Improving interpreter documentation in the emergency department
Creators: name: Bender, Denise
Publisher: name: No Publisher Supplied
Year: 2021

description: Purpose of Project: In the United States, there are over 67 million people who speak a primary language other than English and more than 25 million that have limited English proficiency (LEP) (Census Bureau, 2019). Many times, providers look to family members or friends who are present with the patient for assistance in hopes for better communication, despite knowledge that information may not be accurate. To reduce language barriers and promote healthcare equality, hospitals have adapted the use of in-hospital translators and third-party interpretation services. However, providers still face challenges when using the interpreter phone such as lack of user knowledge, technological malfunctions, lack of time during a busy shift. Often, these challenges result in poor compliance of translator use leaving patients with an unmet need for interpretation. At the site of this project, metric data showed a hospital wide compliance of 19% interpreter compliance, evidenced by documentation in the EPIC translator flowsheet. This project was designed to interpreter use and documentation in the department with a goal of a 20% improvement. Methods: This quality improvement study investigated how the use of flyers and reminders during daily huddles would affect the use of translators in the emergency department by using documentation in the predesigned translator flowsheet as a tool for measurement. A pre/post retrospective chart review was conducted for a total of 500 charts over 4-month period to evaluate documentation of interpreter services for adult patients requesting a translation at time of arrival. Results: Out of 250 patients in the pre-intervention group, only 12 (5%) had documentation of interpreter services. Following the intervention there was a 20% improvement with 62 out of 250 charts containing documentation of interpreter use for patients requesting translation. Significance of the intervention was determined through a chi square test of association and found to have a significance level of p&lt;0.001. Implications: This project was successful in introducing the next step towards a change department compliance and cultural equality. With only a two-intervention period, results of this study showed a significant increase site compliance with hospital and federal policies. Patients receiving translation were able to fully communicate with healthcare staff and provide an adequate medical history. This not only improves patient satisfaction but also decreases the risk of medication errors, additional unnecessary testing, discharge teaching, and collaboration of care. By reintroducing the importance of providing translation to LEP patients in the department, this project provides a unique opportunity to educate existing staff as well as new staff members throughout the hospital. Hospital employees of all levels should be educated on the hospital’s cyracom phone interpreter system, their location, and proper documentation. Ensuring compliance with interpreters can decrease hospital fines associated with turnaround times due to failure to understand discharge instructions or medications. Additionally, improved documentation decreases risk of legal action and associated fines for failure to provide language assistance to patients requesting an interpreter.