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Questions to Ask for Identifying Communication and Accommodation Needs

Questions to Ask for Identifying Communication and Accommodation Needs1

By

June Isaacson Kailes, Associate Director

Harris Family

Center for Disability and Health Policy

Western University of Health Sciences, Pomona, California  

Update 9 -  08.28.16

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Required Citation

© Kailes, J.I Questions to Ask for Identifying Communication and Accommodation Needs, Update 9, 2016, by June Isaacson Kailes, Disability Policy Consultant, jik@pacbell.net, http://www.jik.com

Permission is granted to share and distribute this publication provided you:

  1. Make no changes to the original document

  2. Include proper copyright citation (see above)

  3. Do not sell the contents for profit

Notify June Kailes of use: jik@pacbell.net                                    

Adapted and updated from: INFORMATION FOR ALL - ENSURING ACCESS TO EFFECTIVE COMMUNICATION, (2009) by June Isaacson Kailes, MSW, Associate Director, Center for Disability and Health Policy at Western University of Health Sciences, Pomona, California                                                            

The invisibility of people with disabilities

The invisibility of people with disabilities and others with access and functional needs is very common. In addition to people with disabilities being a protected class under civil rights laws, a larger group actually benefits from physical, equipment, communication, service and program access.

These populations are typically under recognized and very under counted. and are far greater in numbers than those coded as “seniors and people with disabilities” (SPD) or “aged, blind and disabled” (ABD). The numbers are large across all lines of business.

Many people need access related to communication, mobility and service. Many of these people do not identify as having a disability. Therefore, it is important to ask all people about these needs.

Attention to the details is critical when identifying and meeting communication and accommodation needs. Asking a version of this question of all people can help to accomplish this.

Will you need any assistance with (getting on and off a table, walking, seeing, reading, hearing, filling out forms, communicating, speaking, during your appointment? Will you need an interpreter?

If more detail is needed, samples of more in-depth questions that can be used or integrated into the registration process including drop-down options in an electronic health record are provided below.

Record the answers in the health record in a consistent (and prominent) place. This information should be referred to before and during appointments. These needs should be updated and verified before every appointment as needs can change.  Ask: I just want to confirm that you still need …

For example, the recorded note may say:

  • Needs sign language interpreter

  • Needs longer appointment because of slow speech

  • Use height adjustable table in available in rooms 3,12,15

  • Use accessible scale

  • Use 2 techs for total lift assistance onto exam table

Patient or designated support person’s answers these questions.

These questions help determine patients’ access needs including communication access. These questions can be customized for use in the patient registration and appointment setting process as well as the in-patient nursing assessment process.

Patient’s Name:                                                             Date:

                                                                         

  Name (if other than patient answering these questions):

 

  Relationship to Patient:

  ❏ Family Member
  ❏ Friend / Companion          ❏ Personal assistant services
  ❏ Other:__________

PATIENT:

I understand spoken information best when it is in _______________ [language].

I understand written information best when it is in _______________ [language].

Do you need assistance with? [checked boxes should lead interviewer to appropriate questions (or drop-down menus in a computer system) detailed below]

  •  reading

  •  walking

  •  speaking

  •  hearing

  •  seeing

  •  moving (mobility / physical / motor)

  •  remembering, understanding, learning, communicating

 

stop sign with "STOP" in white text centered in red hexagon
 STOP HERE IF NO BOXES ARE CHECKED 

1. MOVING (MOBILITY / PHYSICAL / MOTOR – LIMITED OR NO ABILITY GRAB, GRIP, LIFT, HOLD, ETC)

1.1. Uses

  • Wheelchair

  • Scooter

  • Walker         

  • Cane

  • Braces

  • Prosthesis

  • Service Animal

    • - Overnight stay w/ animal

    • - Overnight stay w/o animal

  • Stretcher

  • O2

  • Ventilator               

1.2. Needs                 

  • Assistance walking

  • Assistance transferring

  • Assistance with positioning

  • Accessible Sleeping  Room / bathroom*

    • Visual notification devices  (Door flasher)

1.3. Accessible medical equipment

  • Scale

  • Exam / diagnostic table or chair

  • Assistance transferring

    • Full

    • Partial

    • Lift equipment

  • Bariatric

    • Bed

    • Wheelchair

    • Lift equipment

  • Other: (i.e. infusion chair, MRI etc )

Call Buttons / TV remote control / Water*

  • Large button / pillow switches

  • Sip / puff

  • Accessible water source

*Inpatient only

2. HEARING

Interpreter [specify type]

  • American Sign Language (ASL)

  • Pidgin Signed English (PSE)

  • Signed English

  • Oral

  • Cued speech

  • Tactile

  • Other. Explain:

Other accommodations:

  • Letter, word, picture, translator boards

  • Pad / pen – writing notes

  • Visual notification devices *

    • door flasher

    • phone ring flasher 

  • Phone with amplified sound *

  • Computer-assisted real time transcription (CART)

  • Assistive listening device

*Inpatient only

3. SPEAKING

Uses:

  • Letter, word, picture, translator boards

  • Speech Generating Device

4. UNDERSTANDING, REMEMBERING, LEARNING, COMMUNICATING

Difficulty with:

  • Thinking of right words

  • Putting thoughts together

  • Following directions

  • Speaking clearly

  • Patient will need a family member/assistant for overnight stays

5. ACCESS TO PRINT MATERIALS:

  • Large print (specify font size _____)

  • Electronic text/disk/CD-ROM/Flash drive

  • Audio Recording (CD, MP3, tape)

  • Braille

  • Qualified note taker

  • Qualified Reader

    • Completing forms

6. TO USE THE PHONE I WILL NEED:*

  • TTY

  • Cordless

  • Large buttons

  • Speaker phone   - hands free phone

  • Speed dialing

  • Amplified volume and loud ringer

  • Flashing light device (indicates telephone is ringing)

  • Other:

*Inpatient only

7. MISCELLANEOUS:

  • Longer appointment

    • Reason:

  • Dietary*                           

    • Specify:

  • Ask if there are any additional needs that may affect her/his care.*

 

*Inpatient only

PREFERRED COMMUNICATION: IDENTIFIES METHODS BY WHICH PATIENTS WANT TO RECEIVE COMMUNICATIONS AND INFORMATION:

8. PREFERS TO RECEIVE INFORMATION REGARDING APPOINTMENTS, TEST RESULTS, ETC

  • USPS mail

  • Email

  • Voice mail

9. WHEN TRYING TO REACH ME IT IS BEST TO USE: [CHECK ALL THAT APPLY]

  • Email (address: _______________)

  • Text message (phone #: ___________)

  • TTY

  • Video relay

  • Speech to Speech relay

  • Phone

  • USPS mail [if not time sensitive]

10. I UNDERSTAND / LEARN / GET DIRECTIONS/ BEST WHEN I GET INFORMATION: [check all that apply]

  • In pictures

  • In writing

  • Explained to me

  • Shown to me

11. WHEN VIEWING FILMS AND VIDEOS I NEED:

  • Descriptive narration

  • Captioning

  • Signed

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