Benchmarking Interpreter Services Ralph Garcia Mission Health System Asheville, NC with support from...
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![Page 1: Benchmarking Interpreter Services Ralph Garcia Mission Health System Asheville, NC with support from Cynthia E. Roat, MPH.](https://reader036.fdocuments.in/reader036/viewer/2022072010/56649dd15503460f94ac79b6/html5/thumbnails/1.jpg)
Benchmarking Interpreter Services
Ralph Garcia
Mission Health System
Asheville, NCwith support from Cynthia E. Roat, MPH
![Page 2: Benchmarking Interpreter Services Ralph Garcia Mission Health System Asheville, NC with support from Cynthia E. Roat, MPH.](https://reader036.fdocuments.in/reader036/viewer/2022072010/56649dd15503460f94ac79b6/html5/thumbnails/2.jpg)
Mission Health System
• Located in Asheville NC, Mission is the 6th largest health system in the state.
• The system’s flagship, Mission Hospital, is a 730 bed tertiary care center with a Level II Trauma Center.
• The system includes Mission Children’s Hospital, Blue Ridge Hospital, McDowell Hospital, Reuters Children Center, Asheville Surgery Center, Asheville Imaging Center, and 15 specialty physician practices.
• Mission serves the 13 Western North Carolina counties. The area has a diverse population including a number of ethnic and racial groups and a significant deaf community.
• The largest LEP group is speaks Spanish with 94% of encounters.
![Page 3: Benchmarking Interpreter Services Ralph Garcia Mission Health System Asheville, NC with support from Cynthia E. Roat, MPH.](https://reader036.fdocuments.in/reader036/viewer/2022072010/56649dd15503460f94ac79b6/html5/thumbnails/3.jpg)
Mission had a question . . .
How does Mission compare with other health systems in the provision
of language access services?
So Mission looked to industry benchmarks.
![Page 4: Benchmarking Interpreter Services Ralph Garcia Mission Health System Asheville, NC with support from Cynthia E. Roat, MPH.](https://reader036.fdocuments.in/reader036/viewer/2022072010/56649dd15503460f94ac79b6/html5/thumbnails/4.jpg)
What’s a benchmark?Merriam Webster says that a benchmark is:
“something that serves as a standard by which others may be measured or judged.”
UNESCO says that benchmarking is:
“A standardized method for collecting and reporting critical operational data in a way that enables
relevant comparisons among the performances of different organizations or programmes,
usually with a view to establishing good practice, diagnosing problems in performance,
and identifying areas of strength.”
![Page 5: Benchmarking Interpreter Services Ralph Garcia Mission Health System Asheville, NC with support from Cynthia E. Roat, MPH.](https://reader036.fdocuments.in/reader036/viewer/2022072010/56649dd15503460f94ac79b6/html5/thumbnails/5.jpg)
What could serve as a benchmark for Interpreter Services?
• Cost per encounter?
• % encounters covered by qualified interpreters or bilingual staff?
• % of interpreters who have received training?
• Spend per bed per LEPs in the system?
![Page 6: Benchmarking Interpreter Services Ralph Garcia Mission Health System Asheville, NC with support from Cynthia E. Roat, MPH.](https://reader036.fdocuments.in/reader036/viewer/2022072010/56649dd15503460f94ac79b6/html5/thumbnails/6.jpg)
Methodology
• Contract with Buncomb County Medical Society and consultant Cindy Roat.
• Literature search: what has been done around benchmarking interpreter services?
• Select and invite hospital systems for study.
• Initial pre-screening.
• Pilot written survey.
• Send out written survey.
![Page 7: Benchmarking Interpreter Services Ralph Garcia Mission Health System Asheville, NC with support from Cynthia E. Roat, MPH.](https://reader036.fdocuments.in/reader036/viewer/2022072010/56649dd15503460f94ac79b6/html5/thumbnails/7.jpg)
The question for each system?
How much is spent to provide what services
to how many patients in how many languages at what level of quality
using what organizational structure?
![Page 8: Benchmarking Interpreter Services Ralph Garcia Mission Health System Asheville, NC with support from Cynthia E. Roat, MPH.](https://reader036.fdocuments.in/reader036/viewer/2022072010/56649dd15503460f94ac79b6/html5/thumbnails/8.jpg)
This presentation is not about what Mission found.
It’s about what Mission didn’t find.
![Page 9: Benchmarking Interpreter Services Ralph Garcia Mission Health System Asheville, NC with support from Cynthia E. Roat, MPH.](https://reader036.fdocuments.in/reader036/viewer/2022072010/56649dd15503460f94ac79b6/html5/thumbnails/9.jpg)
Benchmarking Cost per Encounter
• Definition of “encounter” was different for each respondent.
• Cost per encounter, as a measure, does not account for the quality of the program.
![Page 10: Benchmarking Interpreter Services Ralph Garcia Mission Health System Asheville, NC with support from Cynthia E. Roat, MPH.](https://reader036.fdocuments.in/reader036/viewer/2022072010/56649dd15503460f94ac79b6/html5/thumbnails/10.jpg)
Benchmarking á la Speaking Together
• Speaking Together: a collaborative of 10 hospitals brought together by researchers at George Washington University with a grant from the Robert Wood Johnson Foundation.
• The collaborative measured – screening for preferred language– patients receiving LS from qualified LS providers – patient wait time – time spent interpreting – interpreter delay time.
• None of these indicators were measured consistently enough by enough of our respondents to use as an indicator.
![Page 11: Benchmarking Interpreter Services Ralph Garcia Mission Health System Asheville, NC with support from Cynthia E. Roat, MPH.](https://reader036.fdocuments.in/reader036/viewer/2022072010/56649dd15503460f94ac79b6/html5/thumbnails/11.jpg)
Benchmarking with CSA’s Language Access Ratio
• Common Sense Advisory suggested a measure based on average daily spend per LEP bed, calculated with – the total number of hospital beds
– % of people who speak a language other than English at home, based on the zip code of hospital catchment area,
– IS expenditures.
• Speaking a language other than English at home is not a useful proxy for being limited-English-proficient.
• We substituted number of LEPs in patient database.
• Results were all over the map.
![Page 12: Benchmarking Interpreter Services Ralph Garcia Mission Health System Asheville, NC with support from Cynthia E. Roat, MPH.](https://reader036.fdocuments.in/reader036/viewer/2022072010/56649dd15503460f94ac79b6/html5/thumbnails/12.jpg)
What we did learn?• Trends
– use of multiple language access strategies
– telephonic interpreting as a backup strategy only
– principle dependence on dedicated staff interpreters
– higher-than-expected use of videointerpreting
– continued use of family, friends and untrained bilinguals
• BUT, hospitals are collecting data in such diverse ways that benchmarking is difficult.– Definition of encounter is highly variable
– Differences in documenting LEP patients in the system.
![Page 13: Benchmarking Interpreter Services Ralph Garcia Mission Health System Asheville, NC with support from Cynthia E. Roat, MPH.](https://reader036.fdocuments.in/reader036/viewer/2022072010/56649dd15503460f94ac79b6/html5/thumbnails/13.jpg)
What questions were left?
How can we create common data collection criteria
so as to be able to start benchmarking effectively?