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Vonessa Costa and Ranjani K. Paradise, “Language Access QI Tools for Safe LEP Patient Communication”, presented at the America’s Essential Hospitals VITAL2019 conference, Miami FL, June 2019


Patients with Limited English Proficiency (LEP) face communication barriers that can have adverse effects on safety and quality of care. Language access data collection and analysis is necessary to identify individualized language assistance needs, plan for safe communication at each point of care, and monitor health equity.

Cambridge Health Alliance (CHA) is a pioneer in best practices for LEP patient communication and has prioritized language access as a quality improvement focus area. Currently, 43% of CHA primary care patients identify as LEP and receive care in more than 65 languages at 18 sites located across 5 municipalities. To promote safe and effective communication practices, CHA created the Language Services Documentation Tool (LSDT), an innovative data tracking system within the electronic health record enabling documentation of all modalities of language assistance and identification of gaps and areas for improvement.

The LSDT makes possible consistent collection of comprehensive, accurate, real-time data about how LEP patients’ language needs are met in each clinical encounter and provides a detailed picture of the LEP patient experience across the organization. This imparts a solid foundation for targeted outreach to areas reporting the highest use of concerning communication practices, such as the use of ad hoc interpreters, and has fostered collaborative synergy in QI initiatives resulting in sustained improvements system-wide.

This presentation will provide an overview of recent changes to national language access legislation and regulatory requirements, as well as a comprehensive demonstration of how the LSDT is used in data collection and analysis, and how the resulting data can guide the QI process. The presenters will offer a toolkit for sharing best practices for LEP communication across sites, identifying unit-specific challenges and solutions, and identifying and cultivating language access champions both in leadership and on the frontlines.