SHM Converge Scientific Abstract ePoster Gallery-An Interprofessional Quality Improvement Approach to Increasing Language-Concordant Discharge Instructions

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This quality improvement project focused on improving translated discharge instructions for hospitalized patients with Limited English Proficiency (LEP), a group that makes up a substantial portion of UCSF Hospital Medicine patients. LEP patients often have difficulty understanding discharge instructions, and UCSF Health data showed higher readmission rates for LEP patients than for English-proficient patients.<br /><br />Using an A3 problem-solving approach, the team first studied the current discharge workflow through interviews with staff and patients and surveys of 46 hospitalists. They identified three main barriers: low awareness of UCSF’s professional translation service (Interpreter Services Document Translation Request, or ISDTR), concerns about late discharge changes and slow turnaround time, and general time/resource constraints that made translation requests feel cumbersome.<br /><br />To address these issues, the team implemented a two-part intervention. First, they increased provider awareness by presenting at a division meeting and distributing a video tutorial and flyer explaining how to use the translation service. Second, they improved workflow by having a clinical assistant send reminders 48 hours before expected discharge and offer help with the translation process. Interpreter Services also created a messaging pathway for expedited requests.<br /><br />The intervention increased the proportion of LEP patients receiving translated discharge instructions from 3% to 22%. After implementation on July 15, 2024, translation requests rose immediately and exceeded the 20% goal by August 2024. The project suggests that education plus proactive workflow support can meaningfully improve language-concordant discharge communication.<br /><br />The team noted that interprofessional collaboration was essential to success. Future efforts will evaluate long-term effects, patient and provider attitudes, and possibilities for embedding translation requests into the electronic medical record and using AI-based real-time translation.

Asset Subtitle

Tiffany Husman

Meta Tag

Author List Alessandra Veinbachs, Kasia Kadela, Nancy Choi, Neal Mukherjee, Nicholas Correia, Nwamaka Ijeh, Palveen Sekhon, Tiffany Husman

Category Innovations

Concept Limited English Proficiency

Concept Translated Discharge Instructions

Concept Discharge Workflow

Concept Language Barriers

Concept Professional Translation Service

Distinguished Non-Finalist

Presenter Organization University of California, San Francisco

Presenting Author Tiffany Husman

Track Quality Improvement

Keywords

Limited English Proficiency

translated discharge instructions

hospital readmissions

UCSF Hospital Medicine

professional translation service

A3 problem-solving

workflow improvement

interpreter services

provider awareness

discharge communication

Limited English Proficiency

Translated Discharge Instructions

Discharge Workflow

Language Barriers

Professional Translation Service