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1.
N Engl J Med ; 364(9): 883; author reply 883, 2011 03 03.
Article in English | MEDLINE | ID: mdl-21366488
2.
HEC Forum ; 22(1): 65-72, 2010 Mar.
Article in English | MEDLINE | ID: mdl-20431916

ABSTRACT

The Clinical Ethics Credentialing Project (CECP) was intiated in 2007 in response to the lack of uniform standards for both the training of clinical ethics consultants, and for evaluating their work as consultants. CECP participants, all practicing clinical ethics consultants, met monthly to apply a standard evaluation instrument, the "QI tool", to their consultation notes. This paper describes, from a qualitative perspective, how participants grappled with applying standards to their work. Although the process was marked by resistance and disagreement, it was also noteworthy for the sustained engagement by participants over the year of the project, and a high level of acceptance by its conclusion.


Subject(s)
Ethics Consultation/standards , Quality Assurance, Health Care/methods , Credentialing , Ethicists/education , Ethicists/standards , Humans , New York City , Pilot Projects , Reference Standards
3.
Ann Intern Med ; 149(4): 264-9, 2008 Aug 19.
Article in English | MEDLINE | ID: mdl-18711157

ABSTRACT

The proportion of the U.S. population with limited English proficiency is growing. Physicians often find themselves caring for patients with limited English proficiency in settings with limited language services. There has been little exploration of the decisions physicians face when providing care across language barriers. The authors offer a conceptual framework to aid physicians in thinking through difficult choices about language services and provide responses to common questions encountered in the care of patients with limited English proficiency. Specifically, they describe 4 factors that should inform the decision to call an interpreter (the clinical situation, degree of language gap, available resources, and patient preference), discuss who may be an appropriate interpreter, and offer strategies for when a professional interpreter is not available. The authors use a hypothetical case to illustrate how decisions about language services may evolve over the course of an interaction. This conceptual and practical approach can help clinicians to improve the quality of care provided to patients with limited English proficiency.


Subject(s)
Communication Barriers , Language , Physician-Patient Relations , Quality of Health Care , Decision Making , Health Services Accessibility , Humans , Patient Satisfaction , Physician's Role
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