Effective communication between patients and providers is increasingly recognized as an important risk-management issue, cost-containment factor, and essential component of quality health care and patient safety.
Change to our health care system is a constant, and ASHA is working hard to keep abreast of both the challenges and opportunities for our discipline. We all can appreciate the importance of health care advocacy, evidence-based practice, and ethics. This focus has recently led me to contemplate the role of speech-language pathologists, audiologists, and ASHA in promoting, implementing, and measuring the impact of effective patient-provider communication.
No matter what your clinical setting, this message is for you. We are all health care consumers from time to time, and so are our clients. ASHA's vision and mission statements mandate that we support the rights of all people to communicate. Therefore, when there is a widespread problem with communication, we ought to be talking about it and trying to lend a hand. I am advocating for action.
Based on data from NIH and MarkeTrak VII, estimates of "communication-vulnerable individuals" in health care settings in the United States include 22 to 31 million people with hearing impairments and 46 million with "disordered communication," as well as roughly 90 million people with limited health literacy, 40 million with limited English proficiency, and an unspecified number with cultural, sexual, and religious differences. That figure is more than two-thirds of the entire population.
Importantly, research has demonstrated that effective communication between patients and providers increases the likelihood of (1) positive patient outcomes, (2) accurate diagnoses and timely treatments, (3) patients and family members understanding and adhering to recommended treatment regimens, (4) greatly improved patient safety, and (5) patient and family satisfaction with the care they receive (e.g., Ong, de Haes, Hoos, & Lammes, 1995; Rao, Anderson, Inui, & Frankel, 2007; Stewart, 1995).
On the other hand, communication breakdowns among patients, their family members, and health care staff contribute to such serious problems as medical errors, inadequate pain relief, extended hospital stays, increased costs, and patient anguish and disorientation. Effective communication between patients and providers, therefore, is increasingly recognized as important. Some of our colleagues who provide augmentative communication services are already demonstrating the value of their services to a broad spectrum of patients in intensive care units and emergency rooms, and at bedsides.
The need for improved communication between patients and providers creates a window of opportunity for ASHA and its members. As new federal laws, regulations, guidelines, and standards mandate improved patient-provider communication, the time is now to step up and advocate for our role. As communication experts, we bring skills in assessing, diagnosing, and treating communication disorders and in helping people communicate more effectively. In addition, we promote augmentative communication strategies and the elimination of societal, cultural, and linguistic barriers. We need to work collaboratively with our colleagues in interpreter services, nursing, medicine, allied health, dietary, emergency medicine, pharmacy, compliance, administration, and pastoral care.
We have to demonstrate the value of our treatment procedures with outcome data as we hold paramount the welfare of our clients. I recommend Becky Sutherland Cornett's article on health care reform and speech-pathology practice (The ASHA Leader, Aug. 3, 2010). We also need to promote public understanding of the professions by supporting the development of services designed to fulfill the unmet needs of the public (Code of Ethics, Principles 1 and 3). ASHA works diligently through our Health Care Economics Committee to ensure that speech-language pathology and audiology services are appropriately valued and that procedure codes cover the services we provide. It is up to us to collect data to obtain reasonable reimbursement values from the Centers for Medicare and Medicaid Services. History strongly suggests that if we do the right thing, the money will eventually follow.
We bring well-established, evidence-based practices, an understanding of communication processes, and a long history of working with other disciplines to any table. I have little doubt the reimbursement codes will follow, because the Health Care Economics Committee can advocate for new codes. Moreover, patients need to access communication supports 24/7.
Effective patient-provider communication is a health care advocacy issue. Let's apply our unique training and expertise to solving a national problem.