A NEW APPROACH TO LANGUAGE SERVICES IN HEALTH CARE A Guide for Organizations Considering a Consultant for Language Access Planning
CONTENTS 1 :: A New Approach 1 :: Perceptions 2 :: A History of Language Access Planning 3 :: The Challenge 4 :: Common Language Service Providers 6 :: Choosing a Consultant 7 :: Conclusion Connecting Cultures, Inc. Language Access Solutions for Health Care PO Box 28585 Green Bay, WI 54304 866-687-0407 Telephone 920-544-9380 Fax www.experienceconnectingcultures.com (c) 2012 Connecting Cultures, Inc. All rights reserved.!
A NEW APPROACH Sustainable language access plans are not dependent on any one solution or language service provider. They are managed by health care employees and have clear operational standards that can easily be assessed for improvement opportunities. The outcome is the successful integration of language services into existing operational processes, giving providers a service they can trust and a program leadership can manage. Consulting firms with expertise in operational design for language services will make language access a viable business solution. PERCEPTIONS The common perception of language services is that it is a compliance requirement that puts a financial burden on health care. The message sent to health care is that language services are the rights of the patient. Language access, however, is not a patient access problem. It is a business problem. Are language services for the patient or for health care? Health care needs business solutions for language services that will support strategic initiatives while still complying with industry regulations. Unfortunately, many language access plans fail to add value to an organization because they are built based on a solution that only addresses one part of the larger problem. Until health care sees language services as a business solution, language services will fail to deliver the ideal balance between business and patient outcomes. A GUIDE FOR ORGANIZATIONS CONSIDERING A CONSULTANT FOR LANGUAGE ACCESS PLANNING 1
A HISTORY OF LANGUAGE ACCESS PLANNING Traditionally, health care has depended on language service companies to design the language access programs. As organization s became more aware of the risks of using family members or friends, they started to look at language service companies to meet their language access needs. Such language access programs were the result of the particular solutions the language services company offered. Success has eluded many language access initiatives. While the U.S. demographics changed and the limited English speaking community grew, one vendor couldn't always address all needs of a health care organization. The business model of many language services companies is not specific to health care, resulting in claims that one company can offer any solution the customer needed. Over time, some health care organizations took the initiative to establish agreements with a combination of vendors to improve accessibility. As new vendors continued to come to market with business models similar to the original vendors, language services have become a product rather than a service. The era of one language services company developing an entire language access program based solely on their products has passed. Now many language service companies and providers are simply filling a gap in a program designed by someone else. Today, health care organizations design their own programs based on the research of available material written for health care interpreting. Much has been published by patient advocate organizations and vendors that provide services to a number of different industries outside of health care. Many of these same resources have shaped the current compliance requirements for health care. Unfortunately this information lacks guidance for developing and operationalizing language access programs. A GUIDE FOR ORGANIZATIONS CONSIDERING A CONSULTANT FOR LANGUAGE ACCESS PLANNING 2
THE CHALLENGE Health care is at a disadvantage. Resources for language services are limited to suggested high level guidelines for successful outcomes but fail to help with operational implementation or design. The disconnect between health care administrators, medical providers and patient advocates complicates things even further. Language services are intangible. As soon that they re delivered, they re gone. Language access programs vary from one organization to another. Purchasing chains, budgets, process owners and utilization are equally varied. The design of these programs tend to only look at one solution for one piece of a much larger problem. There is an existing perception that all language service providers deliver a similar service and value. Accordingly, cost and availability are the main, if not only, differentiators for selecting resources for the language access plans. Patient service providers are frustrated with the organizations choices of language service providers and often seek their own solutions. Many patient advocates maintain a perspective that is blind to the business needs of health care. Often the data organizational leaders use to oversee business outcomes does not reflect a positive ratio between the value delivered and the cost of language services. As a result funding for language services is often very low. Unfortunately this ongoing cycle of disconnected perspectives has only strengthened the health care opinion that language access is a compliance issue to serve the needs of LEP patients. A GUIDE FOR ORGANIZATIONS CONSIDERING A CONSULTANT FOR LANGUAGE ACCESS PLANNING 3
COMMON LANGUAGE SERVICE PROVIDERS Language access plans typically use the following solutions for regulatory compliance. Successful businesses design their services according to the experience they hope will keep customers coming back. Language Service Companies give health care organization access to an interpreter when requested. There are various modes of delivery. Many prefer to use on-site interpreters, yet telephonic interpreting companies often become the selected solution because they have access to a wider variety of languages. Most recently video interpreting has become more available to the health care market. Each language service company offers a different combination of resources. Many companies have tried to develop training programs to qualify health care interpreters, but very few have succeeded. Health care interpreter training programs lack standardization in design, delivery, and learning outcomes. The variation makes assessing qualifications difficult for any organization recruiting and hiring an interpreter. Independent Contractors are contacted directly by the health care organization to provide interpreting services. They may also be asked to provide written translations. Many are also contracted to meet customer demand for any number of language service companies. Independent contractors operate as their own business, keeping their own schedules and creating their own fee structure. Historically, many have tried to use independent contractors to meet the demands for language services. The variation of qualifications, training, experience and time spent in the health care environment make this an inefficient solution void of structure or standards. A GUIDE FOR ORGANIZATIONS CONSIDERING A CONSULTANT FOR LANGUAGE ACCESS PLANNING 4
Staff Interpreters may reduce direct costs and resolve availability and utilization problems often caused by language service companies. In this scenario the organization establishes its own hiring and training criteria to select the interpreter. Logistics programs are also needed to facilitate requests between departments and interpreter. As the utilization volume grows, so does the need for additional interpreters, increasing labor costs. Many organizations use these interpreters to provide written translation materials as well. Helath care needs operational standards for language service providers. Bilingual Medical Professionals, other wise known as dual-role interpreters, are another way to provide language access services. When performing their regular duties, they speak with the patient in their native language. In their dual-role capacity they are pulled away from their primary responsibilities to work with others when language services are needed. This may be in their assigned department or in another area of the facility. Hiring and management tools- such as assessments to identify the knowledge, skills and attitudes needed for successful interpreting and quality control- are not standardized by the health care nor the interpreting industry. Organizations also share the same training and retention challenges as language service companies. Process Specialists are being asked by executives to engage in language access program evaluations. Programs designed for compliance lack standardized processes and are notoriously inefficient because program managers are unaware of how language services affects the entire organization. Failure to understand the health care interpreting industry and the implications on patient outcomes create unexpected challenges for process specialists. Industry standards and subject matter expertise for health care interpreting are key components of any process improvement initiative. A GUIDE FOR ORGANIZATIONS CONSIDERING A CONSULTANT FOR LANGUAGE ACCESS PLANNING 5
CHOOSING A CONSULTANT Organizations seeking a new approach to developing a sustainable language access program now have choices. When considering a consultant, an organization should answer the following questions: Does the consultant demonstrate an objective expertise of the interpreting and translation industries? Does the consultant have specific experience working with language access in health care? Does the consultant understand the dynamics of organizational culture and change management? How does your organization define service excellence? Does the consultant understand the principles of continuous improvement theories? Does the consultant have experience designing and implementing sustainable language access programs that focus on business strategy and patient outcomes? Has the consultant designed key quality control metrics that analyze the outcomes of language services and identify opportunities for for program improvements? Does the consultant have experience designing and implementing operational standards for language services in health care? Does the consultant have the ability to objectively assess current market solutions including, but not limited to, language service providers, modes of language service delivery and interpreter training programs? Has the consultant created professional development programs and resources for language access coordinators? A GUIDE FOR ORGANIZATIONS CONSIDERING A CONSULTANT FOR LANGUAGE ACCESS PLANNING 6
CONCLUSION Ask anyone their definition of quality, professional, effective, trained, superior customer service, innovative, easy, or any other word used to describe a service and every person will have a different answer. All of these terms are subjective and the definitions are based on the experiences of the individual. When the perspective on language services shifts from compliance to resource, health care will create a patient access initiative that can achieve strategic business goals and comply with industry language access regulations. It is time for a new approach to language access. Sustainable plans combine health care business needs with professional interpreters that specialize in heath care. The natural consequence will be better access to health care for the limited English proficient population. The reward will be better business outcomes for the health care industry. A GUIDE FOR ORGANIZATIONS CONSIDERING A CONSULTANT FOR LANGUAGE ACCESS PLANNING 7
CONNECTING CULTURES, INC. Language services is only one piece of the larger language access puzzle. We give health care a new opportunity to solve that puzzle. The Connecting Cultures, Inc. consulting, training and language service programs were designed specifically for operational efficiencies in health care. Our foundation is built on the premise that when health care has access to language solutions they trust, we will connect cultures. If you d like to learn more about how you can experience the difference Connecting Cultures can make in your organization, please call 866-687-0407. Rashelle LeCaptain Connecting Cultures President PO Box 28585 Green Bay, WI 54304 866-687-0407 Telephone 920-544-9380 Fax experienceconnectingcultures.com A GUIDE FOR ORGANIZATIONS CONSIDERING A CONSULTANT FOR LANGUAGE ACCESS PLANNING 8