Additionally, federal laws like Section 504 of the Rehabilitation Act of 1973 (Section 504) and The Americans with Disabilities Act of 1990 (ADA), require effective communication for people who are deaf or hard of hearing. The use of appropriate auxiliary aids and services when needed for effective communication are also required.
Communication Tips
Document the patient’s method(s) of communication. Include the patient’s method(s) of communication in your intake questionnaire and document in the patient’s medical record in a prominent location so that everyone in the office that may need to communicate with the patient can see it.
Use the right aid or service for the clinical moment. The healthcare provider is responsible for ensuring effective communication takes place and is responsible for the cost of providing an auxiliary aid or service, if needed. The key to deciding what aid or service is needed to communicate effectively is to consider the nature, length, complexity, and context of the communication, as well as the person’s normal method(s) of communication. Communication with the patient is necessary to discuss what aid or service is appropriate to achieve effective communication.
For example, new patient evaluations, informed consent discussions, discussions regarding serious conditions, etc. are situations where a qualified interpreter would be appropriate. Scheduling or basic follow-up instructions might be communicated effectively through written communication.
Federal law requires providers to give primary consideration to the choice of aid or service requested by the person who has a communication disability unless another equally effective means of communication is available, or that the use of the means the patient requests would result in an undue burden.
Do not rely on family members or friends as interpreters. Using relatives, friends, or untrained staff can compromise accuracy, privacy, and informed consent. Only allow the use of adult companions as interpreters if the patient requests it and it is clinically appropriate. Do not allow an adult companion to interpret if there is reason to doubt the companion’s impartiality or effectiveness.
If a companion is used as an interpreter at the patient’s request, document that professional interpreter services were offered, the patient declined, the name and relationship of the person interpreting, the patient acknowledged the potential risks, and the patient voluntarily chose this option.
Document consent for the communication aid(s) used. It is important to document your discussion with the patient regarding possible communication aid(s) and the patient’s consent for the communication aid(s) used.
If a professional interpreter was used, document the full name of the interpreter, the interpreter ID number (if applicable), the agency or vendor name (if contracted), the type of interpreter (in-person, video remote interpreter, on-site staff interpreter), and the language used (i.e., ASL).
The patient’s understanding of informed consent discussions, patient education, care instructions, questions, and any other communication should be documented along with the communication aid(s) used.
Thorough documentation demonstrates your respect for patient autonomy, regulatory compliance, valid consent, and effective communication. Proper documentation also mitigates risk in the event of a complaint, audit, or malpractice claim.
Conclusion
DHH patients should fully understand their diagnosis, treatment options, risks, and follow-up instructions so they can meaningfully participate in their care. Practices that proactively identify communication preferences, provide appropriate auxiliary aids and services, and document these efforts improve clinical accuracy, strengthen trust, and enhance the patient experience while reducing the likelihood of adverse outcomes, consent disputes, and patient dissatisfaction.
If you are not currently insured with PICA, take a moment to see how we protect our podiatrists. Fill out our online form to receive a free, no-obligation quote.
Disclaimer: The information contained on the PICA Blog does not establish a standard of care, nor does it constitute legal advice. The information is for general informational purposes only. We encourage all blog visitors to consult with their personal attorneys for legal advice, as specific legal requirements may vary from state to state. Links or references to organizations, websites, or other information is for reference use only and do not constitute the rendering of legal, financial, or other professional advice or recommendations. In the event any of the information presented conflicts with the terms and conditions of any policy of insurance offered by ProAssurance Insurance Company of America, the terms and conditions of the actual policy will apply. All information contained on the blog is subject to change.