Imagine your child is in a hospital where she and her caregivers do not speak the same language. She is sick and probably feeling more than a little scared.
Then someone brings in a tablet, presses a button, and up comes an interpreter who resembles her and speaks her language. Suddenly, your child’s doctors and nurses understand not just what your child is saying, but what she means.
On-demand video interpretation has proved especially effective with children. This is partially because Video remote interpreting (VRI) is very similar to platforms with which most kids are familiar, like FaceTime or Skype. In the case of VRI, one touch of a button brings up a live, professional interpreter who speaks the patient’s primary language and picks up on their nonverbal gestures. This linguist interprets for the doctor to the patient, and vice versa.
But mobile interpreting is a novel idea in many hospitals—one that represents a significant shift for language access in many organisations. Implementing this technology requires that leadership understand its value and advocate for its adoption. How does the manager of a hospital’s language program get this degree of buy-in?
Three of the best children’s hospitals in the U.S.—Boston Children’s Hospital, Children’s Health System of Texas, and Children’s Specialised Hospital in New Jersey — have managed to successfully implement on-demand video interpreting to improve understanding between providers, paediatric patients, and their families.
We asked representatives from each of these hospitals what they considered to be the greatest advantages presented by VRI, as well as instances when it was not considered to be a good option.
Question: Do you have any advice on talking to leadership about implementing on-demand video remote interpreting?
Melina Kolbeck, Director of Language Access Services, Children’s Health System of Texas: You should have full support from your leadership and information system department and make them a part of your decision-making about video. It took me a few months. When you go in and say, “This is the way we need to do it, we don’t have enough staff,” you need to have data to support your position. How many times did you pay for an on-site interpreter, only to have that patient no-show?
How many times did you pay an on-site interpreter’s two-hour minimum, only to have that appointment last a much shorter amount of time? Also, every hospital has goals.
What are your goals? Align them to your video interpreting proposal. One of our goals is to improve communication, and video helps us do that.
Shannon Swope MSS, LSW, Manager of Outpatient Care Coordination, Children’s Specialised Hospital: The reporting that you get from the (mobile application) can tell you a lot about the patient population you serve. The mix can sometimes be surprising, which is interesting for leadership to learn.
Question: How has cost management factored into your decision to use video interpreting?
Sandy Habashy, Operations and Training Manager, Interpreter Services, Boston Children’s Hospital: Video does help us manage our costs effectively. We are mainly paying for what we are using, as opposed to paying for a two-hour minimum for an agency’s on-site interpreter. We don’t have to pay when the patient cancels.
MK: When speaking with leadership, I learned to have data—for example, our no-show rate for appointments where we’d scheduled and paid for an interpreter. I also have data for the pricing of a vendor’s on-site interpreter versus a video interpreter. It all helps support the implementation of video interpreting.
Question: Do you have any advice about implementation?
MK: We made sure that as many people as possible knew about our video interpreting program. They knew where the devices would be located and that they were expected to use them. We advertised it system-wide. I was very active in making sure that I got myself invited into manager meetings. It’s something new, and you have to take advantage of that newness to grab their attention. Make it super-exciting. Talk to your marketing department. I was really happy at the beginning of our implementation to discover that people were using the device.
SH: People can be apprehensive about anything new. You can reassure them that the ease of use is very high. It’s really not so strange after you get started.
Question: Did you receive any pushback from your medical team when you initially implemented mobile interpreting?
SH: Some of our healthcare providers were accustomed to in-person interpreters. There was a lot of pushback from them in the beginning about switching to video. Many of them are much more comfortable with video now, though.
Question: What were the challenges you faced in getting your mobile interpreting program off the ground?
MK: One of the challenges is getting the attention of the people that need to be involved. When it comes to a new implementation, you have information systems or the IT department. You might need marketing. You’ll also have a large amount of equipment delivered to your facility, so you need to work with that department. Of course, once everything is assembled, it becomes about getting adoption.
Question: How do you deal with staff education and adoption?
Janet Giordano MSW, LSW, Director of Patient Care Coordination and Patient Experience, Children’s Specialised Hospital: We have an annual computer-based, online learning that is mandatory for all staff. We take that opportunity to go over video interpreting and how to use it. Video interpreting is that important to us. We feel that everybody needs to be understood despite our not all speaking the same language. We tell our staff that language is not a barrier any longer (because) we have devices that are now in place 24/7.
MK: There is going to be pushback from physicians. They might not like you knocking on the door of paediatrics or the ICU and asking, “Are you OK with me coming in with this device?” I think it’s important to find healthcare providers within the organisation who are super-users and champions. If you find physicians who really like it, they can advocate for you and help you get buy-in from others.
Learn more about how video interpreting can help with patient care.