Language Access Systems Improvement (LASI) Initiative

Study Overview

The overarching goal of this proposal was to evaluate the impact of a systems intervention to certify the proficiency of clinicians’ non-English language skills and simultaneously create easy access to professional interpreters through videoconferencing – the LASI initiative – on communication and clinical outcomes for LEP patients. We hypothesized that the LASI initiative would lead to fewer partial and non-concordant visits without professional interpreter use, better patient awareness and completion of clinician recommendations after a primary care visit, and improved clinical outcomes for patients with chronic conditions.

 

To test our hypotheses, we conducted a natural experiment (Aim 1 patient telephone interviews, Aim 2 electronic medical-record-based analysis) comparing interpreter utilization and effective communication as well as clinical outcomes before and after implementation of the LASI intervention. We complemented the first two aims with comparison of communication factors across English and non-English language-concordant and discordant-professionally interpreted visits (Aim 3 audio recordings). Finally, we conducted focus groups with patients and semi-structured interviews with clinicians to give context to our findings, and to gain understanding of the facilitators and barriers to LASI implementation (Aim 4). (Figure 1)

 

Figure 1. LASI Study Overview

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Principal Investigator: Leah Karliner, MD MAS (leah.karliner@ucsf.edu)