A Quality Improvement Initiative to Improve the Discharge Process for Spanish-Speaking Patients.

Area of Science:

• Healthcare Quality Improvement
• Patient Communication
• Health Equity

Background:

• Spanish-speaking patients (SSPs) often receive inequitable care at hospital discharge.
• National quality measures emphasize language concordance for effective verbal and written communication.

Purpose of the Study:

• To increase the percentage of Spanish-speaking patients discharged with translated documents from 65.5% to 82% within five months.

Main Methods:

• An interdisciplinary quality improvement team used process mapping and Ishikawa diagrams to identify workflow gaps.
• Interventions included staff education and electronic medical record (EMR) modifications.
• Key measures tracked included translated discharge documents, translation order placement, provider ordering rates, and length of stay (LOS).

Main Results:

• The percentage of SSPs receiving translated discharge instructions increased from a baseline of 65.5% to 88%.
• The rate of translation orders placed for SSPs rose from 54% to 82%.
• Provider ordering of translations increased significantly from 11% to 75%, with no impact on LOS.

Conclusions:

• The Model for Improvement framework successfully increased the provision of translated discharge documents for SSPs.
• Future efforts should explore EMR integration for greater reliability in automatic document translation.