Intervention Title:
Training and Tools to Ensure Accurate Screening and Registration of Patient Language Needs – Cambridge Health Alliance (CHA); Cambridge, Mass.

Goal:
Ensure that registration staff accurately screen and register patient language needs.

Innovation:
Staff developed a curriculum and supporting materials to support consistent and accurate registration of patient language needs.

Result:
The accurate screening of patient language needs at registration has led to improved collection of accurate language information and an increase in the use of interpreter services during patient encounters.

Institution:
Cambridge Health Alliance
1493 Cambridge Street
Cambridge, MA 02139
P: (617) 665-1000

From the experts:
“The proper registration of patient language needs allows us to provide timely language services to the diverse patients in our care from beginning to end. It is important that we understand who is in the hospital and what kind of support they will need. Without the language preferences being properly registered there is no realistic way that this can happen consistently. Working to educate and support our registration staff about the importance of this effort has made it a clear success.”

Loretta Saint Louis, Ph.D.
Quality Specialist for Linguistic Services

Profile:
Cambridge Health Alliance is a 300-bed hospital in an academic public health system.

Clinical areas affected:

• Registration
• Scheduling

Staff involved:

• Language Services Department
• Registration
• Scheduling
• Information technology
• Marketing Department

Timeline:
Developing the comprehensive set of tools and guidelines for registration staff took two to three months.

Contact:
Loretta Saint Louis, Ph.D.
Quality Specialist for Linguistic Services
P: (617) 591-6955
Lsaint-Louis@challiance.org

Innovation implementation:
An important part of delivering quality language services to all of the patients that require them is ensuring that their needs are accurately screened for—and documented—during the registration process. Frequently, staff will mistakenly assume a patient's preferred language or will hesitate to ask the questions necessary to accurately determine it. Failure to do this will mean that language needs are not always met in an appropriate and timely manner.

To ensure accurate registration of all relevant patient language needs data, the team at CHA worked to implement a reliable process for language screening. The first step was coordinating with the Information Technology Department to add fields to the existing patient registration system. These included recording the patient's primary language at home, preferred language for care and preferred language for written materials.

Next the CHA team developed an educational curriculum for introducing registration staff to the importance of consistently collecting this information. The curriculum clearly explains the vital need to accurately record this information, identifies the subtle differences between the data fields and underscores the impact that failing to record the information can have on the quality of care a patient receives.

To support the effort, a standard script was developed for the registration staff, as well as a poster that explained the patient's right to an interpreter. The poster offers an easy way for patients to request an interpreter, providing a visual, translated listing of more than 30 languages. When unable to communicate with a registrar, the patient can point to a language and have the appropriate interpreter called. If one is not available, the registration staff now have access to telephone interpreters so that all patient needs can be met.

Advice and lessons learned:

1. Look to existing resources. Before developing custom educational materials, be sure to look for existing resources that can be adapted to fit the need. CHA staff modified pre-existing state Department of Health resources for the language poster.
2. Educate staff persistently. It is difficult to ensure uniform adherence to data collection procedures for this type of information. Extra effort must be made to persistently and regularly re-educate staff about the need to collect accurate language information.

Cost/benefit estimate:
Developing the system and supporting materials for registering accurate patient language needs data does not involve new costs and can be handled with existing staff resources. The long-term benefit of recording this information is substantial, both in providing patients with high-quality, safe care and in understanding the true language needs of a community.