158938 Building Infrastructure to Increase Access to Care for Limited English Proficient Patients

Tuesday, November 6, 2007: 3:30 PM

Verónica F. Gutiérrez, MPH , Community Outreach Department, St. Joseph Health System, Orange, CA
George B. Avila, MURP , Manager, Healthy Communities, Mission Hospital, Mission Viejo, CA
Maya Dunne, MA , Community Outreach Department, St. Joseph Health System, Orange, CA
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.

Learning Objectives:
Understand Language Access as a Quality of Care issue; Describe and understand one faith-based health system's multi-level approach to a building Language Access infrastructure; Identify challenges and opportunities facing acute care hospitals respond to linguistic and racial/ethnic diversity of patients in their respective primary service area; Outline next steps to expand the systems and structures necessary for strenthening Language Access in a non-profit acute care setting.

Keywords: Access to Care, Immigrants

Presenting author's disclosure statement:

Any relevant financial relationships? Yes

Name of Organization Clinical/Research Area Type of relationship
St. Joseph Health System Language Access Employment (includes retainer)

Any company-sponsored training? Yes
Did the company pay your travel and lodging? Yes
Were you provide you with slides as part of the training sessions? No
Did you receive an honorarium or consulting fee for participating in the training? No
Any institutionally-contracted trials related to this submission? Yes
Have you received salary support, retainer, or other monies to support your position as part of the research/clinical trials? Yes
Have you served as the Principal Investigator) for the research/clinical trials? No
Have the results of your research/clinical trials been published? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.