The patient safety standards established by the Joint Commission (2023) and the World Health Organization (2007) cite the first patient safety standard "Identify the patient correctly."
Xian Zhao, a fellow at the University of Toronto, researching ethnic name pronunciation, says, the mispronunciation of patient names "hurts trust, recovery, and wellbeing, and reinforces racial health disparities" (Torjesen, 2022).
Our names reflect our individual and social identities and are often imbued with meaning from the contexts of our cultures, languages, and national origins (Dali et al., 2020). For those who already have marginalized identities, chronic mispronunciations [and misspellings] of names can be experienced as microaggressions (Dali et al., 2020; Kohli & Solórzano, 2012). The long- term effects of having one's name phonetically mangled by the majority of the people you encounter can have deleterious effects on the self-esteem and self-perception and induce a form of internalized racism in which you think you must be inferior to the majority culture (Dali et al., 2020; Kohli & Solórzano, 2012). Including the phonetic spelling of an unusual name on a medical chart might help health care providers in pronouncing names correctly.
But this issue is not just a matter of the patient's emotional wellbeing, but in the digital age, the accuracy of electronic health records (EHR) is critical to documenting clinical histories, medication management, and coordinating care between hospital staff. Misspellings of names in EHR can have numerous adverse financial, legal, and medical ramifications, ranging from medical errors leading to patient safety issues to duplicating orders for medical tests (Just et al., 2016). At a very fundamental level, health care providers should always take the time to correctly pronounce and spell a name they are not familiar with, by explicitly asking the patient how to pronounce their names.
Misinformation and misspellings can present potential patient safety issues and set the stage for medical errors (Just et al., 2016). In an analysis of datasets totaling 398,939 patient EHRs, the most common reason for duplicate health records was the misspellings of names (Just et al., 2016). Misspellings of a single patient's name engenders multiple health records with none of them being a complete record of the patient's medical history. While the duplication of records in and of itself may not seem like the basis for imminent danger, when a doctor is making decisions based on an incomplete set of data, such decisions could endanger the patient's life. One of the many consequences of having duplicate records is that the doctor may re-order medical tests that have already been done (Just et al., 2016). Just et al. (2016) found that on the average, duplicate records resulted in more than a thousand dollars of additional costs from reordering tests and treatment delays. 4% of cases involving duplicate records had negative clinical consequences (Just et al., 2016).
1) If you come across a patient whose name you are not sure how to pronounce or spell accurately, what would you do?
ANSWER: Express your intention explicitly and say "I don't want to mispronounce or misspell your name. Could you help me learn how to pronounce your name by saying it slowly twice? I would greatly appreciate it."
2) How would you correct the mispronunciation of your name gracefully without being impolite or creating conflict?
3) Have you ever mispronounced someone's name? How did you handle it? Did you acknowledge the mispronunciation and correct yourself?
REFERENCES
Dali S, Atasuntseva A, Shankar M, Ayeroff E, Holmes M, Johnson C, Terkawi AS, Beadle B, Chang J, Boyd K, & Dunn T. (2022) Say My Name: Understanding the Power of Names, Correct Pronunciation, and Personal Narratives. MedEdPORTAL. 18:11284. https://doi.org/10.15766/mep_2374-8265.11284
Dawood, M. (2005). Patient Identification and Its Ramifications. Diversity & Equality in Health and Care. 1(1).
Joint Commission. (2023). 2023 Hospital National Patient Safety Goals. Retrieved April 23, 2023, from https://www.jointcommission.org/-/media/tjc/documents/standards/national-patient-safety-goals/2023/hap-npsg-simplified-2023-july.pdf
Just, B. H., Marc, D., Munns, M., & Sandefer, R. (2016). Why Patient Matching Is a Challenge: Research on Master Patient Index (MPI) Data Discrepancies in Key Identifying Fields. Perspectives in health information management. 13 (Spring), 1e.
Kohli, R., & Solórzano, D. G. (2012). Teachers, please learn our names!: racial microaggressions and the K-12 classroom. Race, Ethnicity and Education, 15(4), 441–462. https://doi.org/10.1080/13613324.2012.674026
Torjesen, I. (2022) How do I deal with a colleague who keeps pronouncing my name incorrectly? BMJ 377:o1272 doi:10.1136/bmj.o1272.
World Health Organization (2007) Patient Identification: Patient Safety Solutions. Retrieved May 2, 2023 from: https://cdn.who.int/media/docs/default-source/patient-safety/patient-safety-solutions/ps-solution2-patient-identification.pdf?sfvrsn=ff81d7f9_6
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