The Goal:To lay the foundation for a high-quality language services program.

Why It's Important:A successful language services program begins with a strong foundation. Structuring policies, procedures and other elements to reflect and build on the organization's priorities will lead to an integration of language services in the organization.

How to Do It:Language services programs vary in size, number of languages served, systems and modalities of interpretation provided. Before you build your program, ask several questions about your organization, covered in Step 1. Steps 2–5 detail what you need to do in order to build your program's foundation.

1. Take a snapshot of language services within your organization. Review your current policies, procedures and structure for the provision of language services:

  • What policies and procedures are currently in place? Do any require revision and updating?
  • Do current policies and procedures reflect standards of practice for language services?
  • Are language services policies and procedures reviewed by an organizationwide policy committee?
  • Has your organization addressed language services in its strategic plan? If so, does the plan need to be updated?
  • Where is the language services department physically located (i.e., at your organization or at another facility in your system)?

Gauge the extent to which language services are embedded into clinical care and the overall organization:

  • What is the relationship between language services and other departments, such as the quality improvement department?
  • How do senior leaders support language services?
  • Is the language services department represented on clinical teams and committees within the organization?
  • Under which department is language services housed?

Determine whether your organization values language services:

  • Do staff appear to understand the importance of language services?
  • Are staff aware of policies and procedures around language services?
  • Do staff actually use language services? How?

Conduct an organizational needs assessment to:

  • Evaluate demand for language services, considering:
    • Languages spoken by your patient population
    • Geography of your service area
    • Areas of high demand within your organization
    • Times of high demand within your organization.

Also, assess capacity, including internal and external resources available to meet demand:

  • Systems, staff and equipment currently supporting the delivery of language services, including internal and external resources
  • Translated materials and signage within the organization.

2. Develop a language services plan.

Form an interdisciplinary team to construct the language services plan, including:

  • Clinical leaders
  • Front-line staff
  • Language services staff and managers
  • Quality improvement.

Construct a language services plan that fits your organization's priorities and needs, in a manner consistent with safe and effective practice.

Consider defining and incorporating the following elements into your plan:

  • Mission and goals for the plan. Setting goals is essential to improvement. Be sure to include these in your plan.
  • Scope of the plan
  • How the plan complies with federal, state and local laws, as well as accreditation standards
  • How the plan addresses regulatory compliance and risk
  • The department's location, both physically and organizationally
  • Key terms
  • Structure of the department and responsibilities of staff.
  • Policies and procedures :
    • Identifying and recording a patient's language need
    • Informing patients of their right to an interprete
    • Addressing a patient's refusal of an interprete
    • Requesting a language servic
    • Meeting patients' spoken and written language needs, including how and when to use an interprete
    • Documenting the use of a language servic
    • Defining who is qualified or permitted to interpre
    • Training and assessing interpreters, translators and bilingual clinical provider
    • Monitoring and evaluating the quality of interpretation and translation
    • Monitoring and evaluating the quality of language services delivery.

3. Create a budget and monitor the financial performance of your language services program.

Develop a budget based on existing resources and projected demand. Consider the following items when developing your budget:

  • Staff
    • Interpreters and translators employed in the organizatio
    • Vendors, such as telephonic, contract and freelance interpreter
    • Administrative staf
    • Management staf
    • Training and assessment of staff and vendor
    • Differentials for bilingual providers and dual role staf
    • Continuing education
  • Equipment
    • Phones
    • Fax machines
    • Computers, printers and scanners
    • Software
    • Equipment for interpreters, including pagers, cell phones or two-way radio
    • Other equipment for remote interpreting, including video and remote simultaneous interpreting
    • Equipment maintenance
  • Space
    • Central office
    • Satellite office
  • Translated materials and signage for patients
  • Training and educational materials for clinical staff
    • Travel for interpreters to off-site locations.

4. Evaluate and assess your organization's performance.

  • Use information from your snapshot and needs assessments to identify strengths and weaknesses of existing language services in your organization.
  • Routinely evaluate policies and procedures, as well as the language services plan itself, to ensure that they are up-to-date and effective.
  • Measure the performance and quality of language services delivery and operations, including the effectiveness, timeliness and efficiency of services.
  • Routinely monitor budget needs and financial performance, particularly as your program grows and/or changes.

Tip: Many language services departments report the number of interpreted encounters to justify their budgets. Consider adding information about how enhancing your program can improve the quality of health care, or seek testimonials from patients and clinical providers using your services.

5. Develop an improvement plan for language services delivery.

  • Work with an interdisciplinary team, including quality improvement staff, to develop plans for improving language services delivery.
  • Work with a team of language services staff, and others as necessary, to develop plans for improving language services operations.
  • Identify a framework for quality to guide your improvement plan for language services.
  • Use data related to the quality and performance of language services to make improvements.
  • Search for opportunities to detect errors and improve efficiency.
  • Involve clinical and language services staff, as well as any other staff who might be affected, in the development, testing and implementation of new strategies.
  • Test changes before bringing them to the organization as a whole.
  • Regularly report information on the performance of your program to health care organization teams and leadership.
  • Think strategically before building elements into your program. Ask:
    • Do the benefits of building an element of your program outweigh the costs of purchasing a service or product?
    • Is there internal capacity to provide translation services in your organization?
    • Is there potential for partnership with another organization?
    • Should services be centralized or decentralized within your organization?

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