Report Highlight: Languages Other Than English

All patients and their families deserve to feel empowered in their access to and choices around quality healthcare. Interpreter and Translation Services provides critical support to patients and families who use languages other than English to ensure everyone has access to the information and services needed for healthy outcomes. Seattle Children’s commitment to improving the experience of patients and families who use a language other than English is focusing efforts on: 1) stabilizing the Interpreter and Translation Services program to prepare for future growth and improvements, 2) expanding various programs such as access to video interpreters and 3) trying new approaches to providing care using interpretation and translation for languages other than English. 

The need for interpretation is growing

The number of interpreted encounters per year has increased by 19% over a five-year period. In 2021, there were over 140 languages spoken by patient families and more than 79,000 interpreted encounters across both inpatient and outpatient settings. Since 2019, the average number of interpretations per day has almost doubled to nearly three interpretations per day for families who use a language other than English while their child is staying at the hospital. 

Action

Improve experience and increase resources for interpretation and translation services for patients and families who use a language other than English. 

Progress to Date 

• A 13-week human-centered-design project in FY21 resulted in 25 detailed recommendations on how to develop a scalable model to support the needs and improve the experience of patients and families who speak a language other than English. These recommendations and learnings were incorporated into a multiyear project plan with multiple phases; 11 projects are currently in progress, in various stages. 
• Increased capacity to meet increasing interpreter requests by hiring two new positions: a programcoordinator to manage translations and a position to support the Cultural Navigation Program. 
• To hire and retain the interpreters needed for in-person interactions, Seattle Children’s has built and is implementing a career pathway for interpreters and translators to allow for career growth and attract the bilingual staff that patients and families rely on. 
• Expanded the number of iPads available to support real-time video interpretation with a video interpreter. 
• Planned a pilot program in the Gastroenterology clinic to extend appointment times for patients and families who speak a language other than English to better understand the impacts of offering longer appointments. 
  • Developed a robust evaluation plan for a six-month pilot program to launch in summer or fall of 2022 to inform best practices and scaling potential.

What is human-centered design and co-design? 

Human-centered design (HCD) is a process of creating solutions with impacted communities to ensure the results meet their needs and honor their values and priorities. A specific methodology of HCD, co-design, is a newly adopted approach for Seattle Children’s and includes all participants in the interactive work to design a new service, product or solution. HCD is also being applied in some phases of other Action Plan projects, such as the Behavioral Response Project to replace Code Purple. Co-design means that not only do all communities have the opportunity to provide input to help define the problems being solved for, but the design team includes representatives from all communities as well. 

As the project team begins to implement specific solutions, patients and families will be invited back to co-design aspects of the program that impact them most. 

Building momentum on existing efforts 

• Employee certification for language skills of various levels already exists. Many workforce members are currently recognized for language strengths that can support patients and families.  
• Medication instructions are currently provided in multiple languages and there are efforts to increase translation turnaround time for after-visit summaries. 
• The research language office has been in place for a year, improving the recruitment of underrepresented participants into research studies, particularly those who speak a language other than English. 
  • Providing centralized translation and interpreter services helps ensure interactions are high-quality, improving the experience for families and research teams while enhancing scientific validity by ensuring that families who speak a language other than English can fully engage with the research protocol and data collection. 
  • The centralized language resource allowed the hiring of a bilingual Spanish recruitment specialist as a research study team member to support Spanish speaking families through the consent process. The specialist not only provides interpretation, but also supports the recruitment and enrollment of families who use languages other than English into clinical trials at Seattle Children’s. Examples include supporting Spanish-speaking families enrolled in COVID-19 pediatric vaccine trials.