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APHA Scientific Session and Event Listing

Sheila Och, MPH¹, Dorcas Grigg-Saito, MSPH, Evelyne Delori, FNP, and Bonnie Sharpe, RN, BS, MHA⁴. (1) Community Health Promotion, Lowell Community Health Center, 15-17 Warren Street, Lowell, MA 01852, 978-746-7838, Sheilaoc@lchealth.org, (2) Family and Women's Health, Lowell Community Health Center, 15-17 Warren St., Lowell, MA 01852

Lowell Community Health Center (LCHC) in Lowell, MA, serves 22,000 people a year, 72% of whom are better served in a language other than English. LCHC's ethnically diverse patient populations present with increasing levels of acuity and numerous health care needs that are further complicated by the complexity of their medical histories, cultural and linguistic barriers, lack of consistent medical care, and socioeconomic status. According to feedback from Spanish, Portuguese, Khmer (the Cambodian language), and Swahili/French/English patient advisory groups held by LCHC in collaboration with Massachusetts Alliance of Portuguese Speakers and the African Assistance Center, language is a significant barrier to care. A CDC funded Cambodian Community behavioral health risk factor survey revealed that 67% of the 381 adults ages 25 years and older who were interviewed preferred to have an interpreter in the health care setting. The majority of LCHC patients need interpreter services through the continuum of care. Statistics from our management systems database indicate that 23% of LCHC patients speak Spanish,15% speak Khmer (Cambodian language), 9% speak Portuguese, and another significant percentage speak a wide variety of other Asian and African languages. A CQI model, using the FOCUS-PDSA approach, is presented for promoting cultural competence in a community health center and improving the health status of patients through improvements in the patient-provider relationship, specifically looking at cross-cultural communication skills of patients, providers, and interpreters. The Language Access System Improvement Team (LASIT) performance improvement project is described, including the development of interpreting and medical terminology competency assessments, financial incentives for medical interpreters, training for medical providers in other languages and in working with interpreters, training for registration staff on accurate data collection on race, ethnicity and language, development of policies on written translation and verbal interpretation, and the development of an in-house interpreter training curriculum for bilingual staff. Outcomes reported include an increase in bilingual, bicultural staff, increase in Latino, Southeast Asian, African, and Brazilian patients; increase in patient and provider satisfaction; and improvements in employee cultural competence understanding and interpreter capabilities. Recommendations are made for application to other health care settings and funding for the work.

Learning Objectives: At the conclusion of the session, participants at this session will be able to

• Describe ways of improving linguistic access to services through performance improvement.
• Define steps to providing linguistic access to services.
• Articulate methods of increasing input from patients and communities regarding service improvement strategies.

Keywords: Quality Improvement, Cultural Competency

Presenting author's disclosure statement:

Not Answered