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Patient centered communication framework

The Ethical Force Program has developed a framework that will help organizations evaluate their communication policies and practices to ensure effective, patient-centered communication with people from diverse populations.

We have used the framework to develop a consensus report and performance expectations. The framework consists of five main content areas and three sub-areas (listed below); it is based on existing work and expert opinion.

In brief, when examining patient-centered communication capacity, organizations should assess performance in the following stages:

Content Area 1: Understand your organization's commitment
An organization should routinely examine its commitment, capacity and efforts to meet the communication needs of the populations it serves, including leadership involvement; mission, goals, and strategies; policies and programs; budget allocations; and workforce values

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Content Area 2: Collect information
An organization should use standardized qualitative and quantitative collection methods and uniform coding systems to gather valid and reliable information for understanding the demographics and communication needs of the populations it serves.

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Content Area 3: Engage communities
An organization should make demonstrable, proactive efforts to understand and reach out to the communities it serves, including establishing relationships with community groups and developing opportunities for community members to participate in shaping organizational policies.

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Content Area 4: Develop workforce
An organization should ensure that the structure and capability of its workforce meets the communication needs of the populations it serves, including by employing and training a workforce that reflects and appreciates the diversity of these populations.

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Content Area 5: Engage individuals
An organization should help its workforce engage all individuals, including those from vulnerable populations, through quality interpersonal communication that effectively elicits health needs, beliefs and expectations; builds trust; and conveys information that is understandable and empowering.

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Content Area 5a: Socio-cultural context
An organization should create an environment that is respectful to populations with diverse backgrounds; this includes helping its workforce understand the socio-cultural factors that affect health beliefs and the ability to interact with the health care system.

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Content Area 5b: Language
An organization should determine what language assistance is required to communicate effectively with the populations it serves, make this assistance easily available and train its workforce to access and use language assistance resources.

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Content Area 5c: Health literacy
An organization should consider the health literacy level of its current and potential populations and use this information to develop a strategy for the clear communication of medical information verbally, in writing and using other media.

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Content Area 6: Evaluate performance
An organization should regularly monitor its performance with regard to each of the prior content areas using structure, process, and outcome measures, and make appropriate adjustments on the basis of these evaluations.

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After the Ethical Force Program received and incorporated feedback from reviewers, the framework (including the content areas) was approved by the program's leaders through a voting process.

The consensus report on this topic outlines the content areas, rationales for the inclusion of each, exceptions and limitations that may need to be considered, and detailed performance expectations that organizations should be assessing. The performance expectations were also circulated for review and submitted for final approval, they form the groundwork for an organizational assessment toolkit that will soon be available from the AMA.

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