Enhancing Medical Interpretation Services at Tri-City Medical Center: 13th Annual Education Conference

1. TRI-CITY MEDICAL CENTER INTERPRETATION & TRANSLATION PROGRAM 13th Annual Education Conference Francisco Valle, MBA, Ph.D. Candidate Vice President – Marketing, Community Activities & Special Projects

2. Presentation Overview • Diversity in Our Service Area • Key Items within the National Standards for Culturally and Linguistically Appropriate Services (CLAS) • Standard 4 • Standard 5 • Standard 6 • Standard 7 • TCMC’s Interpretation Program • Results

3. Tri-City Healthcare District - Demographics • According to a Service Area Market Assessment Study by Medical Development Specialists Consulting - January 28, 2011: • Population≈ 500,000 residents in service area that includes 13 zip codes in Carlsbad, Oceanside and Vista • Highly variable median household income • Lowest is $44,215 in zip code 92054 in Oceanside • Highest is $109,688 in zip code 92011 in Carlsbad 3

4. Key Features of Hispanic Population Growth Linguistically Isolated Members Aged 14+ Years Old • According to the 2009 American Community Survey issued by the Census Bureau, a linguistically isolated household is a household where all members of the household 14 years and over have at least some difficulty with English 4

5. Educational Level • Education level is an important factors to consider when trying to reach multicultural markets 5

6. National Standards for Culturally and Linguistically Appropriate Services • National Standards for Culturally and Linguistically Appropriate Services (CLAS) in Health Care Based on Title VI of the Civil Rights Act of 1964 • Standards 4, 5, 6, and 7 of Title VI of the Civil Rights Act of 1964 (Title VI) deals with services required for limited English proficient (LEP) individuals • Title VI requires all entities to ensure that LEP persons have meaningful access to the health services that they provide • TCMC complies with these requirements

7. National Standards for CLAS in Health Care (Continued) • Health care organizations should: • Explicitly inquire about the preferred language of each patient/consumer (e.g., the language in which he or she feels most comfortable in a clinical or non-clinical encounter). Record this information in all records. • TCMC modified its MRS to enforce this requirement + more • Health care organizations must provide to patients/consumers in their preferred language: • Both verbal offers and written notices of their right to receive language assistance services • Language services must be made available to each LEP individual regardless of the size of the individual’s language group: • At no cost • At all points of contact • In a timely manner • During all hours of operation TCMC complies with all of this

8. National Standards for CLAS in Health Care (Continued) • Family and friends should not be used to provide interpretation services (except on request by the patient / consumer) • If requested, a note is added to the patient’s medical record • A TCMC’s telephone/face-to-face interpreter must monitor the interpretation

9. Only Staff Personnel Qualified as an Interpreter can provide Medical Interpretation Services • Healthcare organizations must: • Not rely on staff who are apparently bilingual or lack interpreter training because it frequently leads to: • Misunderstanding, Dissatisfaction and Omission of vital information • Misdiagnoses and Inappropriate treatment • Lack of compliance • Assure the competence of language assistance provided by interpreters and bilingual clinical, non-clinical and staff person who are in direct contact with patients • Assess and ensure the training and competency of individuals who provide interpretations services • TCMC’s personnel who have been • qualified through an assessment • performed by TCMC’s outside vendor • are the only ones who can provide • interpretation services

10. TCMC’s Current Enhanced Interpretation Program for All Languages

11. Telephone Interpretation Services for more than 200 languages • The new LSA phones – Corded Dual Handsets • LSA phones can be used to obtain interpretation services for more than 200 languages • Just press the INTERPRETALK button on the phone: • When greeted by a coordinator, please provide the following information: • Department/Unit • Caller’s Last Name and First Name • Patient’s Medical Record Number • Language needed • Cost Center

12. REMOTE ACCESS TO LSA’s Telephone Interpretation Services (continued) • You can secure the LSA service from any place through any telephone or cell phone by dialing a dedicated telephone number • Cost Center

13. Interpretation Services for American Sign Language, Spanish Sign Language, and TTY • The LSA & Wireless NexTalk Video Remote Interpretation Service

14. TCMC’s Assessed/Qualified Bilingual Clinical, Non-Clinical and Staff Personnel • TCMC has assessed bilingual (English-Spanish, English-Tagalog, English-German, and English-Russian) clinical, non-clinical and staff personnel who have volunteered to serve on a dual-role capacity. • NOTE: The individuals assessed are not used to interpreter at other units or departments unless there is an emergency situation

15. In-House, Face-To-Face, Medical Interpretation Service for SPANISH LANGUAGE ONLY • The in-house, English-Spanish medical interpreters providing Face-To-Face interpretation services: • Were rated superior or above by an outside vendor • Hold a medical interpretation certification • Have prior experience as medical interpreters

16. Employee Orientation & Training/Certification Requirements • Each employee must complete a competency check list • Compliance with this requirement is tracked in RESQ • This compliance is scanned into each employee file • LBI will track compliance and report each employee not in compliance with this requirement

17. TCMC’s Interpretation Program • Provides language interpretation services when they are needed and where they are needed • Ensures equal access to medical services and communication tools to LEP patients and their families, friends, support persons, and surrogate decision makers • Decreases missteps, misdiagnosis and miscommunications with LEP patients and their families, friends, support persons, and surrogate decision makers • Meets the interpretation services recommended by Title VI, Joint Commission, and others • Increases the patient satisfaction scores of TCMC • Prevents sentinel events caused by miscommunication

18. You are probably thinking: Does this really work?

19. Results 1. Passed with no findings the JC Survey in Fall 2012

20. Results 2. Recognition throughout San Diego County Francisco J. Valle was named by the U-T San Diego The 2013 Health Professional of the Year

21. Result 3. Contribution to The Overall Medical Center’s Outstanding National Rating

22. Results 4. Hispanic Market Share Growth

23. Questions?

24. Thank You!