Promoting Health Equity Through Language Access
The U.S. Census Bureau revealed that 68 million people speak a language other than English at home, and 26.5 million of this group report speaking English less than “very well.” Language barriers present a significant barrier in their journey to access healthcare.
The objective of promoting health equity through a language access plan is to ensure that patients with limited English proficiency (LEP), deaf, or hard-of-hearing backgrounds can achieve health outcomes comparable to those of native English speakers. However, notable health disparities persist.
"It is 2023 and the fact that kids still have the same experience I had of translating complex medical information for my parents is unacceptable. Children, family members, and others should not be held responsible for translating complicated and emotional information in order for their loved one to access needed care.”
Today, we will outline a step-by-step guide for establishing a comprehensive language access plan for your healthcare organization. Before diving in, let’s explore some key terms.
How to Define a LEP Patient?
Patients with limited English proficiency (LEP) may not speak English as their primary language or have difficulty reading, speaking, writing, or understanding English. Such patients have a right to trained medical interpreters and translators.
In addition to being an ethical decision, maintaining compliance with federal laws and requirements is imperative for hospitals that receive Federal financial assistance. This includes Medicare Parts A, C, and D. Such hospitals must ensure meaningful access to healthcare services for individuals with limited English proficiency. An incomplete or weak language access plan can also impact your hospitals’ CMS (Centers for Medicare & Medicaid Services) and HCAHPS (Hospital Consumer Assessment of Healthcare Providers and Systems) ratings.
What is a Language Access Plan?
A language access plan is a detailed document outlining the strategies, policies, and procedures to provide language assistance to patients with limited English proficiency (LEP). It consists of both oral and written communication services to facilitate meaningful access to and equal opportunities for LEP patients in their health journey.
What is a Language Access Coordinator?
A language access coordinator is responsible for managing the creation and execution of a language access plan. Their responsibilities typically include securing funding and resources, recruiting linguists, offering input on budget-related issues, and consistently evaluating the effectiveness of language access services.
How to Create a Language Access Plan to Overcome Language Barriers in Healthcare?
Crafting a language access plan may seem overwhelming, which is why we’re simplifying the process into manageable steps. This will help you stay organized, evaluate your existing program, and enhance its overall effectiveness.
Step 1: Needs Assessment
Conduct a comprehensive needs assessment to evaluate the current state of language accessibility throughout the journey of Limited English Proficiency (LEP) patients. You can start by:
- Identifying the languages spoken by patients
- Outlining the existing language access services
- Assessing staff training to effectively utilize and provide language support
- Determining the necessity for professional interpreters and translators
- Evaluating budgets and funds required for comprehensive language assistance
This systematic approach will help identify specific needs and language-related disparities in care. To develop a more holistic understanding of the language needs within your hospital patient population, consider leveraging both internal and external data sources. For example,
- Your hospital’s call center information and electronic health records
- Public resources like those offered by the U.S. Census Bureau, which compiles data on non-English languages spoken in the United States
- The Inventory of Resources for Standardized Demographic and Language Data Collection provides information on standardized data collection for various demographics like race, ethnicity, and language
Our free guide on healthcare language access plan also contains a gap analysis tool to help you identify key areas for remediation and build a 12-month plan.
Step 2: Written Policy and Procedures
Develop a written policy and procedure for language access that aligns with the federal and state laws and regulations, as well as the organizational mission and goals. This means identifying:
- Aim and objectives of the language access plan
- Responsibilities of staff and language service provider
- Staff training needs to utilize and implement language support
- Strategy to inform patients about language assistance provided
- Process for monitoring and evaluating the language access plan
Step 3: Align with Organizational Goals
Align the language access plan with overall organizational priorities. Emphasize the positive impact of the language access program, addressing financial, legal, and ethical aspects, while aligning with stakeholders’ primary concerns. Consider the hospital’s overarching goals, collective concerns, and current risks. Language Access Coordinators must present a clear, evidence-backed case for the plan’s necessity and feasibility. Here are a couple of ways you can do this:
- Align the language access plan with the hospital’s broader objectives, showcasing how it contributes to achieving these goals.
- Identify and address collective concerns, threats, and risks faced by the hospital system, positioning the language access plan as a strategic solution.
- Share a pilot project or success story to illustrate how A language access plan can achieve desired outcomes and make a meaningful impact
- Highlight the financial benefits, emphasizing cost-effectiveness and potential revenue enhancement through better language access.
- Understand the politics and the power dynamics of the organization. Identify key influencers and supporters who can advocate for the language access plan and help persuade decision-makers.
Step 4: Financial projection
Use demographic, financial, and patient data, along with credible sources, to estimate program return on investment. For instance, calculate the financial impact of cutting unnecessary tests by investing in improved healthcare language services, whether on-site or virtual.
Alternatively, quantify the risks of an insufficient language access plan into financial projections. Gather case studies showing malpractice suits and use them to underscore the potential financial consequences of lacking adequate language support.
Condense findings into a realistic and easily understandable figure predicting outcomes. For instance:
“If the hospital plans to admit X number of Limited English Proficiency (LEP) patients in 12 months, implementing the plan could reduce admission costs by Y%.”
Step 5: Continuous Improvement Plan
Take a systematic approach to monitoring and continuously improving your language access plan. According to the Centers for Medicare & Medicaid Services (CMS), you can do this by:
- Monitoring complaints and suggestions from LEP patients, community members, and staff regarding language access services
- Staying informed about community demographics and needs by engaging with local public health authorities, school districts, faith communities, refugee resettlement agencies, and other local resources
- Tracking utilization rates for various language access services throughout your hospital’s ecosystem
You could also refer to the Department of Justice’s Language Access Assessment and Planning Tool to monitor, evaluate, and update your language access plan.
Build A Robust Healthcare Language Access Plan with PGLS
Delivering a comprehensive language access plan for LEP patients isn’t just good business sense. It’s also the right thing to do. This is a chance to lead by example, create an equitable and inclusive healthcare environment, and improve patient outcomes for some of our society’s most vulnerable.
As your preferred language access partner, PGLS is committed to helping you navigate the complexities of delivering comprehensive language access while ensuring compliance with government mandates. Our world-class team of translators and interpreters is proficient in over 200 languages and regional varieties, ensuring accurate and culturally sensitive translations and interpretation for healthcare-related content.
PGLS offers comprehensive phone, video, and on-site interpretation services and translation services to facilitate patient-provider communication in their preferred language, so they can understand and make informed decisions about their care.
Contact PGLS today to discover more about our healthcare services and how we can support your language access needs.