In oncology, providers treat patients from all backgrounds and with unique histories and experiences. It is therefore imperative to recognize and understand patients' personal characteristics to create effective treatment plans.
A detailed intake form lays the groundwork for building rapport between patients and their health care providers. When designed thoughtfully to ask enough of the right questions, the intake form gathers critical information and serves as an opening volley in a conversation grounded in trust. “There’s just a lot that I want to know about my patients,” says Maysie, a character portrayed in ACCC’s Beyond Barriers: Speak Clearly, Care Deeply video. “I’d like to know something about their home life, if they have enough to eat ,” she continued. “I’d like to know about their mental health, what kind of stressors they’re experiencing. And then, of course, I want to know what languages they speak and what language they prefer.”
But a form, by its very nature, cannot do all the work—health care teams must act on the information contained in an intake form and equip practices with tools to support their patients. Communication can be a stumbling block if patients and family members in an examination room aren’t equally fluent in or comfortable with the language spoken by the provider even if an ad hoc interpreter is present. In the video, Maysie describes the technical details of a clinical trial too quickly for a Spanish-speaking patient’s bilingual son to translate effectively. When she realizes her misstep, Maysie says, “I can’t believe I did that. I just talked right past him.” Her chagrin prompts her to take action.
Beyond Barriers is the third and final video in the Personalizing Care Video Series, which depicts real-world experiences observed in the community care setting to help multidisciplinary teams better tailor care. In oncology, as in every branch of medicine, providers treat patients from all backgrounds and with unique histories and experiences. Choosing and customizing effective treatment plans is contingent upon recognizing and understanding patients’ personal characteristics including culture, language, religion, financial status, education, and gender and sexual identity. If those facets of a patient’s identity are ignored, cancer programs risk perpetuating established disparities in care and outcomes, several of which are detailed in this Executive Summary on personalizing care for patients of all backgrounds.
As Maysie seeks a speedy workaround in the video, she first asks her bilingual colleague Ricardo for help in translating. He quickly acknowledges that he isn’t a certified medical interpreter and points Maysie toward a helpful resource—an online translation service that offers video to communicate with patients who aren’t fluent in English. The service bridges the linguistic gap via use of a tablet, which allows face-to-face clear communication between the patient/care team and the interpreter.
Inspiration for similar solutions can be found in ACCC’s comprehensive Resource Library, which contains a collection of articles and tools that explores language and cultural barriers, cultural competency, telemedicine, and metrics for gauging organizational health equity in practice. The swirl of terminology relating to cancer diagnoses, treatment regimens, and clinical trial information renders effective communication all the more crucial. Further, the complexity and technical nature of those conversations calls for a standardized process that levels the playing field linguistically rather than relying on momentary stopgap solutions that might compromise the quality of care.
As a complement to the Personalizing Care Video Series, ACCC has also developed an infographic that explores the lack of connection some providers and patients perceive in their conversations with each other as recorded in surveys. To counter that imbalance and enhance the overall quality of communication, the infographic offers practical tips such as being attentive to nonverbal expressions like body language, tone, posture, and eye contact and using the teach-back or repeat-back method to ensure patient understanding.
At the end of Beyond Barriers: Speak Clearly, Care Deeply, a particular takeaway for health care provider resonates—practicing humility and regularly reflecting on how well the provider personalizes patient care. Maysie exhibits humility as she reflects on the experience with her patient, acknowledging that she still has a lot to learn. “It’s one thing to ask about someone’s preferred language on the intake form,” she says, “and another thing to be ready to discuss sometimes life-or-death information with them in the way that they will best understand.”
View the Personalizing Care Video Series, made possible with funding and support provided by Pfizer Oncology, in its entirety here.
