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A toolkit for collecting race, ethnicity, and primary language information from patients.
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Tools and Resources

TOOLKITS

AHIP's Data as Building Blocks for Change:  A Data Collection Toolkit for Health Insurance Plans/Health Care Organizations (PDF) supplies health insurance plans and health care organizations with the building blocks to create change and improve the care for all Americans.  This toolkit serves to expand the general knowledge about the issues surrounding data collection and its potential impact for identifying disparities and measuring quality improvement.

Conducting a Cultural Competence Self-Assessment (PDF), developed by Dennis Andrulis of SUNY/Downstate Medical Center, is a self-assessment for health care organizations wanting to conduct an audit of cultural competence.  In addition to revealing opportunities for an organization to make itself more attractive to diverse populations, conducting the self-assessment is a statement to the workforce, patients, and community that the organization values diversity and desires to increase its cultural competence.

Language Services Action Kit – Interpreter Services in Health Care Settings for People with Limited English Proficiency (PDF), National Health Law Program and the Access Project, February 2004, designed to support individuals working to ensure that people with limited English proficiency receive appropriate language services in health care settings.

Making Public Programs Work for Communities of Color: An Action Kit for Community Leaders, Minority Health Initiatives Department, Families USA, January 2006, provides community leaders with the information, tools, and resources necessary to engage in health advocacy and improve the health and well-being of their communities.

Patient-Centered Communication for Vulnerable Populations, the Ethical Force Program, American Medical Association (AMA).  This program provides a set of measures for health care organizations to address patient-centered communication for vulnerable populations.

GUIDELINES/STANDARDS

Joint Commission

Crosswalk (PDF), the Office of Minority Health (OMH) National Culturally and Linguistically Appropriate Services (CLAS) Standards crosswalked to the Joint Commission 2006 Standards for Hospitals, Ambulatory, Behavioral Health, Long Term Care, and Home Care.

Joint Commission 2006 Hospital Requirements Related to the Provision of Culturally and Linguistically Appropriate Health Care (PDF), Joint Commission on Accreditation of Healthcare Organizations, 2006.

New Requirement at Standard IM.6.20 for the Collection of Information on Language and Communication Needs (PDF), Joint Commission on Accreditation of Healthcare Organizations, January 2006.

U. S. Department of Health & Human Services, Office of Minority Health

ADA Business Brief: Communicating with People Who Are Deaf or Hard of Hearing in Hospital Settings (PDF)
U.S. Department of Justice, Civil Rights Division, October 2003.

Civil Rights Clearance for Medicare Provider Certification
U.S. Department of Health & Human Services, Office for Civil Rights, last revised December 22, 2006.

Guidance to Federal Financial Assistance Recipients Regarding Title VI Prohibition Against National Origin Discrimination Affecting Limited English Proficient Persons, U.S. Department of Health & Human Services, Office for Civil Rights, last revised October 4, 2006. 

National Standards for Culturally and Linguistically Appropriate Services in Health Care (Final Report; PDF), U.S. Department of Health & Human Services, Office of Minority Health, March 2001.

GENERAL RESOURCES

Cultural/Ethnic/Racial

Bridging Cultures and Enhancing Care: Approaches to Cultural and Linguistic Competency in Managed Care (PDF), a 38-page report that highlights events of a national conferences sponsored by the Health Resources and Services Administration and American Public Human Services Assocation. Includes write-ups, recommendations, and tips on the Effects of Race and Ethnicity on the Delivery of Quality Health Care, Building Cultural Competence in Organizations, and Cultural Competence and Linguistically Appropriate Services in the Clinical Setting.

National Healthcare Disparities Report (PDF), 2006, provides an overview of disparities in health care among racial, ethnic, and socioeconomic groups within the U.S.  The report also tracks the progress of activities made to reduce disparities.

Worlds Apart: A Film Series on Cross-Cultural Health Care, by Maren Grainger-Monsen, MD, and Julia Haslett, Stanford University Center for Biomedical Ethics (VHS, 47 min.)

Deaf and Hard of Hearing Populations

DeafLink
Communication access for deaf America

Hearing Loss Association of America
This is the nation's largest organization for people with hearing loss. The Hearing Loss Association of America exists to open the world of communication for people with hearing loss through information, education, advocacy, and support.

Interpretek
American Sign Language interpreting for the 21st century

The Interpreter's Friend

National Association of the Deaf
This organization's mission is to promote, protect, and preserve the rights and quality of life of the deaf and hard of hearing through position and legal statements, advisory letters to federal agencies, as well as providing informational materials on the deaf and hard of hearing.

National Association of the Deaf Info Center (How Do I Become An Interpreter?)

National Technical Institute for the Deaf Deaf Index

Pinky Tells the Real Story
Videophone and Video Relay Service

Registry of Interpreters for the Deaf

Registry of Interpreters for the Deaf Interpreter Service Locator

Signs of Development CD-ROM Interpreter Training

Interpreters/Language

Hablamos Juntos (We Speak Together)
Affordable Language Services:  Implications for Health Care Organizations (PDF), September 2005. This brief provides an overview on the effects of language barriers on patient safety and quality of health care, including challenges health care organizations must address to effectively overcome such barriers.

"I Speak" Language Identification Flashcard (PDF)
This document provided by the U.S. Department of Commerce Bureau of the Census contains a reference of 38 identified languages.

International Medical Interpreters Association
This organization acts as a clearinghouse for collecting and disseminating information regarding medical interpretation and translation, and promotes research into issues regarding cross-cultural communication within health care.  As one of the largest and oldest medical interpreter associations within the country, this organization also provides interpreting services in over 70 languages.

The Interpreter's World Tour: An Environmental Scan of Standards of Practice for Interpreters (PDF), prepared for the National Council on Interpreting in Health Care, funded by The Commonwealth Fund and the California Endowment, March 2005.  Summarizes standards of practice in the areas of general interpreting, health care/medical interpreting, court and legal interpreting, community and liaison interpreting, and conference interpreting.

A National Code of Ethics for Interpreters in Health Care (PDF), the National Council on Interpreting in Health Care (NCIHC), July 2004. 

Point-to-Talk Booklets, Massachusetts General Hospital, 2002. Award-winning booklets to aid limited English proficient patients in communicating with their caregivers. 

Providing Language Services in Small Health Care Provider Settings:  Examples from the Field (PDF), National Health Law Program, funded by the Commonwealth Fund, April 2005.  Provides an eight-step plan to help providers develop a strategy to meet the needs of their LEP patients and the community.

What a Difference an Interpreter Can Make – Health Care Experiences of Uninsured with Limited English Proficiency (PDF), The Access Project, April 2002.  Compares the perceptions and experiences of adults who got an interpreter with those who needed and did not get an interpreter.

ORGANIZATIONS/PROGRAMS

The American Hospital Association (AHA), supports the national focus on eliminating racial and ethnic disparities within health care, and supports the Health Research and Educational Trust on research projects aimed in providing tools to collect race, ethnicity, and primary language in hospitals.  This organization also sponsors the Institute for Diversity in Health Management—designed to promote racial and ethnic diversity in management and executive levels within the health care industry.

The Cultural Competence Leadership Fellowship Program of the Health Research and Educational Trust (HRET) supports leaders' capacity to address health care disparities and create care delivery systems that respond to diverse needs of communities.

Expecting Success is a national program of the Robert Wood Johnson Foundation aimed at improving cardiac care for U.S. minority populations.  The program consists of hospitals that are implementing quality improvement techniques to reduce health care disparities.

National Association of Health Data Organizations (NAHDO) assists organizations on improving health care through collection, analysis,  dissemination, public availability, and use of health data.

National Health Law Program (NHeLP)
HIPAA and Language Services in Health Care, report funded by The California Endowment.

Language Access in Health Care Statement of Principles: Explanatory Guide, October 2006.

Summary of State Law Requirements Addressing Language Needs in Health Care, updated January 2006.

National Public Health and Hospital Institute (NPHHI)
Serving Diverse Communities in Hospitals and Health Systems From the Experience of Public Hospitals and Health Systems (PDF), National Public Health and Hospital Institute (NPHHI), funded by the U.S. Department. of Health and Human Services, Office of Minority Health, June 2004. Presents strategies from the various programs and approaches currently underway in National Association of Public Hospitals & Health Systems (NAPH) institutions.

Office for Civil Rights
This Web site provides information on the agency's initiatives to assist hospitals in communicating with people who are deaf, hard of hearing, or who are limited English proficient.  This site also provides information on efforts to reach African American communities regarding health disparities and race discrimination.

Patient Race & Ethnicity: Improving Hospital Data Collection & Reporting (PDF), developed by the Health Research and Educational Trust (HRET) of New Jersey (an affiliate of the New Jersey Hospital Association) through a grant funded by the Robert Wood Johnson Foundation to improve hospital practices for collecting patient race and ethnicity data.





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