EHR “Alerts” Increase Use of Interpreters

Intervention Title:
Electronic Health Records Alerts to Increase Utilization of Interpreter Services

Use of qualified interpreter services during admission increased from 44 percent to 73 percent over seven months, and during discharge from 26 percent to 60 percent. Overall, both use of qualified interpreters during admission and discharge increased more than fourfold, going from 10 percent to 53 percent in the same time period.

St. Mary’s Hospital
700 S. Park Street
Madison, WI 53715
P: (608) 258-5666

St. Mary’s is a not-profit, 440 bed tertiary referral hospital providing full range of health services. It serves 18 counties in south-central Wisconsin and has more than 24,000 inpatient discharges and 78,000 outpatient visits.

Anne Plesh, BS
Interpreter Services Supervisor
P: (608) 258-5666

Innovation Implementation:
Increasing provider utilization of language services for patients with limited English proficiency is a constant challenge for hospitals. Faced with limited time and myriad priorities, physicians and nurses often overlook or bypass the use of official, qualified hospital language services when treating these patients.

Recognizing this challenge and seeking to improve their use of language services, staff at St. Mary’s Hospital targeted the institution’s electronic health record (EHR) system as a key way to break into and influence provider behavior. Since all records of a patient’s stay and their provider interactions are recorded in the EHR, it is a universal lynchpin in their daily routines.

Working closely with the hospital’s information technology department, St. Mary’s made two changes that significantly improved the use and documentation of language services. First, they moved the language preference to the header of the chart where other critical information for patient care is found (such as allergy information and patient room number). This ensured that all staff could clearly recognize the need for interpreter services and helped to increase the use and documentation of interpreter services.

Secondly, St. Mary’s added a physician Best Practice Alert (BPA) to the EHR that notifies users that the patient requires interpreter services and prompts them to request it. The alert includes information on how to access an interpreter and a recommended dot phrase to facilitate documentation of interpreter services use.

As a result of the EHR changes, St. Mary’s achieved perfect or nearly perfect recording of patients’ preferred written and spoken language for healthcare. Additionally the documentation of the use of qualified interpreter services has increased 66 percent during admission and 130 percent during discharge.