UMass Memorial Medical Center
Interpreter Services Department
UMass Memorial Medical Center
• Three campuses and medical school
• Medical Center Statistics (Worcester):
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Licensed Beds: 771
Employees: 9,610
Hospital Admissions: 40,013
E.D. Visits: 128,250
Ambulatory Department Visits 689,954
Interpreter Services Department
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Director of Interpreter Services: 1.0 FTE
Coordinator of Education, Training, and Translations: 1.0 FTE
Office Support Staff: 2.35 FTE
Staff interpreters: 28.4 FTE (Albanian, ASL, Chinese, French,
Portuguese, Spanish, Russian, Vietnamese)
• Independent Contractors: 40+ interpreters (ASL, Albanian,
Amharic, Arabic, Bengali, Cambodian, Chinese Mandarin,
Chinese Cantonese, Farsi, French, Haitian Creole, Greek,
Guyarati, Hindi, Hmong, Italian, Korean, Polish, Portuguese,
Russian, Spanish, Somali, Swahili, Twi, Tigrinya, Urdu,
Vietnamese)
Interpreter Encounter Totals
FY 02
FY 03
FY 04
FY05
FY 06
FY 07
Forecast
FY 08
Spanish
25552
36358
42244
36827
37232
43471
48697
Portuguese
4954
6177
6526
7262
7640
9594
9992
Vietnamese
3492
3865
3800
3459
4104
5250
6087
Albanian
1879
2795
2643
2822
3109
3667
3482
ASL
1064
720
841
921
1601
1770
1862
"Other"
4462
4731
5403
5682
5944
6333
6125
Total Volume
41403
54646
61457
56973
59630
70085
76155
Interpreter Encounter Totals
80000
75000
70000
65000
60000
55000
50000
45000
40000
35000
30000
FY 02
FY 03
FY 04
FY05
FY 06
FY 07
'08 - Est.
How We Started
1988
1. Formation of an “ Affirmative
Action Committee on services
to LEP patients”
•Findings:
Organization Com
•Interpreters (bilingual staff) were
not trained or compensated
•Services were not monitored on
quality or confidentiality.
•Limited resources to meet the
demand
2. Community Language
skills survey was distributed
1991
• UMMMC Interpreter
Services department is
formed.
1989
1..Formation of an IS Task Force.
2. Complaint to the DHHS, OCR.
based on country of origin and
language
• ISO director
•Advisory Group subcommittee
•Policies and procedures
3. DON for a new outpatient bldg:
•Training program
•Acknowledged UMMC ethical and legal
obligations to LEP patient
• Job descriptions
1999
Merger of UMass Medical
Center and Memorial
Hospital
Centralization of
administrations and
operations
Standardization of policies
and procedures
•Recommends establishing a
professional ISO, recruitment of
bilingual staff and translation of
hospital forms and signs.
•Creation of IS Advisory Group
Sub-committee
Diversity of com
languages
Basic Workflow of Department
• Identify Need for Interpreter
• Schedule Future Appointments
– Face-to-face interpretation
– Telephonic interpretation
• Manage Same-Day Requests
– Onsite dispatchers handling live schedule
• Document Interpretation
– Database & Medical Record
Identifying Need for Interpreter
• Patient’s language, and need for an interpreter, are
required fields in the registration process
• Information is consistently collected at point of
registration or inpatient admission
• Information becomes part of the patient’s electronic
admissions data and medical record (available In IDX
scheduling system)
Future Request Forms
Appointments Linked in IDX
Same-Day Requests
• Business Hours:
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Two dispatchers
Interpreter floaters
Page/call system
Direct Access to Telephonic
Interpretation
• After-Hours:
– Answering Services
– On-site & on-call interpreters
– Direct Access to Telephonic
Interpretation
Just-in-Time Interpretation
Strategies
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Providing just-in-time access to
language services
Eliminates cost of interpreters delay
Meets increasing demand
Complements on-site resources
Meets needs of patient centered
organization and open access
Discourage use of unqualified
interpreters
Tools
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Optimal equipment
Direct access to an outsourced
vendor
Advance scheduling with vendor
Advance notification to departments
Data as Catalyst to Quality
• The Encounter Form
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Location
Date/Time
Providers
Informed Consents
Admission/Discharge
• Data Entry (Statistics)
• Medical Record
Recent Performance Measures
From the RWJ “Speaking Together” Collaborative
• ST-1: Percentage of patients who have been accurately
screened for their preferred languages
• ST-2: Percentage of patients receiving language
services from qualified interpreters or bilingual
providers
• ST-3: Percentage of encounters where patient wait
time for an interpreter is 15 min or greater
• ST-4: Percentage of time interpreters spend providing
medical interpretation in clinical encounters
• ST-5: Percentage of encounters where interpreters wait
ten minutes or more for providers
Data Examples
How Data Helps Prove the Point
Telephonic Interpretation Increased
270% Increase from Apr ’07 to Apr ‘08
1400
1200
1000
800
600
400
200
0
Nov'06 Feb'07 May'07 Aug'07 Nov'07 Feb'08 May'08
Before
Roll-Out
After
Roll-Out
Night-Shift Interpretations
What a difference an on-site interpreter makes!
250
200
150
100
50
0
Nov'06 Feb'07 May'07 Aug'07 Nov'07 Feb'08 May'08 Aug'08
On-Call
Interpreter
On-Site
Interpreter
Case Study for ASL:
Scheduled Appointments at Maximum
110
105
100
95
90
85
80
75
70
Case Study for ASL:
Same-Day Requests Continue to Increase
50
45
40
35
30
25
20
15
10