Getting Started

If your organization is just beginning to address language issues, a first step might involve testing different methods of capturing, documenting and storing information about patient or member language needs.

Steps to Quality Improvement > Implementation > Patient-, Member- or Client-Focused Solutions

Different problems demand different solutions, and as in this example, some problems require multiple solutions. An organization might focus on patients, the community, individual practitioners or providers, or on the organization’s internal systems. Significant changes in outcome often require multiple changes that focus on many—or all—of these different elements, and integrate the different players involved in delivering health care.

Patient-, Member- or Client-Focused Solutions

These are changes intended to reach individual patients and support them in changing their behavior. Examples include providing the following types of language service.

• Interpreter services for patients or members with limited English proficiency
• Translated patient education material, consent forms or discharge instructions
• Low-literacy patient education materials
• Language-appropriate pharmacy consultations and prescription labels

Other patient-, client- or member-focused solutions provide support, such as doulas (for birthing support), promotoras (or health advocates), patient navigator services, transportation, daycare and other non-health care support services to improve patient adherence, overcome barriers to keeping appointments and increase trust.

In addition to addressing language needs and support services, organizations may offer culturally competent programs focused on disease prevention. For example, Chinese Community Health Plan and Health Resource Center have a bilingual Web site (www.cchrchealth.org) that provides patient-education materials in both English and Chinese for monolingual Chinese patients and for providers who want health education materials to share with their Chinese patients (as well as English-speaking family or friends). The site also lists various community health events, such as Chinese Community Fitness Day.

Health care organizations also provide linguistically appropriate disease management programs, and glossaries or other tools to help people from different backgrounds understand how the health care system works. By considering the specific cultural values of the target population, these programs engage members of the community.

Health Net of California’s Salud con Health Net initiative is aimed at “meeting the needs of California’s Latino community with culturally competent care.” It is the first cross-border health care plan to offer affordable, high-quality care in California and Mexico through community-based and international partnerships, education and outreach. Salud con Health Net also offers a network of health care providers and organizations with extensive experience serving the Latino community. Health Net responded to community needs by opening its Community Solutions Center in East Los Angeles, the heart of the Latino community, to provide the face-to-face interaction that members said they wanted from their health plan. The plan also sponsors ProfMex, a nonprofit research organization specialized in Mexican studies, to produce Spanish-language informational guides to educate Latinos about the U.S. health care system and medical insurance.^ibid