Barriers are Falling! The Future of Accessibility for Deaf, Blind, and Non-English-speaking Patients

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HC organizations will be held accountable for providing accessibility such as the scenarios below in the near future. Health care entities are just beginning to visualize what is needed for equal access and accommodation. Many of the solutions outlined below are not yet developed or installed in many places, but all of them are within our technical ability to implement.

Imagine that you are blind, coming to…

this hospital for a clinic visit, a blood draw, and an imaging study. These are spaced far from each other. You have no picture in your mind of the layout of this place. As you enter the main door you make your way to the Information Desk and ask about the location of your three target areas. The volunteer tells you she has a Braille map with raised outlines of the parts of the hospital for you to borrow. There are three sheets because your target areas are on three separate floors. The volunteer guides your finger over the outlines so that you can orient yourself. She also offers to escort you to the first set of elevators herself. You feel confident about being able to find your way.

Imagine that you come from a small village in Guatemala…

You have been directed to the Outpatient Pharmacy in the medical center with a new prescription to fill. You have no idea what to do to be served. Patients are sitting in the waiting area and the staff person at the one open window is deep in conversation with a patient. Then your attention is caught by a colorful display on the wall. There are icons placed on a diagram of the room you are in, showing you where to put your new prescription, where to wait, and where to look for your name when your prescription is ready. You are confident about how to proceed. You are very relieved because you do not speak English and you cannot read well in any language.

Imagine that you are at the Admitting Desk…

being admitted. The Admitting clerk is talking to you with the help of a Cambodian interpreter on the phone. You will have to give consent to several statements, which are long and complex. In the past you have just signed whatever papers were put before you, with no comprehension of their meaning. The clerk gives you a headset to put on your head, then she clicks on her keyboard and you begin to hear the HIPAA short form spoken to you in Khmer. The recording finishes. You feel confident to sign the HIPAA form. This repeats with the consent for care and the financial agreement. The registrar takes back the headset and continues talking with you with the help of the phone interpreter. For the first time in all the years in America you know what you have signed and you know what your rights and responsibilities are.

Imagine that you have relatives who speak English, but you do not want them involved

Imagine that you are an established patient of Hospitality Hospital. In the past, whenever you had a question for your doctor or pharmacist or nutritionist you would call their number. You would leave a message saying please call me with an interpreter, and they would. Now the hospital has a patient portal. Patients have to have a computer, log onto the portal with a password, and then navigate through the menus in English. You have relatives who speak English, but you do not want them involved in the details of your care. You are pretty frustrated with the portal. You are making fewer appointments and getting your medications filled at an outside pharmacy instead of at the hospital where it was cheaper. It is difficult for you and for your care team to keep your med list accurate.

Then one day you log onto the portal and it greets you in your language! You look at the screen and for every menu item there is a colored, BOLD explanation in your language! You can hover over any of these lines and it reads you the words out loud in your language. You feel welcome! You push your luck. You type a message to your nurse into the message box in your language. The portal supports different language fonts. What will happen to your message? Later in the day you get a ping on your email to alert you to go to the portal. You have a reply from your nurse, in your language! Your message and your nurse’s reply were rapidly translated by a professional translator.

Imagine that you are Deaf, and you will soon be delivering your baby…

at the Medical Center. The Admitting Office pre-registered you for the admission. They gave you a URL for a virtual tour of the Labor and Delivery suites. At home, you access the URL on your tablet. The tour is a video in which a nurse describes each part of the L and D area. You cannot hear the narrative, but by clicking on the icon of an ear in the navigation bar, you can see a sign language interpreter sign the entire presentation.

All of these accommodations are necessary in order to make information and communication accessible across language barriers. The language access program manager can lead the way for colleagues in IT, Marketing, Nursing, Patient Services, and units which deliver direct care by describing barriers that patients might face.

Do you have equal access innovations? Please share your innovative approaches to providing language access in the comment section below.

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