University Health System Breaks Down the Language Barrier

University Health System bilingual staff members train to interpret for patients and families.

By Julie Wiley, Corporate Communications Coordinator, University Health System

One way Raul Correa, a registered nurse on the general medicine unit at University Hospital, provides his patients with high-quality care and ensures they will go home understanding what they need to do to prevent readmission, is to communicate important information in the language they understand.

Since many of his patients speak Spanish, being fluent in both English and Spanish makes it that much easier for Correa to effectively communicate with the vast majority of his patients. Understanding that his competency in Spanish could benefit other patients on his unit, Correa decided to be one of the first staff members to join the Medical Interpreter Program at University Health System. He’s not only improving the patient experience, he’s also reducing the need for expensive outside interpretation services and helping assure University Health System is in compliance with The Joint Commission’s patient-centered care communication standards.

“Our bilingual staff has embraced becoming more effective communicators by receiving this advanced training in medical interpreting,” explains Jacqueline Burandt, senior director of University Health System’s Center for Learning Excellence. They see first-hand every day the positive impact it can make on our patients’ safety and quality outcomes.”

Reduce Rehospitalizations and Cut Costs

According to a study released by Harvard University in 2011, providing patients with important information about their health, medications, and treatment options can reduce rehospitalizations by about 20 percent. University Health System’s internal interpreter program is successfully improving timely and effective communication with patients and it also has stemmed the tide of interpreter expense, which had been experiencing significant year-over-year increases for the last three years.

University Health System’s contracted cost for an onsite English-Spanish medical interpreter is $70 per hour, with a two-hour minimum charge. In 2011, onsite interpreters were called to a University Health System location 661 times at a cost of $92,540. This was a 51 percent increase over 2010, and directly led to the establishment of the internal medical interpretation program in 2011.

Organizers for the program looked at on-site interpretation expense by department to ensure staff members from high utilization areas were heavily recruited for the program. In its first year, 48 University Health System employees signed up for the program and passed the first step—a test to determine Spanish proficiency.

All 48 staff members completed a 40-hour English-Spanish medical interpretation course offered through contracts with International Language Center of San Antonio (ILCSA) and Spanish English Foreign Languages for America (SEFLA). In 2012, 31 staff members graduated from the course, and by mid-year another 10 were actively enrolled.

According to Carlos Castaneda, director of Patient Relations at University Health System, by mid-2012, 25 employees had submitted documentation showing they had completed 10 English-Spanish interpretations. “These encounters saved the Health System more than $36,000,” he says.

In the first quarter of 2012, on-site English-Spanish interpreters were called to University Health System 55 times, at a cost of $7,700, almost a 66 percent reduction from the $23,100 average interpreter cost per quarter in 2011.

If University Health System continues to utilize the internal Medical Interpreter Program at the same rate for the remainder of 2012, the savings would amount to $61,600, which is a great start. “As we continue to train and utilize trained employees, we can expect the savings to go even higher and perhaps get close to zero dollars spent in the future for contract English-Spanish interpreters,” Castaneda explains.

Medical Interpreter Criteria

The criteria for serving as a medical interpreter at University Health System include:

  • Earning an acceptable score on the Spanish proficiency exam administered before admission to the course
  • Committing to attend 40 hours of training in medical interpreting
  • Successfully completing the end-of-course competency assessment
  • Agreeing to serve as an interpreter on designated units

The 68 staff members who had met these requirements as of June 2012 work at University Hospital and throughout University Health System’s network of ambulatory clinics throughout Bexar County.

“Training bilingual staff to serve as medical interpreters is the ultimate win-win,” Burandt concludes. “The patients love it. It improves communication and patient safety, as well.”

Julie Wiley is the Corporate Communications coordinator at University Health System in San Antonio, TX. University Health System is an academic medical center and network of outpatient health centers. In partnership with The University of Texas Health Science Center School of Medicine, University Health System went paperless with electronic medical records. It is the first public health system in Texas to be designated as Magnet Hospital by the American Nurses Credentialing Center. University Hospital, its 498-bed acute care hospital, was named Best Regional Hospital U.S. News & World Report in 2011-2012 and is one of just 15 Level I trauma centers in Texas. University Health System’s Community First Health Plans is the region’s only locally owned, nonprofit HMO. For more information, visit

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