Communication Access



Video only: “Hassle Factors” Communication Access


  • How to use Assistive Listening Devices (ALD) (2010).  PDF   Word (3.97MB)   Covers:
    • What are Assistive Listening Devices (ALDs)?
    • Benefits to the patient and health care provider
    • When to use, and
    • How to use.


  • Accessible Web-sites (last accessed 9.14.10) (Copyright ©2002 University of Washington) Covers:
    • What is an accessible web-site,
    • Guidelines for designing an accessible web-site,
    • Accessibility tests
    • Resource links for more information
  • Communicating medication instructions through pictogram – (last accessed 09.13.10) Video (7.14) minutes from the International Pharmaceutical Federation provides communicating medication instructions health professionals a means of communicating medication instructions to people that they have no language in common with and / or who may be illiterate. Includes a download of a pictogram program.
  • The Hospital Communication Book – (last accessed 9.14.10) Originally developed on behalf of The Learning Disability Partnership Board in Surrey. The book contains useful information about why people may have difficulties understanding or communicating. It has useful tips you can use to improve communication, and pages of pictures you can use to help you communicate:
    • Hearing
    • Impairment
    • Visual
    • Impairment
    • Using Pictures Gesture and
    • Signing


A six-page document that presents questions and answers for healthcare providers about auxiliary aids and services such as Sign Language Interpreter services, captioning, and other methods for making aural communication accessible.

  • Advancing Effective Communication, Cultural Competence, and Patient- and Family-Centered Care: A Roadmap for Hospitals. (2010) (last accessed 09.14.10) The Joint Commission. Publication provides recommendations to help hospitals address unique patient needs, meet the new Patient-Centered Communication standards, and comply with existing Joint Commission requirements. Example practices, information on laws and regulations, and links to supplemental information, model policies, and educational tools are also included.
  • Communication Access across the Continuum of Healthcare: An Annotated Bibliography on Patient-Provider Communication. (2009) (last accessed 09.14.10) Smith, H. Research and Resource Associate, Central Coast Children’s Foundation, Inc. Heather D. Smith, Central Coast Children’s Foundation, Inc. Patient Provider Communication. Covers:
    • Understanding Language and Culture Issues between Patients and Providers;
    • Overcoming Language and Cultural Communication Barriers;
    • Understanding Communication Barriers between Providers and Communication Vulnerable Patients Not Related to Language or Culture; and
    • Overcoming Communication Barriers between Providers and Communication Vulnerable Patients Not Related to Language or Culture.
  • Blind Movie  Going Blind: Coming Out of the Dark about Vision Loss; a unique documentary film that increases public awareness of sight loss and low vision issues profoundly affecting the lives of more and more people around the world.
  • How to Write Easy-to-Read Health Materials – (last accessed 9.14.10). On-line resource providing tips for writing easy to read medical information materials including step-by-step processes:
    • Plan and Research
    • Organize and Write
    • Evaluate and Improve
    • Inform Us and Stay Informed
  • Making Text Legible: Designing for People with Partial Sight, (1999). (last accessed 9.13.10) Arditi, Aries, Lighthouse International. Covers maximizing legibility for people with partial sight.
  • Providing Information in Alternative Formats (2005) (last accessed 9.1.10), Covers:
    • Reviews communication needs of people with visual, hearing, learning, and cognitive disabilities, including:
    • Who is responsible for producing materials in alternative formats,
    • When to provide alternative formats,
    • How you plan, produce, and deliver alternate formatted material, and
    • Sources (vendors) for the production of alternative formats.

The Joint Commission and the U.S. Department of Health & Human Services (HHS) Office for Civil Rights worked together to support language access in health care organizations with the video Improving Patient-Provider Communication: Joint Commission Standards and Federal Laws. The video highlights what the Joint Commission standards require as well as Federal civil rights laws with respect to patients who are deaf or hard of hearing, or have limited English proficiency.  A list of resources and tools that health care organizations can use to build effective language access programs accompany the video.


  • “Guidelines for Services to Deaf and HOH (hard-of-hearing) Adults,” Delmarva Foundation for Medical Care, Inc., Gallaudet University, and the Health Care Financing Administration.


  • Bonnie L. O’Day, Mary Killeen, and Lisa I. Iezzoni, “Improving Health Care Experiences of Persons Who Are Blind or Have Low Vision: Suggestions from Focus Groups,” American Journal of Medical Quality 19 (2004), p. 193.

Persons who are blind or have low vision face special challenges in obtaining care that is safe, effective, timely, and patient centered. To explore perceptions of care and recommendations for improvements, authors conducted 8 interviews with experts and 2 focus groups with 19 persons, all of whom are blind or have low vision. Interviewees perceived that they confront special barriers to care because of being blind or having low vision. Barriers fell into 4 broad categories: basic respect, including concerns about physicians thinking they cannot participate fully in their own care; communication barriers, including difficulties interacting with physicians and office staff; physical access barriers, including difficulties getting to and around physicians’ offices; and information barriers, including receiving written materials in inaccessible formats (eg, not in Braille, large print, or audiotape). Using common courtesy and individualized communication techniques, physicians and office staff could improve health care experiences of blind and low-vision patients.

  • Ann Williams, “A Focus Group Study of Accessibility and Related Psychosocial Issues in Diabetes Education for People with Visual Impairment,” The Diabetes Educator 28, no. 6 (2002), pp. 999–1007.

This study provides qualitative support for the view that visually impaired people in the United States may, as a group, be systematically excluded from receiving high quality diabetes care and education. Equal access to diabetes care and education for visually impaired people requires increased accessibility of diabetes care and education programs, and increased professional and public awareness that the diabetes programs are accessible. Some specific recommendations are to make all patient education materials available in low-vision/nonvisual formats and to teach all diabetes education professionals how to work effectively with visually impaired people.