensure coveted accreditation by The Joint Commission.
Here’s a sneak peek at just a handful of the Proposed Requirements (the bolded areas are mine…):
(Leadership Chapter) Standard LD.04.03.01 The hospital provides services that meet patient needs. EP 4. The hospital uses available population-level data to help determine the needs of the population(s) served. Note 1: Population-level data sources may include for example, census figures, voter registration data, and school enrollment profiles. Note 2: The needs of the population(s) served may be based on the following demographic characteristics: -Age -Sex -Disability -Language(s) -Race/ethnicity -Religion(s) -Socioeconomic status -Education level -Sexual orientation -Gender identity or expression. EP 5. The hospital uses aggregated patient-level data to help determine the needs of the population(s) served.
(Provision of Care, Treatment, and Services Chapter) Standard PC.0X.0X.0X. The hospital effectively communicates with patients when providing care, treatment and services. EP 1. The hospital identifies the method by which patients want to receive and provide information. Note: Methods may include the use of a preferred language, auxiliary aids, and plain language materials. EP 2. The patient’s preferred method of receiving and providing information is communicated across the care continuum to individuals who are involved in the patient’s care. EP 3. The hospital provides language access services and auxiliary aids to facilitate communicate with patients when providing care, treatment and services. Note: Language access service options include bilingual staff, interpreters, and contract interpreter services. Auxiliary aid options include communication boards, hearing aids, and speech output devices. EP 4. The hospital assesses the patient’s understanding of the information provided. Note: Understanding may be assessed by asking open-ended questions, using “teach back” methods, or return demonstrations.
(Rights and Responsibilities of the Individual Chapter) Standard RI.01.01.01. The hospital respects patient rights. EP 6. The hospital accommodates the patient’s cultural and personal values, beliefs, and preferences. Note: The cultural and personal values, beliefs and preferences of individuals served are varied and may require special considerations. The hospital will accommodate these values, beliefs, and preferences, unless they infringe on others’ rights, safety, or are medically or therapeutically contraindicated. EP 9. The hospital accommodates the patient’s right to religious and other spiritual practices. The spiritual practices of individuals served are varied and may require special considerations regarding scheduling, space, or other accommodations. The hospital will accommodate these practices unless they infringe on others’ rights, safety, or are medically or therapeutically contraindicated.
Obviously, the aim of the new standards isn’t to create more work for hospitals (or more opportunities for lawyers). It’s to ensure better care for all patients. The majority of studies find that racial and ethnic disparities in healthcare remain even after adjustment for socioeconomic differences and other healthcare-access related factors. With approximately 80% of the nation’s hospitals currently accredited by The Joint Commission, the potential for the new standards to make a true impact on patient care (and on your to-do list) is great.
