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Best in CLAS: Maintaining Culturally and Linguistically Appropriate Services

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Despite having an advanced healthcare system, the U.S. still lags behind many developed countries in overall health outcomes.

Disparities among our diverse population are a major contributing factor. These disparities — in outcomes for underrepresented racial, ethnic, and social groups, including those with disabilities and those with limited-English proficiency (LEP) — are well documented.

For decades, public health professionals have been raising alarms about worsening health outcomes and lower quality care for these populations when compared with others, including English-speaking patients. It could be argued that providing culturally and linguistically appropriate services (CLAS) is the primary way to improve health equity. But sometimes, that is easier said than done.

What is CLAS?

According to the U.S. Department of Health and Human Services, national CLAS standards are:


“[I]ntended to advance health equity, improve quality, and help eliminate health care disparities by establishing a blueprint for health and health care organizations to provide effective, equitable, understandable, and respectful quality care and services that are responsive to diverse cultural health beliefs and practices, preferred languages, health literacy, and other communication needs.”

Health equity is one of the most serious concerns in the U.S. healthcare system. While our system is widely known as one of the best, providing some of the most innovative care anywhere in the world, only some of the population has access to that high-level care.

Health disparities in the most marginalized groups contribute to higher levels of chronic disease and preventable deaths, lower life expectancy, and higher overall health utilization and costs.

Effective care begins with ensuring that everyone can access the same level of services and quality, regardless of their personal situation, health, or finances. Understandable and respectful care addresses the need for a culturally sensitive approach, with care in a language that the person can easily speak and understand.

The only way to mitigate these effects is to have clear standards to ensure the same level of care for every patient, regardless of their race, sexuality, gender, ability, and English proficiency. CLAS standards provide that blueprint, so everyone is working from the same set of expectations and standards, so providers can accurately and objectively measure progress.

What are the Standards?

Along with the principle standard above, CLAS includes 14 additional standards that specifically address:

  • Governance, leadership, and workforce — promoting sustainable leadership and a culturally and linguistically diverse workforce that is representative of the local patient population.
  • Communication and language assistance — offering comprehensive information in a language the patient can understand and ensuring healthcare and medical competency in language support professionals.
  • Engagement, continuous improvement, and accountability  establishing goals and continually assessing each organization’s efforts to address community health needs, as well as providing methods for people to share their experiences and have their concerns addressed.

The Role of Language Access

Language access is a key component of the CLAS standards. Offering patients written and verbal information about their care in a timely manner — and in a language they can easily speak, read, and understand — is the first step to closing gaps in care access and quality.

Studies reveal that patients who have access to medically qualified interpreters have shorter hospital stays and lower readmission rates. They are also less likely to get an incorrect diagnosis or suffer a serious adverse event in the hospital.

The emphasis on a medically qualified and culturally competent interpreter is key. For some patients, miscommunication and poor health outcomes go beyond a person’s inability to understand the words a medical professional is saying. Their cultural beliefs, behaviors, and attitudes also factor into their ability to get great care. Culturally competent interpreters not only accurately translate the words you say, but they can also capture nonverbal and cultural nuances that could improve patient compliance and reduce errors.

Language access is so important that four of the 15 standards are devoted exclusively to outlining how healthcare providers can improve in this area.

Following “The Blueprint”

If you’re not sure where to start with implementing CLAS standards, you’re not alone. That’s why the HHS Office of Minority Health created a complete guide to walk you through each.

A Blueprint for Advancing and Sustaining CLAS Policy and Practice — or just “The Blueprint” for short — explains each standard in detail. It includes compelling reasons why enhanced national CLAS standards are necessary, along with plans on how to implement these standards.

Each one includes details on the purpose and components of the standard, strategies for implementation, and real-world examples of what steps leading healthcare organizations have taken to improve in this area. You can also find links to additional resources to dive deeper into any of the standards you feel are important to address in your organization.

How CLAS Can Help You Meet Other Accreditation Requirements

Every healthcare provider and administrator today knows there are numerous regulations and requirements from various organizations that require your attention. Finding the time to address each one is difficult, but it’s also essential. Fortunately, the standards in CLAS align well with many other accreditations and quality standards.

To help ease some of that administrative burden, the Department of Health and Human Services published a series of “Crosswalks.” Each one shows how compliance with CLAS standards aligns with other regulatory requirements, such as Patient-Centered Medical Home (PCMH)recognition, the Communication Climate Assessment Toolkit (C-CAT), and the Joint Commission Hospital Program and Ambulatory Program.

How to Become Best in CLAS

With 15 total standards, it’s not easy to ensure compliance in every area. But partnering with a language services provider can help you meet communication and outreach standards and immediately bridge the gap in healthcare access and quality for your patients with limited-English proficiency. Talk to GLOBO today to learn more about our medically qualified interpreters, written translation services, video remote interpreting, and transcreation services to get started.

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