Building Infrastructure to Increase Access to Care for Limited English Proficient Patients

The 2003 Institute of Medicine's report, Unequal Treatment: Confronting Racial & Ethnic Disparities in Healthcare, provides evidence that socio-cultural differences between patient and provider influence communication and clinical decision-making. Research suggests that provider-patient communication is directly linked to patient satisfaction, adherence, and subsequently, health outcomes. In order to begin to address patient-provider communication issues, systems and structures need to be established from a systems perspective.

The provision of culturally and linguistically appropriate care is the responsibility of the whole healthcare system and has direct implications for quality of care. Over the last three years, St. Joseph Health System (SJHS), a Catholic non-profit health system with hospitals in California and Texas, has incrementally expanded its Language Access Initiative systemwide, through support from The California Endowment and the UniHealth Foundation, to begin to systematically address the linguistic needs of its Limited English Proficient patients. A central component of the infrastructure includes the role of Language Access Coordinators who are responsible for developing the systems and structures for Language Access in their local hospital.

The presentation describes the infrastructure in place and the key strategies, challenges and opportunities experienced over a three year period. A key component includes securing internal leadership support, building information technology capacity and developing training for staff. Curriculum development for healthcare interpreter training is one of several strategies to increase staff competencies to respond to the needs of Limited English Proficient (LEP) patients. The discussion will also outline the methodology followed in the development and implementation of continuing education tools for healthcare interpreters and healthcare professionals. Finally, the presentation will describe the next steps to continue to build the needed internal infrastructure to respond to the changing demographic and linguistic needs of Califonia and Texas non-profit hospital's patient population.