UMass Memorial Medical Center

Interpreter Services Department

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

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)

FY 02 FY 03 FY 04 FY05 FY 06 FY 07 Forecast

FY 08

Spanish 25552 36358 42244 36827 37232 43471 48697

Portuguese 4954 6177 6526 7262 7640 9594 9992

Vietnamese 3492 3865 3800 3459 4104 5250 6087

Albanian 1879 2795 2643 2822 3109 3667 3482

ASL 1064 720 841 921 1601 1770 1862

"Other" 4462 4731 5403 5682 5944 6333 6125

Total Volume 41403 54646 61457 56973 59630 70085 76155

Interpreter Encounter Totals

Interpreter Encounter Totals

30000

35000

4000045000

50000

55000

60000

6500070000

75000

80000

FY 02 FY 03 FY 04 FY05 FY 06 FY 07 '08 - Est.

How We Started

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

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)

Future Request Forms

Appointments Linked in IDX

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

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

Data as Catalyst to Quality

• The Encounter Form– Location– Date/Time– Providers– Informed Consents– Admission/Discharge

• Data Entry (Statistics)• Medical Record

Recent Performance MeasuresFrom 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

Data Examples

How Data Helps Prove the Point

0

200

400

600

800

1000

1200

1400

Nov'06 Feb'07 May'07 Aug'07 Nov'07 Feb'08 May'08

BeforeBeforeRoll-OutRoll-Out

After After Roll-OutRoll-Out

Telephonic Interpretation Increased270% Increase from Apr ’07 to Apr ‘08

0

50

100

150

200

250

Nov'06 Feb'07 May'07 Aug'07 Nov'07 Feb'08 May'08 Aug'08

Night-Shift InterpretationsWhat a difference an on-site interpreter makes!

On-CallOn-CallInterpreterInterpreter

On-SiteOn-SiteInterpreterInterpreter

Case Study for ASL:Scheduled Appointments at Maximum

70

75

80

85

90

95

100

105

110

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

10

15

20

25

30

35

40

45

50