Improved language services staffing in a large health system

Effective communication between providers and patients impacts patients' understanding of medical conditions, follow through with care plans, discharge planning, and ability to take preventive measures. Recent statistics showed that 9% of the United States population was considered to be Limited English Proficiency (LEP). Unlike nurse-to-patient ratio, there are no established standards for interpreter-to-patient ratio. Patient outcomes from the use of interpreters have been investigated and although there are some contradictions in the literature, there is evidence that interpreter services have positive impacts on outcomes, and on patient and provider satisfaction. As Christiana Care Health System works to optimize interpreter staffing and scheduling, we uncover key areas that present challenges and opportunities for improvement. This presentation will focus on areas identified, lessons learned, and our approach to overcome these challenges. Some of these areas include underestimation of the LEP patient population, re-construction of fulfilled demand data due to lack of unique patient identifiers, population-specific outcomes study, projection of future LEP patient populations based on retrospective hospital data and census data, and sensitivity analysis of optimal staffing based on specificity of projected LEP data. Industrial Engineering techniques used include time and motion study, simulation-optimization, and various statistical approaches.