1. IMPROVING ACCESS TO CARE FOR SPANISH SPEAKING PATIENTS IMPROVISAR AXESOS HA CUIDADOS PARA PACIENTES QUE HABLAN ESPANOL

2. PEDIATRIC PRACTICE TEAM MEMBERS MYRNA ENRIQUEZ, JENNIFER COLLIER, ANNEMARIE LALLY, GINA MARZULLO, MARY HOFFMAN RN, KATHY LENZ, JEROLD STIRLING MD, LAURA BELLING MYRNA ENRIQUEZ, JENNIFER COLLIER, ANNEMARIE LALLY, GINA MARZULLO, MARY HOFFMAN RN, KATHY LENZ, JEROLD STIRLING MD, LAURA BELLING

3. OPPORTUNITY STATEMENT  In the pediatric practice, it was noted that many Spanish speaking patients accessed care in person rather than by phone  Baseline data gathered over 2 weeks showed that 83% of walk in patients were Spanish speaking  GOAL: Implement a system to improve access to care for Spanish speaking patients To decrease walk in rate for Spanish speaking patients

4. MOST LIKELY CAUSES Language Barriers  No bilingual triage staff  Triage phone prompts only in English  Spanish speaking patients reluctant to leave messages in Spanish despite instructions by bilingual clerical staff  Patient’s inability to communicate with English speaking MD’s without the assistance of a translator Patient Knowledge:  Unaware of triage line  Unaware that appointments are necessary for clinic visits Patient Preference:  Patients know there is bilingual staff at the front desk that will help them

5. SOLUTIONS IMPLEMENTED Added a Spanish option to the Nurse Phone Triage line to promote phone access and triage for Spanish speaking patients:  Redesigned phone triage tree and recorded the Spanish option  Spanish messages answered and translated by bilingual clerical staff  Promoted Spanish option during clinic visits and the quarterly patient newsletter

6. SOLUTIONS IMPLEMENTED Implemented use of the AT&T language line to facilitate phone communication with non-English speaking patients  Staff education  Established staff expectations for use of the language line and monitored utilization Expanded use of the AT&T language line to clinic visits  Purchased a portable phone for interpretation in the exam rooms  Established expectations for use by faculty and staff

9. RESULTS & ANALYSIS  The Spanish speaking patient walk in rate decreased dramatically with implementation of new access to care processes for this patient population  The percent of Spanish speaking triage calls increased with the implementation of the Spanish phone option  Clinical care has improved through effective translation services for both phone triage and clinic visits

10. NEXT STEPS  Establish a routing system for Spanish speaking calls to allow for effective triage  Monitor portable phone utilization during clinic visits  Develop Spanish patient education tool to instruct patients how to access care  Explore opportunities for on site certified medical translators  Continue efforts to hire bilingual staff