Recognizing the Importance of Language Need in Healthcare: The US Experience

1. Recognizing the Importance of Language Need in Healthcare:The US Experience Elizabeth A. Jacobs, MD MPP John H. Stroger, Jr. Hospital of Cook County Welsh Language in Healthcare Conference Cardiff, Wales March 26th, 2010

2. Why Would I be Informative? • Wales • Small Population • Homogeneous • National Health Care • Emphasis on Primary Care • Welsh Language predominant “other” language” • US • Large Population • Heterogeneous • Mostly Private System • Emphasis on Specialty Care • 303 languages spoken at home

3. We Have the Same Problems

4. Although, Not Exactly • Welsh Language Need • 20% speak Welsh • Code-switching • Especially when communication important • US Language Barriers • 20% speak English “less than well” • Linguistic access services are essential

5. Why Aren’t Language Needs Met? • Lack of data • Lack of planning • Lack of awareness • Attitudes • Cost • Lack of access to language resources G. Roberts and Colleagues. Report of a Study of Welsh Language Awareness in Healthcare Provision in Wales . 2004

6. Data: Garbage In Garbage Out • Need to ask (the right way) • Need to record • Need to use

7. Planning: “One More Thing?!” • Data • Dedication • Diligence

8. Awareness? "If English was good enough for Jesus, it’s good enough for Texas schoolchildren”

9. Attitude?

10. Awareness Attitude • Data • Stories • Solutions

11. Why Should We Pay for This? • We pay already • It is cheap • “Do no harm”

12. How Do We Do It? • Bilingual providers • Professional interpreters • Face-to-face • Telephonic • Video • Dual-role interpreters • Ad hoc interpreters

13. Your Stories?

14. How Do You Do It? • Bilingual providers • Professional interpreters • Face-to-face • Telephonic • Video • Dual-role interpreters • Ad hoc interpreters

15. But Are They Qualified?

16. Making it Happen

17. 4 Critical Questions • Who is my audience? • What do they need to know? • What is my ask? • Who are my allies?

18. 1. Who is My Audience? 1. Administrators 2. Clinicians

19. Power of Positive Intentions • No one made the decision that all patients should communicate in English, regardless of language need • They just don’t know: • The consequences • How to provide the appropriate services

20. 2. What do They Need to Know? • What happens when patients don’t have access to care in Welsh • How do they provide care in Welsh

21. Providing Insight

22. Top 3 Tools • Stories • Stories • Stories

23. Providing Solutions • Be the source • Think about what you want them to do • Then make and present a realistic plan as to how they can do it

24. 3. What is My Ask? • What do I want? • What data do I have to support it? • How will I support it?

25. 4. Who Are My Allies? • Doctors • Patients • Staff • Administrators • Board members • Politicians

26. “I wanted to ask them about my illness. I couldn’t because there was no one to help me [communicate].”

27. ejacobs@rush.edu