When Esmerelda Cruz Aleman of Branson gave birth at Cox South in mid October, she had access to the experts in Labor and Delivery and they, in turn, had support from a new service that helps caregivers communicate with patients who speak limited English.
Being hospitalized can be a stressful experience for anyone and for those who speak little or no English, it can be even more challenging.
Caring for these patients has long involved working with in-person interpreters or caregivers who are fluent in another language. Occasionally, staff members have even communicated through a patient’s family members — a practice that is a major error when dealing with health information.
This month, however, the formal introduction of the Language Line service will create a single, consistent source for translation services.
It’s a move that’s designed to improve patient safety and help CoxHealth better serve a rapidly growing part of the community.
“Springfield traditionally hasn’t been a diverse population, but we are becoming more and more diverse and we’re starting to see our need for language interpretation with micro segments of the population is increasing at a rapid rate,” says Vicki Good, CoxHealth’s director of nursing. “It’s becoming increasingly difficult to meet that demand.”
Language Line is a California-based company that provides access to interpreters in more than 170 languages, 24 hours a day, seven days a week. Staff members will be able to access a translator by calling an 800 number, where an operator will connect them with an interpreter.
For common languages such as Spanish, Language Line officials estimate that a translator will be available in 3-20 seconds. Less common languages may require more time, but waits will still be less than 90 seconds.
Frederique O. Rich, a business development executive for Language Line, says the company works with about 95 percent of all health care providers in the United States, offering everything from transcription services to phone-based and in-person translation.
For the phone service, Language Line employs more than 8,000 interpreters, all of whom have passed language proficiency tests and undergone a curriculum of courses on translation skills. Interpreters specializing in health care also have training in medical terminology and concepts and many also have skills in a variety of specialties, such as oncology.
Rich says the service has become popular as hospitals work to serve their patients in a way that improves patient safety while remaining cost conscious.
“The system is efficient, especially when hospitals are resource strapped,” she says. “Most medical errors come from poor communication. When you add a layer of foreign language, that risk multiplies. It’s important to have the right resources.”
Getting the right resources in place at Cox has been a goal for Nursing Administration since they first began exploring Language Line as an option. The demand for translation services has been on the rise and the costs of working with local, in-person translators can be startling: Last year, Good says the system spent between $600,000 and $800,000 on translators.
A lot of that cost comes from the way in-person interpreters are paid. Interpreters typically charge by the hour, from the time they are dispatched until a patient’s appointment or procedure is complete. In the case of a surgery, for example, an interpreter would be on duty throughout the entire procedure, even if translation were only needed for pre- and post-op care.
Nursing Administration also spent a lot of time seeking out and coordinating with local interpreters. When a patient needed a translator, staff would go through a list of approved interpreters. For an urgent care visit, they would look for one who could drop what they were doing and come right away. For a scheduled appointment, it was a matter of coordinating a time when the doctor, the patient and the interpreter would all be available.
“Face-to-face translation isn’t quick and it isn’t cost effective,” says Nursing Administration’s Ruth Loy, noting that Language Line will replace all of the current procedure with a phone call. “This is instant, it will help when doctors are making rounds or if an employee just meets someone in the hall who doesn’t speak English.”
Loy says it has been a challenge to find face-to-face interpreters for the increasing variety of languages staff members are working with. While Spanish is the most frequently encountered, Russian, Vietnamese and Romanian are also becoming common.
Switching to Language Line will allow staff access to interpreters in all of those languages, while eliminating the time spent coordinating with, and billing for, an in-person interpreter.
In the long run, Good and Loy say Language Line will offer a higher quality service for less. The service is budgeted for a $150/month fee plus translation at a rate of $1.40 per minute.
Good says the system is key to making sure all staff can communicate with non-English-speaking patients in a consistent manner, regardless of the situation.
“For the safety of our patients, we want to have guaranteed, rapid access to a competent interpreter,” Good says. “At any point, our staff will be able to pick up the phone and reach someone who can assist them. You can be assured that when you get somebody on the phone you have someone who is nonbiased and competent and can relay the information.”
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