The 131st Annual Meeting (November 15-19, 2003) of APHA

Abstract #63158

Katherine Ornstein, MPH and Jeremy Boal, MD. Visiting Doctors Program, Mount Sinai Hospital, Box 1216, New York, NY 10029, 212-241-4141, kath1975@yahoo.com

The Mount Sinai Visiting Doctors Program provides primary medical care to 600 homebound patients in Manhattan each year. More than one third of the patients seen in the program live in East Harlem, a predominantly Latino neighborhood where Mount Sinai Hospital is located. Spanish is the primary language for one out of every four patients and for many of the patients’ family caregivers and paid attendants. Language barriers between patients and their providers create huge challenges in providing care, especially when communication involves challenging end-of-life care discussions. In August 2001 a full-time Spanish language translator was hired through grant funding. All of the translator’s interactions with patients and caregivers were routinely tracked. Additionally, qualitative data about the impact of translation on complex care situations were collected and a follow-up satisfaction survey was conducted with patient caregivers and program staff. The translator was involved with the care of 135 patients, ranging from one-time family telephone conference calls to weekly house calls. 70% of the translator’s contacts were made in the home and 75% lasted more than 30 minutes. Contacts involved medical providers, specialists, social workers, community agency staff, family members, and aides. Program staff felt that the service improved their ability to care for patients, often empowering patients by making them less reliant on home attendants for translation. Caregivers indicated that they were able to communicate effectively with program staff members and that, in particular, they appreciated consistently working with the same translator.

Learning Objectives:

• Describe the incorporation of a skilled Spanish language translation services into an urban home medical program
• Explore how Spanish translation services influence end-of life care discussions
• Discuss the impact of Spanish language translation service on overall patient care as well as provider and caregiver satisfaction

Keywords: End-of-Life Care, Latino Health

Presenting author's disclosure statement:
I do not have any significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.