In a blog I wrote last month titled, 17 Frustrations Deaf and Hard of Hearing Individuals Experience In Healthcare Settings, I shared it is critical to review and revise your communication access policy and internal procedures to fix any outstanding communication access barriers Deaf and Hard of Hearing individuals face. In this post, I’m going to offer six ways to determine if your communication access policy works.

Being able to communicate in medical settings is something many people take for granted. In hospitals, patients communicate to ask for pain medication, call the nurse for assistance, and make phone calls to family members and friends, as well as order food. They listen to doctors’ diagnoses, directives for tests and procedures, and discharge instructions.

On the flip side, it has been well documented that the 48 million Americans who are Deaf or Hard of hearing experience difficulty accessing effective communication in healthcare settings. To this end, if you’re a hospital administrator and you’re thinking deeply about your hospital’s communication accessibility for your Deaf and Hard of Hearing patients and companions, then you’re already a bit ahead of the game.

1) Easier for us to say what we can’t do

Imagine, if you will, being a patient in a hospital and all decisions regarding your care are made right in front of you without any input from you – simply put, you are not given the opportunity to express what it is you are experiencing.

To add insult to injury, imagine you also cannot make or receive phone calls, don’t have access to a nurse call/alert button, and your television has no volume.

Deaf and Hard of Hearing individuals like myself experience similar frustrations with communication access. We’ve been told the hospital cannot locate an interpreter, does not provide an interpreter, and cannot provide a laptop or tablet for phone calls to be made via Video Relay Service. We’ve also been told captions in public places cannot be turned on for an array of reasons and services will be delayed until an interpreter is present.

If your hospital has shared any of the above with Deaf and Hard of Hearing patients or companions, then chances are good you have an issue with your communication access policy.

2) Plan is Not Comprehensive

At a minimum, a communication access policy should incorporate a comprehensive, detailed list of all auxiliary aids and services that are, and should be, made available to patients, companions, and/or patient representatives who have Limited English proficiency (LEP) or a sensory or a manual impairment such as hearing, speech, vision or inability to write.

28 C.F.R. § 36.303(b)(1), a section from the ADA Title III Regulation 28 CFR Part 36, lists a wide breadth of auxiliary aids and services that should be made available to allow patients and companions to participate in their own care and/or in the care of their loved ones.

If a patient or companion requests for a specific aid or service and your employees cannot or refuse to provide said aid or service, you could be subjecting yourself to a lawsuit if effective communication does not take place.

3) Plan Lacks All-inclusive Guidelines and Procedures

Your Communication Access Policy should include any comprehensive guidelines and procedures related to the provision of auxiliary aids and services during defined critical points of care. Policies should also include standard procedures regarding the collection and documentation of communication needs, guidance on what providing auxiliary aids and services in a “timely manner” means, direction on how to select the appropriate auxiliary aid and services, and minimum instructions on how to provide the aid or service, if appropriate.

In sum, these questions must be asked:

1. Is our process fully documented?
2. Do we rigorously follow it?
3. Do we provide training to ensure adherence?

If any of your answers to these three questions is no, then chances are there is a problem with the policy.

4) Plan Doesn’t Adhere to Recommended Standards

While the Joint Commission Standards and the National Standards for Culturally and Linguistically Appropriate Services in Health and Health Care (The National CLAS Standards) are non-binding authorities, they provide points of consideration to help hospitals to identify risks, reduce liability and implement appropriate services.

As a part, these standards identify best practices to achieve effective communication throughout the continuum of hospital stays, as well as define the underpinning processes and systems. Adhering to these standards eliminate an improvised, reactive approach and help ensure hospitals provide quality health care and deliver consistent quality time after time.

5) Receiving Complaints about Communication Access

The next indicator is a fairly obvious one. When people file complaints, this is indicative there is an underlying issue that needs to be addressed. The problem becomes magnified when these complaints are not shared with middle or upper management or management does not take corrective action to remedy the issues.

Additionally, when Deaf people explain or film their experiences on social media, they are sharing with others that can identify with their pain and frustration. More often than not, someone responds and recommends suing. The rest may be history.

6) You’re Facing a Lawsuit

A good policy proactively responds to problems before they arise. While you may be past this point, it is critical to address your policy’s deficiencies to 1) show the judge a good faith effort to remedy outstanding issues with policies and procedures and 2) prevent additional lawsuits from being filed against your healthcare entity.

Recommended Next Steps

If you have just one of these problems and do not currently face a lawsuit, then you may be at risk of being hit with a lawsuit. With that said, if you found yourself nodding your head to two or three of these, then you most certainly have a serious issue that must be promptly dealt with.

To this end, contact us for a comprehensive review of your communication access policy and procedures to mitigate any risks and compliance issues.