1. UMass Memorial Medical Center Interpreter Services Department

2. UMass Memorial Medical Center Three campuses and medical school Medical Center Statistics (Worcester): –Licensed Beds: 771 –Employees: 9,610 –Hospital Admissions: 40,013 –E.D. Visits: 128,250 –Ambulatory Department Visits 689,954

3. Interpreter Services Department Director of Interpreter Services: 1.0 FTE Coordinator of Education, Training, and Translations: 1.0 FTE Office Support Staff: 2.35 FTE Staff interpreters: 28.4 FTE (Albanian, ASL, Chinese, French, Portuguese, Spanish, Russian, Vietnamese) Independent Contractors: 40+ interpreters (ASL, Albanian, Amharic, Arabic, Bengali, Cambodian, Chinese Mandarin, Chinese Cantonese, Farsi, French, Haitian Creole, Greek, Guyarati, Hindi, Hmong, Italian, Korean, Polish, Portuguese, Russian, Spanish, Somali, Swahili, Twi, Tigrinya, Urdu, Vietnamese)

4. FY 02FY 03FY 04FY05FY 06FY 07 Forecast FY 08 Spanish25552363584224436827372324347148697 Portuguese4954617765267262764095949992 Vietnamese3492386538003459410452506087 Albanian1879279526432822310936673482 ASL1064720841921160117701862 "Other"4462473154035682594463336125 Total Volume41403546466145756973596307008576155 Interpreter Encounter Totals

6. How We Started

7. Basic Workflow of Department Identify Need for Interpreter Schedule Future Appointments –Face-to-face interpretation –Telephonic interpretation Manage Same-Day Requests –Onsite dispatchers handling live schedule Document Interpretation –Database & Medical Record

8. Identifying Need for Interpreter Patient’s language, and need for an interpreter, are required fields in the registration process Information is consistently collected at point of registration or inpatient admission Information becomes part of the patient’s electronic admissions data and medical record (available In IDX scheduling system)

9. Future Request Forms

10. Appointments Linked in IDX

11. Same-Day Requests Business Hours: –Two dispatchers –Interpreter floaters –Page/call system –Direct Access to Telephonic Interpretation After-Hours: –Answering Services –On-site & on-call interpreters –Direct Access to Telephonic Interpretation

12. Strategies Providing just-in-time access to language services Eliminates cost of interpreters delay Meets increasing demand Complements on-site resources Meets needs of patient centered organization and open access Discourage use of unqualified interpreters Tools Optimal equipment Direct access to an outsourced vendor Advance scheduling with vendor Advance notification to departments Just-in-Time Interpretation

13. Data as Catalyst to Quality The Encounter Form –Location –Date/Time –Providers –Informed Consents –Admission/Discharge Data Entry (Statistics) Medical Record

14. Recent Performance Measures From the RWJ “Speaking Together” Collaborative ST-1: Percentage of patients who have been accurately screened for their preferred languages ST-2: Percentage of patients receiving language services from qualified interpreters or bilingual providers ST-3: Percentage of encounters where patient wait time for an interpreter is 15 min or greater ST-4: Percentage of time interpreters spend providing medical interpretation in clinical encounters ST-5: Percentage of encounters where interpreters wait ten minutes or more for providers

15. Data Examples How Data Helps Prove the Point

16. BeforeRoll-Out AfterRoll-Out Telephonic Interpretation Increased 270% Increase from Apr ’07 to Apr ‘08

17. Night-Shift Interpretations What a difference an on-site interpreter makes! On-Call Interpreter On-SiteInterpreter

18. Case Study for ASL: Scheduled Appointments at Maximum

19. Case Study for ASL: Same-Day Requests Continue to Increase