Effect of Clinical-Community Situation on Patient Care - Assignment Example

? Language Barrier Introduction Migration is undeniably a global phenomenon and presents major implications for host healthcare systems, given that they necessitate attending to the health and social needs of ethnically and linguistically diverse communities of migrants. In the past four decades, UK has attracted immigrant from all over the world with the bulk of emigrating from Africa, Caribbean, Asia, and the rest of Europe. The resulting rise in ethnic, cultural and linguistic diversity has been accompanied by a significant and rising need for language access services within the health settings. The issue of language barriers within the health care settings has drawn significant attention, especially increasing incidents of the language barrier within the health delivery within the community.1 Evidence of the significance of communication within the effective provision of healthcare implies that language can be a prominent barrier to accessing health and social care services. The paper explores the present multilingual landscape that may herald challenges to the provider and users of health and social care services. The paper concludes that there is an urgent need to pay more attention to the implementation of policies that respond to language barriers within England. The core emphasis should rest on supporting service users’ engagement and participation. Background In the UK, estimates of the number of persons facing difficulties in conversing in English broadly differ, from 400,000 to 1.2 million. UK is becoming an increasingly diverse society with close to 7.9% of the population coming from black and other minority ethnic groups. This represents a significantly heterogeneous group manifesting diverse migration and settlement patterns, culture, and language. In England, individuals from four main minority ethnic communities (Pakistani, Indian, Bangladeshi, and Chinese) may encounter difficulties in communicating effectively with a health professional. The issue of the language barrier in patient care remains largely experienced in delivering care to underserved communities, especially minority ethnic communities within England. Patients coming from cultural minority groups may be subjected to the impacts of low health literacy compared to patients from the dominant culture owing to the interactions between literacy, cross-cultural communication barriers, inclusive of language and the experience of bias.2 English-born patients would be capable of depending on English proficiency and familiarity with the NHS healthcare system, whereas the refugee lacks experience in such areas. Individuals, families, and communicates have systematically experienced social and economic disadvantage that impedes on attainment of optimal health. The disparities within health, safety, and well-being can be cited as a significant factor that impacts on the attainment of the full potential for health. This has largely been my motivation in pursuing my professional practice in underserved localities within the UK (in the City of London). Discussion Nurses in the contemporary healthcare environment provide care, education, and case management to an increasingly diverse population that faces a myriad of linguistic, cultural, and literacy barriers. Several health practitioners have reported that language barriers present a considerable impediment to quality care and a source of stress within the workplace. Language barrier may yield to cases of incomplete nursing assessments, misunderstood medical information, and absence of therapeutic relationships between providers of healthcare and patients.3 The moment that a patient visits a clinical member of a treatment team the clinician employs available knowledge base to shape decision on the information to collect, and how to collect the data. The clinician, as well as other members of the team, collects the data via conversations with the patient, observation of the patient, mental and physical examination, imaging and laboratory testing. This shapes the patient’s diagnosis and prognosis, and, ultimately, the treatment plan. The bulk of this information derives from oral and written communication between the patients, their families, and the team members. Collection of accurate and comprehensive patient specific data shapes the foundation of proper diagnosis and prognosis; eliciting informed consent; engaging the patient within treatment planning; and, availing explanations, instructions, and education to the patient and the patient’s family.4 In the absence of comprehension, there cannot be effective communication, and where effective communication is absent, the provision of healthcare ends-or accompanied by errors, poor quality, and risks to the patient. The challenge of the language barrier is most dominantly experienced in health facilities located in places where most ethnic minorities live. The inability to communicate effectively in English can generate barriers, misunderstandings, and misconceptions within patient-health professional relationship. Indeed, patients themselves point out ineffective communication as prominent cause of unsatisfactory experiences of health services. Moreover, the patients are unlikely to engage in and contribute to their local community. Absence of effective communication generates situations in which medical errors can easily occur. Medical errors, especially those generated by ineffective communication are dominant problem in contemporary health care organizations. Communication failure is a leading cause for medical errors and delays in treatment. Medical education emphasizes the significance of error-free practice, employing intense peer pressure to attain perfection within both diagnosis and treatment. In cases where patients with limited English proficiency are attended by physicians, as well other health professionals who are only proficient in English, a triple threat can be created, which impedes on the attainment of effective communication. First, the language barrier is itself a barrier to the attainment of effective communication, whereby the patient and the clinician may underestimate the language barrier manifest between them yielding to poor patient care provision. Second the divergence in language may yield to cultural differences that frequently impede on effective communication. Third, low health literacy may be a barrier to the effective communication between the patient and the healthcare professional. In instances in which language or cultural barriers are highlighted, it frequently yields to the clinician exploring whether the patient comprehends her oral and written communication.5 While the healthcare system has at the forefront in promoting cultural competence in healthcare delivery as indicated by capability of healthcare systems in availing care to patients with diverse values, beliefs, and behaviours, inclusive of tailoring delivery to satisfy the patient’s cultural, social, and linguistic needs challenges still remain.6 Increasingly, the local community health facility is grappling with barriers to the provision of culturally competent care. Effective communication with patients remains critical to the safety and quality of care. Barriers to the attainment of effective communication encompass differences in language, low health literacy, and cultural differences. Evidence-based practices that minimize the barriers ought to be integrated into the healthcare work processes.7 Personal development such as earning a second language can be regarded as one way of overcoming the language barrier. However, learning a language does not necessarily translate to understanding a culture and individuals who share a culture may not share a common culture; hence, this presents a risk of underestimating the impact of cultural differences of cultural differences or stereotyping individuals based on their culture, which interfere with the effectiveness of communication.8 In contemporary healthcare system and delivery processes involve multiple interfaces with various levels of educational and occupational training. Team collaboration is pertinent given that when the communication between healthcare professional and the patient is ineffective, patient safety is at risk based on a number of reasons: absence of absence of critical information, overlooked change in status, and misinterpretation of information.9 Collaboration in healthcare necessitates that healthcare care professional assumes complementary roles and cooperative, sharing responsibility for problem-solving and undertaking decisions to formulate and carry out plans to promote patient care. The evaluating of the teamwork model within healthcare necessitates an application of an interdisciplinary approach. Another way of overcoming the challenge of the language barrier in health provision centres on taking up team roles and activities. Although, an extensive review of literature indicates that communication, collaboration, and teamwork do not always manifest in clinical settings, the social, organizational, and relational structures can contribute significantly to overcoming communicational failures proven to be significant contributors to adverse clinical events and outcomes. It is essential that healthcare practitioners foster the development of a cooperative rather a competitive agenda that benefits the overall patient care.10 A powerful incentive to the creation of teamwork among professionals draws from directing attention to the areas in which changes are likely to yield in measurable enhancements for patients that they serve. Health practitioners find themselves in an ideal position to foster the interconnections between the patient culture, health literacy, and language so as enhance health outcomes for culturally diverse patients.11 Nurses working with patients from increasing diverse cultural groups face challenges in effective provision of care at the system, patient and provide levels. Professional medical interpreters bear positive impact on clinical care for limited proficiency patients. Research has demonstrated positive benefits of professional interpreters on communication (errors and comprehension), clinical outcomes, utilization, and satisfaction with care. The capability for nurses to appreciate likely interaction between patients coming from different language and cultural background necessitates adaptation of open communication approaches and care plans. The attainment of systemic cultural competence (within the structures of the health care system) necessitates addressing initiatives such as conducting community assessments, and instituting mechanisms for community and patient feedback. Making on-site interpreter services available within health care settings can be regarded as one way of addressing the challenge faced by the healthcare practitioner when serving ethnic diverse populations. Conclusion It is apparent that high-quality medical care necessitates effective communication between patient and health professional. The complexity presented by language diversity may be compounded by the fact that, a significant number of doctors working within primary care in the UK are themselves, not native English speakers. Language diversity aids to propel shared understanding and knowledge of health beliefs and expectations among health care professionals; nevertheless, this becomes a problem when the healthcare professional attends to patients with non-functional English, which necessitates interpreting services. This may incorporate informal interpreters such as family members; however, this can be problematic when the issues explored are embarrassing, or when the informal interpreter’s language skills are poor. Although, good quality professional interpreting cannot entirely remove the language barrier, effective communication can be attained, which in turn, yields to enhanced patient care that is comparable to that accessed by English speaking patients. 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