Think Cultural Health
Advancing Health Equity at
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Communication Tools

Effective communication matters. Mutual understanding between health professionals and the individuals seeking services from them helps ensure the provision of safe, quality health care. It is important that all individuals seeking care or services receive the same access to and quality of care regardless of their communication needs.

Language assistance services are a specific approach for facilitating effective communication. Examples of language assistance services include interpretation of oral communication, translation of written documents, signage, and symbols for wayfinding.

The Guide to Providing Effective Communication and Language Assistance Services

Think Cultural Health offers a Guide to Providing Effective Communication and Language Assistance Services. It is a tool to help you and your organization facilitate communication with the culturally and linguistically diverse individuals receiving care and services from your organization, including those with limited English proficiency (LEP).

The Guide covers strategies for communicating in a way that considers the cultural, health literacy, and language needs of your patients and their families. Two tracks of the Guide are available:

  • One is tailored to health care administrators, with information on planning, implementing, and evaluating effective communication and language assistance services.
  • One is tailored to health care providers (or those providing direct care and services), with information on cross-cultural communication skills, working with an interpreter, and more.

This Guide is grounded in the National Standards for Culturally and Linguistically Appropriate Services in Health and Health Care (or the National CLAS Standards), designed to advance health equity, improve health care quality, and help eliminate health care disparities.

Click here to access the Guide to Providing Effective Communication and Language Assistance Services!

Patient Points of Contact

Effective communication matters at every point of contact within an organization, not just in a direct care or service interaction.

The graphic below shows some of the points of contact between an organization’s staff and the patients it serves. Click on a point of contact to learn more about it.

  1. Image of Initial contactInitial contact

    An individual comes to your organization, whether in person during business hours, after hours, nights, or weekends, through an emergency room, through a telephone call, or through an online communication portal. Appropriate language assistance services, including interpretation services, translated materials, signage, and wayfinding, are provided.

  2. Image of Appointment schedulingAppointment scheduling

    An individual contacts your organization to schedule an appointment, whether in person, through a telephone call, or through an online system. For individuals with communication or language assistance needs, interpretation services and/or translated materials are available for this interaction.

  3. Image of Entering the organizationEntering the organization

    An individual enters your organization during business hours, after hours, nights, or weekends, or through the emergency room. Language assistance services for those entering the building are available, including multilingual signage and "I speak" cards.

  4. Image of Navigating the system/buildingNavigating the system and building

    An individual uses signage and wayfinding tools in the organization to navigate, and become oriented to the organization.

  5. Image of RegistrationRegistration

    An individual completes forms required by the organization, potentially with the assistance of staff or an interpreter. An individual's communication and language assistance needs should be determined and documented at this time to inform resource allocation and to help plan for any interpretation needs.

  6. Image of Preparation for visitPreparation for visit

    The organization prepares for the individual’s appointment by allotting staffing and communication and language assistance resources (e.g., available interpreters, having video remote interpreting (VRI) available, etc.) as needed by the individual.

  7. Image of Waiting in the lobbyWaiting in the lobby

    The organization provides informational materials (such as patient education materials) and signage in formats and languages most commonly used within the communities or areas served.

  8. Image of Initial care or service encounterInitial care or service encounter

    The organization provides an interpreter or other interpretation service, if necessary, and allots enough time for the appointment, taking into consideration the extra time needed for interpretation services.

  9. Image of Receipt of service or careReceipt of service or care

    An interpreter may be present during receipt of service or care. The provider verifies that the individual understands what is discussed during the appointment and ensures that the individual has opportunity to ask questions. The individual receives information and other instructions in a manner appropriate to his or her communication and language needs. The organization should have a way for departments and staff to communicate, so that everyone who interacts with the individual is aware of the individual's communication and language needs. If an interpreter is necessary, he or she accompanies the individual throughout the organization. Follow-up instructions, including referral processes, are explained to the individual in a manner appropriate to his or her communication and language needs. Outside organizations are notified of the individual's communication and language needs and are assessed to ensure they can accommodate these needs. If care involves pharmacy services, and these services are available onsite, all forms, prescription labels, and instructional sheets regarding prescriptions and refills must be provided in the individual's preferred language (note that some individuals may not be literate in their native or preferred language). If the individual is to receive pharmacy services from outside of the organization, efforts are made to ensure that the individual receives information and instructions in his or her preferred language.

  10. Image of BillingBilling

    The organization has a system for communicating internally between departments so that all staff, including those in the billing department, are aware of the individual's communication and language needs. If necessary, an interpreter accompanies the individual to the billing department or upon check out. The organization provides appropriate translated information on payment and health insurance, and how to seek assistance with the billing process.

  11. Image of RemindersReminders and follow-up communication

    Reminders and follow-up communication are sent to the individual (via mail and/or telephone) in a manner appropriate to his or her communication and language needs. The individual's contact information is confirmed, and his or her need for communication and language assistance is periodically re-assessed and documented.

  12. Image of FeedbackFeedback, complaint, and incident reporting

    The organization informs the individual of his or her right to file a complaint and provides an explanation of how to do so, in a manner appropriate to the individual's communication and language needs.