The Quality Report - July 2010

A monthly report on the RWJF Quality/Equality program area

July 2010

Improving Quality of Care for Patients Who Speak Little English

For many patients, talking about their own health care can feel like speaking a foreign language. For others, it literally is. Approximately one-sixth of the U.S. population speaks a language other than English at home. Every year, hospitals admit more patients with limited English proficiency (LEP), who speak English as a second language, or not at all. In many instances, these hospitals do not know how to communicate effectively with these patients—or measure whether they are doing so. This lack of communication between patients and hospital staff can create big gaps in the quality of care that is delivered.

Overcoming language barriers is a key component of hospitals’ efforts to provide high-quality care. But creating the processes necessary is no easy task for one hospital to tackle alone. That’s why the Robert Wood Johnson Foundation is working to address this issue as part of its Aligning Forces for Quality initiative.

Hospitals across the 17 Aligning Forces communities have the opportunity to participate in a learning collaborative that helps them improve the delivery and availability of language services for patients with limited English proficiency, improve the safety of LEP patient care, and implement performance measurement efforts to improve language services.

Early participants are implementing improved processes for identifying LEP patients immediately upon admission, and noting their written and spoken language preferences. The data collected during the registration process is then used to deliver better-informed, more culturally sensitive care to patients who prefer to speak and write in a language other than English.

One way to deliver equitable care is to have professionally trained translators on-site, or alternatively, bringing in translators when an LEP patient is admitted (either through the telephone or other electronic methods). Without this, hospitals too often rely on family members or hospital staff members who happen to be bilingual, but are untrained in medical interpretation.

To discover more about RWJF’s efforts or to access tools developed from RWJF-sponsored programs:

Aligning Forces for Quality Update

Willamette Valley, Oregon Highlights Involvement of Patients in Decision-Making
On June 10, the AF4Q community in Willamette Valley, Ore. released a report highlighting patient and family involvement in health care decision-making. In conjunction with the report, community health care leaders hosted a panel to discuss best practices underway in the state. More than 80 people were in attendance, including representatives of local medical groups, health plan leadership and patient advisors.

See the report.

Report Shows Care for People with Diabetes Improving in Cleveland
Better Health Greater Cleveland released its fifth Community Health Checkup in late June, showing that the region is gaining momentum in improving care for people with chronic conditions—particularly diabetes, heart failure and high blood pressure. In the case of diabetes, almost half of area patients (48%) received all of the recommended tests (for kidney function, cholesterol and blood sugar control) and immunizations (for pneumonia)—an improvement of nearly 10 percentage points since 2007. For local patients with hypertension, 68 percent had their blood pressure under control in 2009, significantly higher than the national rate of 50 percent.

See the report.

Latest from RWJF Quality/Equality

Catch up on the latest news releases, journal articles, research reports or other publications in the RWJF Quality/Equality program area.

Report: Physicians and Defensive Medicine

This report focuses on defensive medicine—delivering more procedures and tests in hopes of deterring potential malpractice claims—which can cause overuse of health care services, and is frequently cited as a major cause of increased health spending.

Read the report.

Newsletter: PROMETHEUS Payment Reform

The quarterly newsletter provides brief updates on the latest work to transform health care payment in real communities.

Read the newsletter.

Papers: Recommendations for Payment Reform

There is widespread belief that to improve the quality of health care that is delivered in the U.S., fundamental changes must be made in the way it’s paid for.

Webcast and Issue Brief: Measuring Emergency Department Performance

New materials from the RWJF-supported Urgent Matters program highlight progress a series of hospitals made in developing ED performance measures and using them to improve operations.

Issue Brief: Creating a Sustainable Future for Medicaid

With the passage of health reform legislation and the expansion of Medicaid in 2014, states will soon bear the responsibility to purchase cost-effective, quality insurance.

Read the brief.

07/13/2010