Intervention Title:
Simplifying Interpreter Access Through the SPEAK Line, Seattle Children’s Hospital, Seattle, Wash.

Goal:
Simplify fast access to interpretation and increase utilization of phone interpretation.

Innovation: 
Installation in all hospital rooms of dual-handset phones with one button connecting directly to interpreters allowing for instant access to interpretation for patients and their families. 

Result:
Created quick, hassle-free way for patients, their families and health care providers to access interpreters. Providers learned not to wait to communicate with limited English proficient (LEP) patients and instead access interpreters right away. Nurses are now able to communicate with LEP patients in real time and develop better relationships with patients and their families.

Institution:
Seattle Children's Hospital
4800 Sand Point Way, NE
Seattle, WA 98105
P: (206) 987-2000

From the C-Suite: 

“Before implementing the SPEAK-line, we were concerned that families with limited English proficiency were not having frequent interactions with providers. The SPEAK-line has enabled immediate communication in real-time with patients and their families, and has become integrated into our practice as part of every hospital service.” 

Patty Hencz, R.N.
Manager Interpreter Services

Profile:
250-bed hospital and pediatric referral center for Washington, Alaska, Montana and Idaho.

Clinical areas affected:

• Inpatient units
• Interpreter and Translation Services 

Staff involved: 

• Nurses
• Physicians
• Supervisor of Interpreter Services
• Telecommunications staff 

Timeline: 
A one-week rapid improvement process workshop led to the immediate implementation of a single-dial phone line to reach interpreters. One year later, the hospital implemented the use of a dual phone (one handset for provider and one for patient) at the bedside. Within six months, they were installed in every patient room in every unit hospitalwide.

Contact:    
Juan Fernandez
Supervisor, Interpreter and Translation Services
juan.kraus@seattlechildrens.org
P: (206) 987-2825

Innovation implementation:
Seattle Children’s Hospital implemented a single-dial phone line for clinical staff to reach hospital interpreters, but soon realized that a better system was needed. When using a single phone line, clinical staff and patients’ families had to use a speaker phone, or a dual handset phone not located in the patient room, to communicate with an interpreter over the phone. This process proved tedious and often resulted in providers waiting to communicate with patients who had limited English proficiency.

To improve access to phone interpreters, Seattle Children’s Hospital installed dual phones that included two handsets for one phone line. These new phones enabled both clinical staff and a patient (or his/her family member) to be on the phone with an interpreter, making communication easy and readily accessible. While in-person interpreters are still ordered, the SPEAK-line allows opportunities for simple, quick interactions, as well as for providers to develop fuller relationships with patients and their parents.

The implementation of the SPEAK-line was fine-tuned to make it as easy as possible to utilize. Phone cards were placed on each phone with simple instructions. Cards with information about the SPEAK-line were developed and added to staff hospital badges. The telecommunications staff was involved to help ensure a smooth initial roll out. Peer-to-peer trainings taught staff how and when to utilize the SPEAK-line.

Advice and lessons learned:

1. Embed champions. Identify champions on each unit to encourage peers to use the SPEAK-line. Nurses teaching nurses and small group workshops among colleagues improved utilization.
2. Make it accessible. Keep the tool easy to access so that it’s integrated into practice and not an afterthought.
3. Listen to feedback. Learning from staff feedback, especially nurses, helped fine-tune the process to make it simple and easy to use. 

Cost/benefit estimate:
Phone encounters average seven minutes at approximately $1.50 a minute, or about $10.50 per call. An in-person interpreter costs approximately $40 an hour. With the SPEAK-line, there is no time lost while an interpreter waits around until he/she is needed.