Improving the Quality of Language Services Delivery: Findings from a Hospital Quality Improvement Initiative

Abstract

Over 24 million individuals in the United States speak English "less than very well" and are considered limited English proficient (LEP). Due to challenges inherent in patient-provider interactions with LEP patients, LEP individuals are at risk for a wide array of negative health consequences. Evidence suggests that having an interpreter present to facilitate interactions between LEP patients and health professionals can mitigate many of these disparities. This article presents the results and lessons learned from Speaking Together: National Language Services Network, a quality improvement (QI) collaborative of the Robert Wood Johnson Foundation to improve the quality of language services (LS) in hospitals. Using five LS performance metrics, hospitals were able to demonstrate that meaningful improvement was possible through targeted QI efforts. By the end of the collaborative, each of the hospitals demonstrated improvement by more than five percentage points on at least one of the five recorded quality metrics. Lessons learned from this work, such as the helpful use of quality metrics to track performance, and the engagement of physician champions and executive leadership to promote improvement can be utilized in hospitals across the country because they seek to improve care for LEP patients.

Interpreter perspectives of in-person, telephonic, and videoconferencing medical interpretation in clinical encounters

“…Despite a national mandate for access to interpreter services in settings receiving federal funds [17], under-use of interpreters persists [18–25]. While in-person medical interpretation by trained interpreters is considered the gold standard when patient–clinician language concordance is not possible, numerous factors limit use in clinical settings including interpreter staffing and schedules, language requirements, and wait times [20,22,23,26]. Remote methods including telephonic interpretation and videoconferencing medical interpretation (VMI), which allows for two-way audio–visual communication using a mobile unit, are increasingly used to increase access where in-person interpretation is unavailable and/ or where demand is high [23,26].…”

Evaluation of a Quality Improvement Intervention to Increase Use of Telephonic Interpretation

“…The original Speaking Together learning collaborative, a network of 10 hospitals constituting the first national language services QI network (of which SCH was 1), resulted in modest improvements in at least 1 language service process metric per participating hospital, such as screening for preferred language for care. 39 At another institution, installation of standard, dualhandset telephones with easy interpreter access in every hospital room improved provider-reported use of telephone interpretation. 40 These interventions demonstrated improvements in the foundational aspects of providing high-quality language services, namely identifying need and improving access, which are essential first steps.…”

Satisfaction With Dental and Medical Education Quality Among Foreign Students Considering Non-Native English-Speaking Origin of the Teachers

“…Previous studies demonstrated that near 75% of analyzed US hospitals provided medical care for patients who are not native English speakers, while only 18% of surveyed medical facilities validated the level of foreign language proficiency among stuff. [15][16][17][18][19] Based on that, authors resumed that assessment of foreign language skills should be categorized as a mandatory measure within medical educational system, while improvement of such should be provided by specifically design of language training courses. 19 Such English language mastering by individual or group patterns together with English language curriculum classes could improve the overall quality of dental and medical education among foreign students.…”