ICH and CHA’s work on language access recognized as a Remarkable Project by America’s Essential Hospitals

by |

A multi-year collaborative effort between ICH and Cambridge Health Alliance (CHA) was selected by America’s Essential Hospitals (AEH) as a 2019 Gage Award finalist. The Gage Awards program recognizes AEH members for successful improvement and change projects; spreads best practices and innovative programs to other organizations; and supports the association’s research, policy, and advocacy work.

ICH and CHA’s project (detailed below) was designated as a Remarkable Project and was featured in the program at AEH’s VITAL2019 conference last week. ICH and CHA also recently published an academic article about this work in The Joint Commission Journal on Quality and Patient Safety, which can be found here.

Project description: Effective communication assistance is vital to ensuring quality and safe care for patients with Limited English Proficiency (LEP). Although communication via a professional medical interpreter or qualified bilingual medical provider is preferred, health care providers often resort to untrained interpreters, such as patients’ family members or friends. However, the use of untrained interpreters poses risks to communication accuracy, patient safety, care quality, and privacy.

At Cambridge Health Alliance (CHA), 43 percent of primary care patients have LEP, and the interpreter services program has maintained a longstanding partnership with the Institute for Community Health on several language access quality improvement projects. While the health system has a robust interpreter services program, the quality improvement team in 2012 identified 16 ambulatory clinics that used family and friends to interpret for more than 10 percent of LEP patient encounters, based on data from the Language Services Documentation Tool in the electronic health record.

The health system revised its interpreter services policy to explicitly prohibit the use of ad hoc interpreters, except in emergency situations. Quality improvement team leaders met with clinical managers and staff to discuss the policy and identify opportunities for improvement. Additionally, CHA added 86 videoconference interpreting units across 14 sites from 2012 to 2018. Team leaders surveyed patients on the timeliness, sound and video quality, and effectiveness of remote interpreting services, and the health system maintained a 90 percent service level of all calls answered in 60 seconds or less from fiscal years 2013 to 2018.

From 2012 to 2018, the number of CHA clinics using family members or friends as interpreters for more than 10 percent of LEP patient encounters decreased from 16 to 11.