Poster Presentations (Group I)

Healtheast had a lot of no shows appointments and surgical cancellations within our Limited English Proficient (LEP)  population. In looking into this situation , we found that pre-op instructions were sent to them in English and patient couldn’t read it. Therefore patient arrived with no history and physical exam or they ate before coming to the appointment. We also found that for scheduled out-patient and clinic appointments, patients didn’t show up because they couldn’t arrange transportation, couldn’t understand the directions sent to them or were afraid to come because of language barriers.

LEP patients don’t  know  who to call in case they want to cancel the appointment or may think that no show doesn’t cost us anything or is meaningless to us. Some LEP populations might come from a cultural group that scheduling a visit is not part of their practice and  walk-in is their preferred method of visiting doctors.

So we implemented the following programs and services:

1.      Surgery Program

• Created tracking log for any LEP patient who requests interpreter services:

Ø      Surgery sends surgery schedule and request for interpreter to interpreter services department

Ø      Interpreter calls patient 3 days before the surgery date asking if patient/family is aware of surgery and has a history and physical exam. Interpreter will address any identified barriers and let know to call if anything changes.

Ø      The day before surgery, interpreter and surgery nurse will call patient in 3 way phone conference, giving accurate prep-instructions, directions to the facility and time of arrival to patient or family member.

Ø      The day of surgery, interpreter will be with patient during registration, surgery admission, surgeon visit, anesthesiologist visit, post surgery (in recovering room)  and discharge instructions.

2.       2.     For all other Out-patient appointments other than surgery such as Radiology, Cardiology, Chemo, Mental health, Physical therapy, etc…

Ø      Interpreter calls patients the day before the appointment date:

·        Interpreter attempts to reach patient at different times to remind patients about their next day appointment and to remove any barriers associated with transportation, directions or other issuesi. If patient says they are not coming, then interpreter informs scheduler about the cancellation.

·         Interpreter gives  prep-instructions to patient properly according to the department’s instructions. Additionally Interpreter will remind patients to bring their medication and other information with them to help assure that language barriers will not affect getting information needed to assure quality outcomes in care.

·        Interpreter gives directions to the facility and parking lot.

·        Interpreter ask If this is patient’s first time in the facility. If it is, interpreter will be at the lobby entrance waiting for patient or tell patients to go to the information desk with doctor’s order. 

3. Success of program

a.       Since program creation we have had no same day surgical cancellations for LEP populations and no-show appointments also decreased dramatically. 

b.      Program effective with employee or agency staff

Program details and outcome data will be shared during this presentation allowing participants to implement a similar program within their setting.