Care coordinators face countless challenges, and communication is one of the biggest. No matter how good you are at your job, communication breakdowns within circles of care create major problems.
The relationships between care coordinators and patients are fundamental to home and community care. In Ontario, they’re a large part of what keeps care patient-centred. So it goes without saying that when communication within these relationships is threatened, there are often consequences for patients.
The single biggest issue may be language barriers. What happens when a care coordinator doesn’t speak the same language as the new Canadians he treats?
The results can often be less than positive. Suboptimal treatment. Care that doesn’t align with patient preferences. Unnecessary health expenditures. And major headaches for care coordinators. These are just a few of the repercussions of major language barriers.
In this post we’ll look closely at this growing issue—and whether community care coordinators are equipped to deal with it.
A Mounting Set of Challenges
Between the years 2000 and 2015, almost four million permanent residents landed in Ontario. As this number continues to rise, the province must take steps to ensure these individuals have every opportunity to succeed. Ensuring physical and mental health will be key
Unfortunately, newcomers face unique challenges when it comes accessing health care. Language barriers are one of the most serious—especially when care is provided at home.
Home care practitioners know the importance of passing along information efficiently. If you work in the sector, you’ve almost certainly faced issues related to delayed, indirect, or unclear communication. These struggles frequently come up when patient information and care instructions are passed from one worker to another.
But as the number of Ontario newcomers grows, it’s becoming obvious that many patients struggle to understand their practitioners—and to be understood.
While most new Canadians speak either English or French, proficiency varies. An Indian-born resident who knows English well enough to get by at the post office may be unable to provide her thorough medical history. She may not know all of the terms her physician uses, or understand the language well enough to ask for clarification.
Of course, it’s not just doctors and nurses who speak directly with patients. In a province where patient-centred care has become the norm, those who coordinate care play a huge role in communication.
If you’re a care coordinator, you deal with patients who have complex sets of medical needs. You ensure that each patient’s needs are understood by his entire care team —along with his medical history, health goals, and care preferences. This is an incredibly difficult job in the best of circumstances. Throw in a language barrier, and patient-centred care begins to seem impossible.
Unfortunately, the costs of ignoring these communication challenges are high.
The Costs
There are inefficiencies in every sector, including health care. Luckily, creating strong circles of care can go a long way towards efficient care delivery. And it all starts with clear communication between a patient and her care coordinator.
But what happens when care coordinators have trouble understanding patients who speaks limited English or French? Let’s start with dollars and cents.
Across Canada, health care budgets are stretched to the limit. Policymakers are looking for cost-effective solutions. In many cases, home care fits the bill. At-home care is what most patients prefer, and it can be delivered at a fraction of the cost of acute care.
Unfortunately, shifting care increasingly out of hospital beds is no easy task. It requires a long-term revamping of existing health care systems. And here in Ontario, there are still plenty of kinks to work out.
Care coordinators are grappling with many challenges brought on by this shift. If you work in the community, you’re often dealing one on one with patients—without direct support from outside health care professionals. When you have trouble communicating with those you’re trying to help, your work becomes even more demanding.
Consider this shocking statistic. According to a recent study, a language barrier can triple the amount of care coordinator time it takes to complete an assessment. That time translates to a sizeable chunk of health care expenditures.
There are also many hidden costs involved in not dealing with language barriers. As just one example, doctors tend to over test when they don’t fully understand what a patient is telling them. Care coordinators can nip these situations in the bud—but only if they understand the patients themselves.
Sadly, the biggest and most significant costs aren’t monetary. Care coordinators are most impacted by the health and quality-of-life issues that poor communication has on their patients.
Solutions for Care Coordinators
For care coordinators who work in the community, overcoming language barriers is critical. Patients who aren’t easily understood may give up on trying to voice their health issues and concerns. In such circumstances, patient-centred care is never the result.
Common solutions are often haphazard and ineffective—not to mention risky. In traditional health care settings, practitioners frequently ask staff members who speak their patient’s language to interpret. In home care, family members are more often called upon to act as interpreters.
If you’re a care coordinator, you’re probably already aware that these are less-than-ideal solutions. There are dangers involved. Loved ones may withhold or distort information from patients, or offer invalid consent. Using children and youth can be especially problematic. (Sadly, kids can be psychologically damaged by this type of involvement in a loved one’s care).
And of course, confidentiality issues may also arise, which can land home care organizations in hot water.
Professional interpreters are key—specifically, professionals trained to perform translations in medical contexts. Sensitivity, precision, and confidentiality are just a few areas that the right interpreter should be adept in.
But the method of connecting interpreters, patients, and health care workers also matters. In home care, it’s not always possible to have all relevant parties in the same room.
The Globe and Mail notes that many health care facilities use translation phone lines. But these solutions can be both costly and unpredictable with regard to translation quality.
Luckily, innovation can help. New technologies are making circle-of-care communication easier (and more cost-effective) than ever before. From three-way videoconferencing to secure methods of sharing images and videos, apps can help newcomers receive exactly the care they need—even when language barriers are an issue.
Moving Forward
Language barriers can present serious challenges to community care coordinators. If you coordinate care for patients who live at home, you’ve probably felt concern when these barriers have arisen.
Luckily, in Ontario and across Canada, the future looks bright for newcomers seeking quality medical care. With the right technology and a basic understanding of how communication impacts health, those involved in coordination can make a real difference.
Feature image courtesy of Ken Banks
