1. Health Care Navigation & Resources
Kheir Mugwaneza, Immigrant Health, Center for Inclusion Health. AHN
Alicia Moore, Senior Project Manager, Executive Nursing. AHN

2. Agenda Introduction Why It Matters
Current State: AHN Policy and Interpretive Services
Additional Community Resources
Call to Action 2

3. Current Laws and Regulations
Introduction
AHN Summary
Establishing a strategy to assist limited English proficiency patients
Stratus Video Remote (VRI)/Phone (OPI) Interpretation implementation
Interpretive service standardization and expansion
Services included:
Video
Phone
In-person
Document Translation
Inclusive of inpatient and Allegheny Clinic facilities
Improved staff/provider education on diverse patient needs
Current Laws and Regulations
Title VI of the Civil Rights Act, 1964
Executive Order 13166
Title III of the Americans with Disabilities Act, 1990 3

4. Current Laws and Regulations: Title VI
Services that are more limited in scope or lower in quality
Unreasonable delays in the delivery of services
Limiting participation in a program or activity
Providing services that are not as effective
Examples of practices
which may violate Title VI:
Any organization or individual that receives Federal financial assistance, either directly or indirectly, through a grant, contract or subcontract, is covered by Title VI.
Example of covered entities:
Hospitals
Health service providers
Nursing homes 4

5. Why It Matters Clear communication Mutual understanding Instructions
Potential litigation
Healthcare Barriers
Treatment/diagnosis misunderstanding
Fewer visits
Delay in preventative services
Exacerbation of chronic condition
Longer hospital stays
Poor patient satisfaction rates
Fiscal impact 5

6. Accessing AHN Interpretation Resources
Review of Network Policy
Current Services Provided
Obtaining Interpretive/Translation Services
Defining the Strategy Ahead 6

7. Policy Overview – Introduction
Policy Statement
Effective patient-provider communication is necessary for quality and patient safety. Research shows that patients with communication problems are at an increased risk of experiencing preventable adverse events, and that patients with Limited English Proficiency (LEP) are more likely to experience adverse events than English speaking patients. Patients may have hearing or visual needs, speak or read a language other than English, experience difficulty understanding health information, or are unable to speak due to their medical condition or treatment. Additionally, some communication needs may change during the course of care.
Goal:
To ensure provision of the most effective communication between the patient and his/her provider in a manner that meets the patient's needs. The key to deciding what aid or service is needed to communicate effectively is to consider the nature, length, complexity, and content of the communication, as well as, the person's preferred method(s) of communication. AHN entities are encouraged to consult with the person with a disability to determine what aid or service is appropriate.
Codifies AHN’s commitment to patient centered care through effective communication
Outlines best practices for effective communication and obtaining interpretive and/or translation services
Applies to AHN hospitals, Surgery Centers, Allegheny Clinic facilities 7

8. Policy Overview – Summary
Any patient and/or companion who is limited English proficient or deaf or hard of hearing must be offered interpreter services or auxiliary aids free of charge at point of contact
Family, friends and non-qualified employees may not be used as interpreters unless a qualified interpreter is declined by the patient and the former is requested
Minor children should never be used as interpreters; they may be used for non-critical communication
In emergency situations, it is appropriate to provide any necessary medical treatments and use best efforts to provide the most effective communication possible until the interpreter arrives
 initial point of contact includes (registration, emergency department, outpatient or inpatient area). 8

9. Policy Overview – Summary
Examples of critical points where qualified interpreter is required:
Admission for inpatient care
(Patient Rights, Advance Directive, Admission Assessment)
Informed consent
Treatment and procedure explanations and results
Discharge
As deemed necessary by caregivers to provide information to the patient or to receive information from the patient
Full policy available on PolicyStat:
Communication: Auxiliary Aids and Language Assistance
Services/Interpreters 9

10. *Video Remote Interpretation
Current Resources
*Video Remote Interpretation
Phone Interpretation
In-person
Interpretation
TDD/TTY Devices
Document Translation 10

11. Obtaining Interpretation/Translation Services*
Contact House/Hospital Operations Administrator or Unit Manager
Can coordinate the delivery/pick-up of interpretation devices such as I-Pads or phones
Note site-specific variations in who to contact
HOA’s are first point of contact on off-shifts
Call/ Stratus Video for Document Translation
Requests for translation at AHN must be submitted directly from the facility to the Document Translation Coordinator
Iris Dittmaier Ext. 565
Requests may also be submitted online
Coordinate Directly with Community Providers
Includes:
Center for Hearing and Deaf Services (HDS)
TransPerfect
Truspoint
Reference Hospital or Facility Flow Chart When Needed
Available as addendum to policy on PolicyStat
Flow charts available for all applicable faciltities
Includes directions for I-Pad/phone use
Contact Variations: Nursing Administration (WPH); Patient Access staff (WXF); Patient Relations/LC (SVH); or Case Management/Social Work 11

12. Strategy Moving Forward
Education
Resources
Policy/Process
Partnership
Standardized and improved education around culturally and linguistically appropriate care
Expansion of high quality, contracted service providers to support the network (In-person, Video/Phone, Document Translation)
Improved aids for language identification and service requests
Review of current system processes to improve clarity on documentation requirements, procedures for identifying appropriate interpretation modality with patient
Strengthen medical, nursing, ancillary services collaboration and coordination regarding communication aid/services 12

13. Social Service Providers
Additional Resources
Online Resources
Social Service Providers
Practical Guide to Culturally Competent Care:
HSS Office of Minority Health:
Federal Interagency Working Group on LEP:
National Consortium for Multicultural Education for Health Professionals:
Refugee Resettlement Agencies: AJAPO; JFCS; NAMSC
Latino Immigrants: Casa San Jose, Latino Community Center, Latino Family Center
ISAC (Immigrant Services and Connections): 13

14. Additional Resources Think Cultural Health Resources
Office of Minority Health Resource Center
Resources
Education (Nurses, Physicians, Administrators)
Culturally and linguistically competent nursing care, including a self-awareness tool and strategies for delivering . Patient-centered care.
Communication and language assistance, including how to work effectively with an interpreter.
Organizational CLAS-related activities, including strategic planning, staff training, and community partnerships. 14

15. Join AHN Immigrant Health Quarterly Meetings
Call to Action
Join AHN Immigrant Health Quarterly Meetings
Be a champion at your facilities
Plan events and activities to raise awareness
April: National Minority Health Month
June: Immigrant Heritage Month 15

16. Questions ? 16