Language lessons

DEERFIELD, Ill. - Working with patients on their own turf to adhere to treatment is always a challenge—even more so when there are language and cultural differences.

“We are a guest in their home, so making sure we've done our work in preparing staff from a cultural sensitivity and diversity training perspective is key,” said Joan Couden, national program director of the Bleeding Disorder Program for Walgreens Infusion Services. “We have to speak to their level and we have to respect their home practices.”

Couden recently gave a poster presentation on caring for patients with bleeding disorders who speak little or no English at the National Hemophilia Foundation's Annual Meeting in Anaheim, Calif.

This type of preparation is becoming more common. Walgreens, which has more than 1,400 clinicians serving patients through 75 infusion pharmacies and 100 alternate sites across the country, has a set of core competencies for employees and provides additional resources as needed. Sometimes a translator is necessary.

“It depends on if they are able to grasp their plan of care and understand their disease process in English,” said Kirstin Schmidt, national clinical director of the Bleeding Disorder Program. “Sometimes, we do need a translator for at least the first educational visit.”

While Walgreens has a national Spanish care coordinator, less common languages can require some creativity, not only in finding an appropriate translator, but in setting appropriate expectations of care, says Couden. She pointed to a patient that spoke only Farsi and comes from an area where drugs commonly used to treat bleeding disorders were simply not available.

“He wasn't adhering and the clinician in the home realized there was something missing,” she said. “(He didn't understand) that having bleeding into his joints doesn't have to happen anymore. There were different expectations for managing his care.”

Ultimately, the goal for any patient is to get them independent and managing their own care, says Schmidt.

And the Farsi speaker?

“He got a job, health insurance and all of those other things that lead to really good integration (into American society),” said Couden.