Ignore regs at your peril - JCAHO's interested, too
This facility's 29th language is sign
Make sure your hospital won't be among those paying dearly because they neglect to heed federal regulations regarding hearing- and speech-impaired patients. Not only are patients bringing lawsuits against offending institutions, but facilities stand to lose even more because the Joint Commission on Accreditation of Healthcare Organizations in Oakbrook Terrace, IL, is making sure that the rights of hearing- and speech-impaired patients are not being violated.
Pat Staten, associate director and team leader at the Joint Commission, says the accrediting agency looks to hospitals to have a mechanism in place for meeting the patients' communication needs. However, she says, "The standard is not one of our most frequently cited. It doesn't rank in our top five noncompliances - the ones that drive random, unannounced surveys." She says the reason the Joint Commission hasn't had major problems with hospitals not complying with communication requirements is that they have the higher priority of complying with the federal Americans with Disabilities Act.
The Joint Commission requirement is addressed in the section on patients' rights and organizational ethics, Standard RI.1.3.6: "The hospital has a way of providing for effective communication for each patient served, including the hearing- and speech-impaired."
"Communication and information are important areas of rights and respect for patients," Staten says. "That standard includes the provision of interpreters of foreign languages as well."
If a hospital scores a "5" on "Does the hospital provide effective communication for all patients, including the hearing- and speech-impaired?" that one score would not result in loss of accreditation, Staten says, but it could go directly to the grid. And a number of 5s on the grid score could result in eventual loss of accreditation or conditional accreditation.
Signing translation also is addressed in the patient-family education standard, where the requirement is to provide education in a language the patient understands: "Hospital identifies and provides the education resources required to achieve its educational objective."
In June, a Newark, NJ, hospital agreed to pay $700,000 to four hearing-impaired people who were denied sign-language interpreters. Attorneys said the patients visited the 400-bed Jersey City Medical Center 300 times over a 10-year period. As a result of the lack of interpreters, one patient who was HIV-positive didn't receive counseling.
Federal law has required sign-language interpreters in hospitals since 1973, yet most facilities don't provide them, said a plaintiffs' lawyer in the case. Jersey City's president said his hospital now has interpreters available in 28 languages - sign language will be its 29th. Signage to that effect will be posted in the admissions office and emergency department, and hearing-impaired patients will have access to amplified telephones.
Thirty-two Connecticut hospitals have established statewide round-the-clock sign language interpreters for the deaf or hard of hearing, resolving a class action lawsuit alleging that Connecticut hospitals were violating the Americans with Disabilities Act by failing to provide sign language interpreters. The agreement is expected to be approved by the court and the class of plaintiffs.
The hospitals agreed to set up a statewide on-call system to provide qualified sign language and oral interpreters 24 hours a day, seven days a week; provide telecommunications devices that enable the hearing-impaired to use public telephones throughout the hospitals and, when requested, in patient rooms; add visual alarms where audible ones now exist; train employees and volunteers in communicating with the deaf and provide special training for emergency, psychiatric, and social workers; post signs advising that sign language interpreters and other aids for the hearing-impaired are available free; and offer training to all affiliated doctors.
Fourteen of the hospitals will pay a total of $333,000 in compensation to 54 deaf, hard-of-hearing, or other people who were affected by the lack of effective communication. They also will pay $20,000 in attorney fees to the state Office of Protection and Advocacy, which brought the original class action suit against 10 hospitals.
Recently, the Justice Department also intervened in and resolved a lawsuit against Maine Medical Center of Portland. Under an agreement approved last spring by a federal court, Maine Medical Center will provide sign language and oral interpreters and other aids necessary for hospital workers to communicate with the hearing-impaired.
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