Date of Award

January 2025

Document Type

Open Access Thesis

Degree Name

Doctor of Nursing Practice (DNP)

Department

Yale University School of Nursing

First Advisor

Laura K. Andrews

Abstract

Language barriers in healthcare contribute to significant disparities including delays in diagnosis and treatment, patient confusion, and increased mortality (Kwan et al., 2023). Approximately 21.5% of the people in the United States speak a language other than English at home and 8.2% of that population subset report speaking English less than very well (U.S. Census Bureau, 2021). Furthermore, in 2023 8% of Medicare beneficiaries have limited English proficiency (LEP) speaking and 7% have LEP reading (Centers for Medicare &Medicaid, 2024). Ensuring meaningful language access to LEP patients is essential for improving clinical outcomes and maintaining compliance to federal anti-discrimination policies. This quality improvement project aimed to develop, implement, and evaluate the effects of an evidence based assessment flow chart and toolbox to facilitate the identification and utilization of professional interpreter services for LEP patients in the in-patient setting. The implementation was 10 weeks on an in-patient oncology unit in a Level one tertiary medical center in the northeastern United States. This included pre-implantation education, data collection via chart reviews and data analysis via Stata®. The data indicates statistical significance in the decrease of professional interpreter services utilization between the fourth and fifth encounters, as well as a negative correlation indicating a decrease in the utilization of professional interpreter services with extension of the in-patient stay. These results emphasize the need for continuing interventions to promote consistent language access throughout the in-patient stay.

Comments

This is an Open Access Thesis.

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