Sarah Dunlop (right), provides a mobile virtual interpreter session with a patient. (Note: This photograph preceded the current requirement for mask-wearing for clinicians and patients in a care setting.)
As a clinical planner with Vancouver Coastal Health (VCH), Sarah Dunlop is driven to provide quality patient care. In 2017, she noticed that patients who didn't speak English were faced with unique barriers to their care. In particular, in-person language interpreters could sometimes take 24 to 48 hours — delaying important patient-care conversations between the team, the patient and their families.
A recent audit of VCH patients and clients highlighted that five per cent of people had limited proficiency in English, while 21 per cent did not speak any English at all. Seeing these numbers reflected on the frontline, Sarah was growing frustrated with the difficulty in providing timely care to patients who didn't speak English. So, she decided to do something about it and brought her concern and ideas to Susan Seeman, Operations Director, Access and Flow, Care Management, who then linked her to the Transformation Office.
“If it wasn't for Susan Seeman, the Mobile Virtual Interpretation project probably wouldn't have happened at all," said Sarah. “She took the time to listen to someone on the frontline, made something happen with it, and encouraged me to do it. It's really kudos to leadership to foster that for frontline people. I've had really good leaders on this project who have taught me a lot, supported me a lot, and I'm really thankful for that."
With Susan's encouragement, support of the Transformation Office as well as Provincial Language Service (PLS) the Mobile Virtual Interpreter pilot project was developed, bringing virtual, on-demand, live interpreters to patients in over 240 languages. It wasn't long before Sarah noticed an improvement in care, and when they looked at the data, they saw that it reduced the length of stay significantly.
“All staff members loved it and it really made a difference to our quality of care," said Sarah. “Patients were laughing with it and families were so thrilled with it."
Soon departments throughout VCH wanted their own mobile virtual interpreter. That's when the Virtual Health team got involved to launch a second, larger implementation in 15 areas across VCH. Again, the project was well-received by all departments, showing a 47 per cent reduction in length of stay for low English proficiency patients, a 27 per cent reduction on time required for an admission decision from the Emergency Department, as well as a decrease in overall admission rates to hospital.
Survey results from staff, medical staff and patients have also demonstrated the success of the project, including:
97 per cent of patients say they have a good understanding of their health condition and instructions provided thanks to the tool
Only one per cent of staff and medical staff feel their patients are at risk of receiving untimely care due to communications barriers
84 per cent of staff and medical staff feel they're able to communicate with non-English speaking patients and create a relationship
95 per cent of patients feel they're able to communicate their needs and concerns to their care team
“What I love about this project that it was truly because of Sarah's passion for patient care," said Megan Stowe, Executive Director of Clinical Informatics and Virtual Health. “The transformation for the experience of the clinician and of the patient is just so phenomenal, and we've decided that this is the tool of choice to move forward with."
With this recent success, the project is now expanding throughout the health authority into 62 new areas. And, it's truly because of the hard work of everyone involved.
“It just shows how with many people together and many teams together, we made it all happen," said Sarah. “Staff have done a lot. To make something happen and have concrete data and make it work, the frontline's participation was invaluable.