Language Access Systems Improvement initiative: impact on professional interpreter utilisation, a natural experiment

Area of Science:

• Healthcare Access and Equity
• Medical Interpretation Services
• Primary Care Research

Background:

• Effective communication is crucial in primary care, especially for language-discordant patient populations.
• Professional interpreter utilization remains a challenge in many healthcare settings.
• The Language Access Systems Improvement (LASI) initiative aimed to address these communication barriers.

Purpose of the Study:

• To evaluate the impact of the LASI initiative on professional interpreter utilization in primary care.
• To explore patient and clinician perspectives on professional interpreter use.
• To identify barriers and facilitators to interpreter use in a primary care setting.

Main Methods:

• A quantitative natural experiment design comparing pre-LASI and post-LASI periods.
• Qualitative data collection through semistructured interviews with clinicians and focus groups with patients.
• Analysis of language concordance for primary care visits and professional interpreter utilization rates.

Main Results:

• Professional interpreter utilization increased from 57% pre-LASI to 66% post-LASI (p=0.01).
• Video medical interpretation was perceived as convenient and well-liked by both clinicians and patients.
• Partially language-concordant visits showed the lowest increase in professional interpreter use, with some clinicians reporting frustration and patients preferring family for support.

Conclusions:

• The LASI initiative successfully increased professional interpreter utilization in primary care.
• Interventions like LASI require additional support for clinicians and patients with partial bilingual skills to maximize interpreter use.
• Understanding differing perspectives on the role of family members in interpretation is essential for improving language access.