Health Policy Commons^™

Challenges In Language Services: Identifying And Responding To Patients' Needs, Marsha Regenstein, Holly Mead, Kathryn E. Muessig, Jennifer Huang

Health Policy and Management Faculty Publications

Objective: Identify characteristics of hospitalbased language services (LS), and describe practices of identifying patients with limited English proficiency (LEP) and interpreter training.

Participants: Seventy-one hospitals applied to participate in a national initiative. Applicants were non-federal, acute care hospitals with substantial LEP populations, at least 10,000 discharges, and in-person interpreters.

Methods: Descriptive statistics were generated on language, collection of language data, LEP volume and service utilization, staffing and training requirements and organizational structure. The relationship between admissions and encounters was analyzed.

Results Ninety percent of hospitals collect primary language data. Spanish is the most common language (93% of hospitals). …

Leveling The Field--Ensuring Equity Through National Health Care Reform, Bruce Siegel, Lea Nolan

Health Policy and Management Faculty Publications

Members of minority groups have higher rates of disease, poorer health, and more limited access to care than their white counterparts. They account for half of the uninsured population and 58% of the low-income uninsured population. Even when they have coverage, minority patients are at risk for receiving lower-quality medical and surgical care than white patients. The factors underlying these inequities are complex and go far beyond the health care system,but any meaningful reform must, at a minimum, confront disparities in care. Health care reform provides a unique opportunity to reversea legacy of inequality in health and health care. This …

Talking With Patients: How Hospitals Use Bilingual Clinicians And Staff To Care For Patients With Language Needs, Jennifer Huang, Karen C. Jones, Marsha Regenstein, Christal Ramos

Health Policy and Management Issue Briefs

Improving access to language services in health care settings has become a focal point for health reform and disparities-focused legislation, in recognition of the increasing linguistic and cultural diversity of individuals across the nation. Bilingual staff and clinicians can serve as enormously valuable resources to hospitals and other health care organizations, offering a critical set of skills to interact with individuals who require care in a language other than English. Bilingual clinicians can serve a vital need for hospitals by providing high-quality health care, improving patient safety, and meeting organizational priorities to provide linguistically and culturally appropriate care for patients. …

Emergency Department Operations In Top-Performing Safety-Net Hospitals, Lea Nolan, Marsha Regenstein, Donna Anthony, Bruce Siegel

Health Policy and Management Faculty Publications

This report profiles five safety-net hospitals—Boston Medical Center, Denver Health, Memorial Regional Hospital, Memorial Hospital West, and Virginia Commonwealth University Health System—that made improvements to curb emergency department (ED) crowding, reduce long waits, and lower the number of hours spent on ambulance diversion. Hospitals used a combination of interventions, including: reconfiguring the ED to maximize efficiency; devising a pre-diversion system to alert staff of ED crowding; installing an electronic tracking system; designating staff members to be responsible for tracking patients; and developing meaningful performance metrics. To be successful, such interventions need to take place within a broader improvement strategy that …

The Application Of The Emergency Medical Treatment And Labor Act (Emtala) To Hospital Inpatients, Lara Cartwright-Smith, Sara J. Rosenbaum, Karen Belli, Elaine Purcell, Tasmeen S. Weik

Health Policy and Management Issue Briefs

This issue brief provides a brief overview of the Emergency Medical Treatment and Labor Act (EMTALA) and focuses on its application to hospital inpatients. EMTALA applies differently to patients than non-patients, and also applies differently to patients admitted through the emergency department than patients admitted as regular inpatients. In addition, courts and the Centers for Medicare and Medicaid Services (CMS) have differed in their interpretation of the statute. Depending on the specific facts of any particular case, EMTALA may or may not have implications for specialty-related transfers and discharges.