Audio interpreter call volume rose from 2 calls (20 min) at baseline to 20 calls (257 min) in the final project month

Description #

Audio (telephone) interpreter usage on the perianesthesia unit rose sharply over the project period after staff in-service education and the phased provision of audio interpreter options. Prior to implementation, perianesthesia staff placed just 2 audio interpreter calls totaling 20 minutes; after the initial in-service session and a second telephone interpreter service (June 2018) usage rose to 10 calls (261 minutes), then 12 calls (220 minutes) once a second audio service was added to wearable devices (October 2018), 23 calls (305 minutes) in January 2019, and 20 calls (257 minutes) in March 2019 (Fig. 1). The trend was a large increase from baseline but not strictly monotonic month-to-month. These are uncontrolled descriptive counts from LAP interpreter call logs, not a controlled comparison.

"Prior to project implementation, two audio interpreter calls were placed by perianesthesia staff, which totaled 20 minutes of interpreter use. Following the initial staff in-service session and the addition of a second telephone interpreter service in June 2018, a total of 10 interpreter calls were made by staff, which totaled 261 minutes. After a second audio interpreter service was added to staff-held wearable communication devices in October 2018, 12 calls were placed, totaling 220 minutes." (Linda, 2023, p. 361)

"In March 2019, 20 audio calls were made, totaling 257 minutes, and 33 video sessions were recorded, totaling 368 minutes, indicating that staff continued to adhere to the use of interpreter services for patients with LEP." (Linda, 2023, p. 361)

Methods Context #

What? #ⓘ

The observable: the number of interpreter calls per month and the minutes per interpreter call, tracked as a measure of interpreter-service utilization on the unit (Fig. 1).

"Minutes per interpreter call and the number of calls per month were assessed to determine the efficacy of the intervention (see Figure 1)." (Linda, 2023, p. 361)

How? #ⓘ

An uncontrolled pre/post quality improvement evaluation: interpreter usage was extracted from LAP interpreter call logs spanning April 2018 (prior to the initiative) to March 2019, alongside the staff education and technology rollout described in A-0012ArtifactA-0012Initial AI draftMSKCC perianesthesia LEP communication initiative (staff education + language assistive technology)To improve communication and foster health equity for surgical oncology patients with limited English proficiency (LEP) — and those with hearing, speech, or visual impairments — in the perianesthesia setting, by equippin…. Only descriptive statistics were computed.

"The quality improvement project was evaluated by reviewing interpreter usage data from LAP interpreter call logs from April 2018 (prior to the initiative) to March 2019. Minutes per interpreter call and the number of calls per month were evaluated to determine the effectiveness of the intervention." (Linda, 2023, pp. 360–361)

Who? #ⓘ

Perianesthesia nursing staff caring for surgical patients with cancer with LEP on the main perianesthesia unit at MSKCC (23 presurgical beds and 35 PACU beds), admitted between January 2018 and March 2019.

"between nursing staff and a sample of surgical patients with cancer with LEP who required admission and were treated on the main perianesthesia unit between January 2018 and March 2019." (Linda, 2023, pp. 359–360)

Other Notes #

Usage counts are the intervention-adoption proxy; no patient-level clinical outcomes were measured. Monthly counts fluctuated (e.g., October's 12 calls / 220 min was below June's 10 calls / 261 min in total minutes), so the finding is a sustained rise from a near-zero baseline rather than a smooth monotonic increase.

Caveats #

• Uncontrolled pre-post interpreter-usage counts confounded by concurrent expansion of interpreter service options [Inferred] The rise in interpreter usage is documented as uncontrolled descriptive call-log counts with no comparison unit or adjustment, and the education intervention was rolled out simultaneously with the addition of new interpreter service options (a second telephone service in June 2018, a second audio service on wearable devices in October 2018, and a video interpreter tablet in January 2019). Because more — and more convenient — services became available at the same time as the education, the increased usage cannot be cleanly attributed to staff education versus simply expanded/easier access, and part of the "increase" (video sessions) reflects a modality that did not exist at baseline rather than a behavior change. Monthly counts also fluctuated rather than rising monotonically. In addition, only utilization was measured; no patient-level clinical, safety, or satisfaction outcomes were assessed, so the effect on care quality is unmeasured.
• Single-center, single-unit QI project with COVID-limited expansion and unknown generalizability The interpreter-usage findings come from a single quality improvement project conducted on one perianesthesia unit at a single cancer center (MSKCC). The task force had planned to extend the interventions to the hospital's other medical, surgical, inpatient, and outpatient units, but that expansion was curtailed by the COVID-19 pandemic (remote LAP staff, nurse redeployment, and paused education sessions), and the authors state it is unknown whether the observed usage data would have been reproduced on other units. Generalizability beyond this single unit and institution is therefore unestablished.