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Improving Communication in a Diverse WorkforceBy Angela Kennedy Walk through the halls of most hospitals and you will see and hear an increasingly multi-national, multi-cultural operating environment. This diverse workforce brings with it different approaches to problems and forms stronger teams than would otherwise be possible. However, it can also form impediments to communication while nonnative speakers struggle with English pronunciation. In the healthcare environment, this can mean the difference between quality care and satisfaction and frustration and clinical error. Degraded spoken communication affects a hospital throughout its operation. Patients do not understand discharge instructions. Physician conferences are belabored and less efficient. Transcription of foreign medical graduates is often error prone and expensive. Everyone from the receptionist to the respiratory therapist to the nurse to the attending physician has the opportunity to impact quality, satisfaction and risk. Some organizations have even been forced to settle malpractice cases due to the inability of the physician to present well at the deposition. This challenge is only going to increase with time. More foreign medical graduates and nurses are coming to fill the difference in the supply and demand for domestically-trained talent in our healthcare system. The English as a second language population of the United States has more than doubled in the last decade and has grown eight times faster than the population as a whole. In 2003, more than 10 percent of students in the public school system were nonnative speakers of English. Healthcare is not the only industry facing the spoken communication challenges of an increasingly "flat world." The business process outsourcing sector has been addressing this problem head on and is looking to technological solutions to address individualized training needs. To that end, Carnegie Speech, a spin-off from Carnegie Mellon University in Pittsburgh, has developed an artificial intelligence-based speech recognition software package that listens to a user's pronunciation, rhythm and pitch, explains what they did wrong and how to correct the problems. Then, it listens and responds patiently, again and again, until the user is able to pronounce the sound like a native speaker would. In as little as 13 hours of training, business process outsourcing personnel around the globe have shown dramatic improvement in their pronunciation capability due to the individualized curriculum the product delivers. Combined with Carnegie's speech assessment software, the two products could deliver everything a hospital needs to perform quality assurance screening and training in this area. It has been calculated that a teaching hospital invests about $15,000 to make a nurse productive in its environment. Community hospitals invest about $10,000. Until Carnegie Speech came out with its computerized assessment and training program, a hospital had no way of predicting whether that investment would produce a fully-functioning nurse. The pronunciation training is a tiny investment to ensure that all of the medical staff's other expensive training can be utilized effectively. Some Chief Medical Officers who have heard about the Carnegie Speech program have said that they would even consider changing their medical by-laws to require assessment and training before privileges are offered so that they could ensure that their doctors speak English clearly. Hospitals in the Sun Belt have calculated that about 30 percent of their entire employee base could benefit from pronunciation training. In order to maximize the potential of our healthcare organizations' increasingly diverse workforce, the communication issues need to be addressed. Luckily, technology is providing us with a solution. With a modest investment in both time and dollars, we can realize a significant increase in the spoken communication capabilities of our organizations. This will have a significant impact on the quality of care we deliver. |
Awarded an Advanced Technology Program Grant from NIST |
Angela Kennedy is chief executive officer of Carnegie Speech. She has held significant management positions with Westinghouse Electric and IBM. She has authored articles in the fields of artificial intelligence and cognitive science. Ms. Kennedy holds an M.S. in computer science from Carnegie Mellon University and a B.A. from the University of Tennessee.
