UMass Memorial Medical Center Interpreter Services Department

UMass Memorial Medical Center Three campuses and medical school Medical Center Statistics (Worcester): –Licensed Beds: 771 –Employees: 9,610 –Hospital Admissions: 40,013 –E.D. Visits: 128,250 –Ambulatory Department Visits 689,954

Interpreter Services Department Director of Interpreter Services: 1.0 FTE Coordinator of Education, Training, and Translations: 1.0 FTE Office Support Staff: 2.35 FTE Staff interpreters: 28.4 FTE (Albanian, ASL, Chinese, French, Portuguese, Spanish, Russian, Vietnamese) Independent Contractors: 40+ interpreters (ASL, Albanian, Amharic, Arabic, Bengali, Cambodian, Chinese Mandarin, Chinese Cantonese, Farsi, French, Haitian Creole, Greek, Guyarati, Hindi, Hmong, Italian, Korean, Polish, Portuguese, Russian, Spanish, Somali, Swahili, Twi, Tigrinya, Urdu, Vietnamese)

FY 02FY 03FY 04FY05FY 06FY 07 Forecast FY 08 Spanish Portuguese Vietnamese Albanian ASL "Other" Total Volume Interpreter Encounter Totals

How We Started

Basic Workflow of Department Identify Need for Interpreter Schedule Future Appointments –Face-to-face interpretation –Telephonic interpretation Manage Same-Day Requests –Onsite dispatchers handling live schedule Document Interpretation –Database & Medical Record

Identifying Need for Interpreter Patient’s language, and need for an interpreter, are required fields in the registration process Information is consistently collected at point of registration or inpatient admission Information becomes part of the patient’s electronic admissions data and medical record (available In IDX scheduling system)

Future Request Forms

Appointments Linked in IDX

Same-Day Requests Business Hours: –Two dispatchers –Interpreter floaters –Page/call system –Direct Access to Telephonic Interpretation After-Hours: –Answering Services –On-site & on-call interpreters –Direct Access to Telephonic Interpretation

Strategies Providing just-in-time access to language services Eliminates cost of interpreters delay Meets increasing demand Complements on-site resources Meets needs of patient centered organization and open access Discourage use of unqualified interpreters Tools Optimal equipment Direct access to an outsourced vendor Advance scheduling with vendor Advance notification to departments Just-in-Time Interpretation

Data as Catalyst to Quality The Encounter Form –Location –Date/Time –Providers –Informed Consents –Admission/Discharge Data Entry (Statistics) Medical Record

Recent Performance Measures From the RWJ “Speaking Together” Collaborative ST-1: Percentage of patients who have been accurately screened for their preferred languages ST-2: Percentage of patients receiving language services from qualified interpreters or bilingual providers ST-3: Percentage of encounters where patient wait time for an interpreter is 15 min or greater ST-4: Percentage of time interpreters spend providing medical interpretation in clinical encounters ST-5: Percentage of encounters where interpreters wait ten minutes or more for providers

Data Examples How Data Helps Prove the Point

BeforeRoll-Out AfterRoll-Out Telephonic Interpretation Increased 270% Increase from Apr ’07 to Apr ‘08

Night-Shift Interpretations What a difference an on-site interpreter makes! On-Call Interpreter On-SiteInterpreter

Case Study for ASL: Scheduled Appointments at Maximum

Case Study for ASL: Same-Day Requests Continue to Increase