Intervention Title:
Giving Registration Staff the Tools They Need to Provide Timely Services to Limited English Proficient (LEP) Patients – Phoenix Children's Hospital; Phoenix, Ariz.

Goal:
Increase the speed with which the ever-growing number of Spanish-speaking patients and their families are registered for admittance to the hospital.

Innovation:
An additional handset and splitter were added to existing phones at each desk in the registration areas so that an over-the-phone interpreter could be readily accessible during the registration process. Families who speak Spanish benefit from the immediate availability of the over-the-phone interpreter, while on-site interpreters are able to focus on other encounters that are lengthy or complex.

Result:
Previously, registration staff tended to wait until a Phoenix Children's Hospital interpreter was available on-site when registering Spanish-speaking families. Now, Spanish-speaking families are moving more quickly through the hospital's registration process because an interpreter is immediately available by telephone. Additionally, patients are more accurately screened for their language needs.

Institution:
Phoenix Children's Hospital
1919 E. Thomas Road
Phoenix, AZ 85016
P: (602) 546-1000

From the C-Suite:
“As new technologies become available for health care settings, hospital Information Technology (IT) Departments can help to assure that a new product is the best fit, given future needs, current technology and industry trends. Plan ahead. Call IT early in the process when considering any changes or modifications.”

Robert Sarnecki
Vice President and Chief Information Officer

Profile:
Phoenix Children's Hospital is one of the 10 largest, free-standing children's hospitals in the U.S. with 299 licensed beds, approximately 12,000 annual admissions and nearly 60,000 annual Emergency Department visits.

Clinical areas affected:

• Language Services
• Registration

Staff involved:

• Information Technology
• Language Services
• Registration management and staff

Timeline:
From the time the idea arose to add handsets and splitters to existing phones, to the time that handsets were available and training took place, several months were needed.

Contact:
Irma Bustamante
Manager, Language Services
P: (602) 546-3352
ibustam@phoenixchildrens.com

Innovation implementation:
Registration staff at Phoenix Children's Hospital have long had access to medical interpreters for a number of different languages via contract telephonic interpreters, but they relied on in-house interpreters, bilingual registrars and other bilingual staff to assist them in registering Spanish-speaking families with limited English proficiency.

Although many of the patients themselves – children – are fluent in English, often one or both parents are not and need assistance communicating with registration staff, health care providers and others.

Registration staff were sharing one dual handset telephone for other languages, but the hospital's significant volume of Spanish-speaking families required that all on-duty registration staff have his/her own separate handset for connecting a Spanish interpreter with a family member.

Language Services engaged the Information Technology Department to determine what equipment would be best, and then two handsets with a splitter were purchased for each registration station – ensuring that a registration staff member could easily conduct a three-way call involving him/herself, a Spanish interpreter and a parent or other family member registering a child patient.

There are no longer delays in registration due to waiting for a Spanish medical interpreter. Patients are quickly being admitted for surgery or admitted to the emergency room, whether they and their family members speak English, Mandarin, Russian or Spanish.

Advice and lessons learned:

1. Befriend IT. Phoenix Children's Language Services Department now has an established relationship with the hospital's IT Department. IT contacts Language Services whenever they need help, such as updating and programming all of the hospital's phone lines to prompt callers to “Press 2 to hear this message in Spanish.”
2. Accurate information upfront serves you in the long-run. As staff in other areas have become more confident in using telephonic interpreters, and with the accessibility of telephone interpreting, Phoenix Children's now has more accurate information about the number of LEP families requiring interpreter services. Such data has allowed Language Services to hire another full-time Spanish interpreter and has motivated Registration management to hire more bilingual staff who can communicate with families in Spanish.

Cost/benefit estimate:
One indicator that the additional telephone equipment is being utilized is the rise in the hospital's telephone bill for Spanish language interpretation.