Archive for May 31, 2013

Growing Gardens of Hope

We talk about diminishing disparities and improving health literacy for multilingual populations on a routine basis in this blog. Approaching this from a slightly different perspective, I’d like to share Patricia Leigh Brown’s article “Seeking Serenity in a Patch of California Land” that ran in the New York Times this week which highlights a California city’s innovative approach to wellness for immigrant families.

Fresno recently created seven community gardens for immigrants, refugees and residents of impoverished neighborhoods with mental health money from the state. Gardens include the Hmong Village Community Garden, the Slavic Community Garden, the Punjabi Sikh Sarbat Bhala Community Garden and more.

Patricia shares that spending state money this way has been controversial. While, some think of it as frivolous in an era of ever diminishing resources, others believe there is true healing power in the gardens:

The thinking of community leaders and health professionals is that gardens can help foster resiliency and a sense of purpose for refugees, especially older ones, who are often isolated by language and poverty and experiencing depression and post-traumatic stress. Immigrant families often struggle to meet insurance co-payments, and culturally attuned therapists are in short supply.

In addition, it may very well be a highly cost effective solution – as many immigrant and refugee cultures do not have a tradition of formal mental health treatment. The article quotes Rocco Cheng, a psychologist and a director of the California Reducing Disparities Project, a statewide policy study, who tells us “Therapy is a Western concept. The Hmong do not have a word for mental illness.”  But, he said, they are well able to grasp the idea of mental, physical, spiritual and emotional wellness.

As we redesign the healthcare delivery and reimbursement systems with a focus on outcomes over the next few years, I applaud new ideas and novel approaches to meeting all patients, regardless of their age, illness, language or culture, in a meaningful way. This truly is a unique way to look at patient engagement.

Does Your Roadmap Include Translation?

I recently joined the Healthcare marketing network group on LinkedIn and noticed that one of the most popular discussions is “One Big Reason Health Exchanges May Fail” which was started by Andrew Atkin, CEO, Planet H. Mr. Atkin makes some fantastic points and I agree that building a roadmap will greatly improve the customer experience for any state’s exchange program. That said, I think there’s one key element that should be added: language and cultural barriers.

Mr. Atkin notes that many of the 12 million new customers and 11 million small businesses that will flood the insurance market in 2014 “be less educated and more racially diverse.” In addition, he calls out a few great questions that healthcare marketers need to be thinking about, such as “How do you reach these customers?” But one question he doesn’t ask is “How do we communicate with the subset of these customers who don’t speak English as their first language?”

Research shows that limited-English-proficient (LEP) and minority populations are more likely than their white counterparts to have chronic disease, lack health insurance, and have difficulties communicating with healthcare providers, even if qualified as highly literate in their primary language. Even for those who speak English as a second language, comprehension of new vocabulary or subject matter can be quite low. This is especially true when faced with difficult medical terminology.

Bridging the language gap is key to ensuring your culturally diverse communities enjoy equal access to healthcare. True understanding happens when they can internalize the material in their native language. Therefore, I would recommend adding an 8th step to the roadmap: Tailor communication to the targeted cultures through translation and localization. Further, I would expand Mr. Atkins second big idea to say that trusted translators should be included in the close marketing partnerships with insurers, navigators and exchanges in order to truly “power the Customer Experience Road Map.”

To find out more about how to create readable health materials in any language, read our brief The Growing Challenges of Health Literacy.

Healthcare Translation: What You Need to Know to Save Time and Money

Addressing the diverse communities your organization serves in their own language, culture and literacy levels can be difficult at best. Between managing day-to-day delivery of services and controlling operating and outreach expenses, healthcare professionals are left with little time to focus on language access issues and even less budget to implement language access programs. Whether it’s vital documentation or marketing outreach materials, it takes a lot of time and effort to translate your organization’s information effectively. Luckily there are ways to simplify this process—from file formats to translation memory, even the tiniest tweak can save your organization heaps of time and stretch your budget so you can serve the greatest number of LEP (Limited English Proficiency) populations in your community.

Below are a few steps we recommend to get the most out of your time, money and translation projects:

  • Use Translation Memory. Translation memory software is a databank that captures previously translated text so you will be able to recycle translation from one document to the next.
  • Use a Glossary, Term List and Style Guide. Language is subjective and there are many ways to translate the same sentence. Many translation dollars can be saved by defining style and dialect preferences upfront.
  • Centralize Translation Ordering. By building and maintaining a centralized repository of health education content, you can streamline the translation process and establish consistent terminology use and corporate style across all geographies.

Want to know more? Sign up for a free virtual workshop  and we will give you the latest tips, tools and tried and true best practices to help you reap the maximum benefits from your healthcare translations.

VIA assists with OHSU Intercultural Customer Service Initiative

Oregon Health Science University (OHSU) is committed to continuously improving the patient care environment and patient experience across all levels of the organization and all patient touch functions. I’m delighted to share an opportunity they recognized in the Environmental Services department.

Environmental Services employs several hundred people and is one of the departments that have multiple patient interactions each day. This department is one of the most diverse at OHSU, with over 65% of employees identifying their first language to be something other than English. After observing the various native and non-native housekeepers to evaluate their language skills, OHSU found that many were struggling to follow the AIDET (Acknowledge, Introduce, Duration, Explain, Thank) protocol.  As a result, they developed a training initiative in partnership with the Department of Applied Linguistics of Portland State University then worked with VIA to translate the documents at the appropriate literacy level into the top nine language groups spoken by the staff.

The translated handouts were used in conjunction with the English versions during 23 training sessions and they helped the non-native English speakers to fully comprehend the materials. Following the training, these handouts were laminated and distributed to each housekeeper in English and the language of their choice.

Participants provided feedback that the initiative increased their confidence and competency with the tasks they are asked to perform. In particular, they said that practicing the AIDET script in their own language along with English would make it easier for them to do their job well. As a result, they were able to provide better service and help OHSU to deliver health equity to its all patients regardless of their cultural or linguistic background. This was reflected one month after the training initiative when the November 2012 HCAHPS overall raw scores improved.  Read the full case study to learn more.


Why Centralize Your Healthcare Translation Approach?

When it comes to translations, maintaining consistency and efficiency can be tricky, especially when organizations are managing multiple languages and multiple translation vendors. How can healthcare organizations ensure their brand is consistently translated from one language service provider to the next? And how can version control be maintained when there are numerous versions of documents living in multiple places at once?

The key to avoiding these issues is establishing a centralized translation process. While this may not be the solution for every organization, it may be the right step for larger organizations that are challenged with some of the following:

  • Supporting large volumes in one or more languages
  • Various types of healthcare content
  • Standardized healthcare preferences and terms
  • Private health information content
  • Meeting compliance regulations
  • Desire to improve quality management, reduce costs and minimize mistakes

If any of the above applies to your organization, it may be time to consider the idea of centralization. Centralizing enables fast, predictable turnaround of multilingual projects and delivers cost savings through the use of linguistic assets such as translation memories and technology tools. Centralization also saves time by allowing for a single record of all active and live documents that have been translated. It takes a bit of effort to get there, but it’s definitely worth your while. To read more about centralizing, and how it worked for a large California health System, click here.