In an effort to address healthcare disparities among limited English proficiency (LEP) patients, a groundbreaking quality improvement project was implemented at the University of North Carolina Medical Center (UNCMC). This project sought to improve the recognition of clinical deterioration in hospitalized patients with LEP.
Healthcare disparities for LEP patients are a pervasive issue, and language barriers can lead to communication breakdowns between patients and providers, potentially causing delays in the activation of the rapid response system. The consequences of such delays can be dire, resulting in adverse outcomes for these patients.
A multidisciplinary team, consisting of UNCMC Spanish interpreters, quality improvement experts, rapid response nurses, medical students, and physicians, was formed to tackle this issue. The following is a list of the team:
- Project leads: Evan Raff, MD and Carlton Moore, MD
- Team members: Lauren Raff, MD; Andrew G. Blank, MPH; Ricardo Crespo Regalado; Emily Bulik-Sullivan; Lindsey Phillips, MD; Lilia Galvan Miranda; Brittany Davis, RN; Ellenita Kornegay, RN, BSN; Jennifer Mack, MHA, MBA, BSN, RN, CCRN.
- Special thanks to the rapid response nurses as well as Mary Jo Barfield, MBA, and Kelly Reilly, MEd.
The initiative introduced a systematic approach that combined early warning scores (EWS) and the integration of medical interpreters into the rapid response process for LEP patients. The project ran from May 2022 to March 2023, and the results were nothing short of remarkable. EWS-triggered evaluations for LEP inpatients led to sustained quality improvements in various measures. There was a noticeable increase in post-rapid response event escalation of care, a reduction in hospitalization length, and a drop in mortality rates for these patients.
This health equity project, funded by an ECBR Health Equity Grant through The North Carolina Translational and Clinical Sciences Institute, has shown that a combination of early warning scores and interpreter services can bridge language barriers, improve communication, and ultimately enhance the clinical outcomes for hospitalized patients with limited English proficiency. This innovative approach offers valuable lessons for addressing healthcare disparities and improving care delivery.
In October, the project team was recognized as a Top Finalist for The Joint Commission and Kaiser Permanente Bernard J. Tyson National Award for Excellence in Pursuit of Healthcare Equity. This prestigious annual award is dedicated to celebrating and acknowledging healthcare organizations and their collaborative partners who have demonstrated exceptional dedication to reducing one or more healthcare disparities, achieving measurable and sustained progress. The award recognizes the collective commitment of healthcare organizations and their partners in bridging gaps within the healthcare system, and highlights the importance of these efforts in enhancing the overall health and well-being of underserved communities.
