It is undeniable that racism is a patient safety issue in health care.
Racism and discriminatory acts directly oppose The Joint Commission’s mission and vision to help its accredited and certified organizations provide safe, high-quality care to all people all the time. The Joint Commission has standards to guide its organizations and help ensure that all people receive care that is free from discrimination, and it has no tolerance for bias or discrimination in its institutions.
Nonetheless, The Joint Commission also is aware that institutional, systemic racism and bias still are realities in health care.
Core concepts addressed in the campaign
In early October 2021, The Joint Commission released a new Speak Up Against Discrimination educational campaign that encourages patients to speak up if they experience discrimination while receiving health care.* The campaign comes at a time when the coronavirus pandemic has brought health inequities and disparities to the forefront.
The Speak Up™ Against Discrimination campaign includes the following:*
- An informational poster, available in three different sizes and in both English and Spanish
- An animated video, in both English and Spanish, that shows two examples of patients experiencing discrimination: one features a patient interacting with health care professionals, and another example shows a patient experiencing inequitable access to care based on geographic location
- A user guide aimed at helping organizations determine the best ways to distribute the materials to patients in various health care settings
“The Joint Commission has no tolerance for discrimination in health care. Every patient deserves to be treated with respect and dignity,” stated Ana Pujols McKee, MD, executive vice-president and chief medical officer, chief diversity and inclusion officer, The Joint Commission, in a press release issued after the campaign launched in October 2021. “Unfortunately, institutional, systemic racism and bias still exist in health care. While we have Joint Commission standards and requirements in place to help health care organizations provide care that is free from discrimination, I strongly encourage any patient who receives discriminatory care to speak up and act. By doing so, you may help future patients from being discriminated against.”†
Differences in the quality of care received by patients or barriers and impediments to care can be the result of a range of factors, including the following:
- Access to care or lack of resources, such as Internet or transportation
- Education level
- Gender identity or expression
- Geographic location
But the Speak Up campaign calls out the rights that every patient is entitled to, including the following:
- Timely and appropriate care that is free from discrimination
- Being treated with courtesy and respect
- An interpreter who can help effectively communicate with care providers
Patients can play an active role
The campaign also includes several recommended steps that patients can take if they experience discrimination and substandard care. They are as follows:†
- Find out about the hospital’s or health care network’s policy for reporting complaints, and try to work with the administration to rectify the situation.
- Talk to the institution’s patient advocacy department (sometimes called the patient liaison office or the patient advocacy team).
- File a complaint with the Office for Civil Rights, which is part of the U.S. Department of Health and Human Services, or with the state’s health department. Patients can learn more at https://www.hhs.gov/civil-rights/filing-a-complaint/index.html and file a complaint at https://ocrportal.hhs.gov/ocr/smartscreen/main.jsf.
- Contact the U.S. Department of Justice’s Civil Rights Division by phone at 202-514-3847 or by phone device for the deaf (TTY) at 202-514-0716.
- If the patient’s issue remains unaddressed and the organization is accredited or certified by The Joint Commission, the patient can speak up by reporting the patient safety concern online at https://apps.jointcommission.org/QMSInternet/IncidentEntry.aspx or by mailing a report describing the incident to the Office of Quality and Patient Safety, The Joint Commission, One Renaissance Boulevard, Oakbrook Terrace, IL 60181.
Encouragement for patients to Speak Up
The Speak Up program launched in 2002 and has been used in more than 70 countries. A refreshed version of the program debuted in 2018 after evaluating national market research, including focus group feedback from patients and their families.
The goal of Speak Up is to help patients and their advocates become active in their care. Organizations are free to reproduce and disseminate Speak Up Against Discrimination materials if they credit The Joint Commission.
For more information about the Speak Up program, visit https://www.jointcommission.org/resources/for-consumers/speak-up-campaigns/.
The thoughts and opinions expressed in this column are solely those of Dr. Jacobs and do not necessarily reflect those of The Joint Commission or the American College of Surgeons.
*The Joint Commission. Speak Up Against Discrimination. Available at: https://www.jointcommission.org/resources/for-consumers/speak-up-campaigns/against-discrimination/. Accessed November 9, 2021.
†The Joint Commission. New Speak Up Against Discrimination campaign from The Joint Commission. October 5, 2021. Available at: https://jointcommission.newmedia-release.com/2021_speak_up_against_discrimination/. Accessed November 9, 2021.