Background: Patient-clinician/clinician-family communication presents multiple challenges in the setting of serious illness. Cross cultural interactions compound these challenges. Amongst the United States’ American Indian (AI) tribes, there is minimal research that has addressed the challenges in clinician-patient communication. Studies in other ethnic minorities reveals an interest by patients and families for more direct information regarding the health status of the patient1. In the height of the COVID-19 pandemic, an immediate need was identified for clinician guidance in communication with AI patients and their families.

Purpose: To develop and offer clinicians a communication guide for providing patients and families healthcare updates.

Description: In 2020, following the initial surge of COVID-19 cases amongst the southwest United States AI tribes, particularly the Navajo Nation, a collaboration between two healthcare facilities, the University of New Mexico Hospital in Albuquerque, New Mexico, and an Indian Health Services facility, Gallup Indian Medical Center in Gallup, New Mexico was created. GIMC is an IHS facility that serves several American Indian Tribes. Due to proximity to the Navajo Nation, which is the largest U.S. Federally recognized tribe, GIMC predominantly serves patients who are Navajo. The Navajo Nation was disproportionately affected by COVID-19 and had one of the highest rates of COVID-19 positive cases in the country in the initial months of the pandemic in the United States. With a higher incidence of COVID-19 infection came an increased number of patients requiring escalating levels of care at tertiary care centers, including the University of New Mexico Hospital. The impact COVID-19 had on existing disparities prompted the development of the collaboration between UNMH and GIMC. One of the projects that resulted from this collaboration was development of plain language scripts to describe in plain English interventions performed in the care of severely ill patients. Multidisciplinary work, including input from several palliative medicine, internal medicine, and critical care clinicians, helped to ensure clinical relevance. Guidance was specifically sought from collaborators in the UNMH Native American Health Services Office, Health Literacy, and Interpreter Language Services to ensure the content was culturally responsive. Both documents were added to a publicly available website that was made accessible to multiple hospitals throughout New Mexico, Arizona, and Utah providing care to American Indian patients.The website may be accessed here (and saved as an app):

Conclusions: The GIMC-UNMH Collaboration is an ongoing collaboration that has resulted in the development of multiple tools to assist in improving the care of hospitalized patients. These guides are updated continually and are a reflection of the combined experiences of this multi-disciplinary collaboration. These tools are available to and have been shared with clinicians across New Mexico and the southwest region.