Register      Login
Australian Health Review Australian Health Review Society
Journal of the Australian Healthcare & Hospitals Association
RESEARCH ARTICLE

Bridging the language gap: a co-designed quality improvement project to engage professional interpreters for women duing labour

Jane Yelland A B H , Mary Anne Biro C , Wendy Dawson A , Elisha Riggs A B , Dannielle Vanpraag A , Karen Wigg D , John Antonopoulos E , Jenny Morgans D , Jo Szwarc F , Chris East C D and Stephanie Brown A B G
+ Author Affiliations
- Author Affiliations

A Healthy Mothers Healthy Families Research Group, Murdoch Childrens Research Institute, 50 Flemington Road, Parkville, Vic. 3052, Australia. Email: wendy.dawson@mcri.edu.au; elisha.riggs@mcri.edu.au; dannielle.vanpraag@mcri.edu.au; stephanie.brown@mcri.edu.au

B Department General Practice and Primary Health Care Academic Centre, The University of Melbourne, Parkville, Vic. 3052, Australia.

C School of Nursing and Midwifery, Monash University, Wellington & Blackburn Roads, Clayton, Vic., 3800, Australia. Email: Maryanne.biro@monash.edu; christine.east@monash.edu

D Monash Women’s, Monash Health, David Street, Dandenong, Vic. 3175, Australia. Email: Karen.Wigg@monashhealth.org; Jenny.Morgans@monashhealth.org

E Community and Allied Health, Monash Health, 135 David Street, Dandenong, Vic. 3175, Australia. Email: John.Antonopoulos@monashhealth.org

F Victorian Foundation for Survivors of Torture, 6 Gardiner Street, Brunswick, Vic. 3056, Australia. Email: szwarcj@foundationhouse.org.au

G Department of Paediatrics, The University of Melbourne, Parkville, Vic. 3052, Australia.

H Corresponding author. Email: jane.yelland@mcri.edu.au

Australian Health Review 41(5) 499-504 https://doi.org/10.1071/AH16066
Submitted: 9 March 2016  Accepted: 20 July 2016   Published: 29 August 2016

Abstract

Objective The aim of the study was to improve the engagement of professional interpreters for women during labour.

Methods The quality improvement initiative was co-designed by a multidisciplinary group at one Melbourne hospital and implemented in the birth suite using the plan-do-study-act framework. The initiative of offering women an interpreter early in labour was modified over cycles of implementation and scaled up based on feedback from midwives and language services data.

Results The engagement of interpreters for women identified as requiring one increased from 28% (21/74) at baseline to 62% (45/72) at the 9th month of implementation.

Conclusion Improving interpreter use in high-intensity hospital birth suites is possible with supportive leadership, multidisciplinary co-design and within a framework of quality improvement cycles of change.

What is known about the topic? Despite Australian healthcare standards and policies stipulating the use of accredited interpreters where needed, studies indicate that services fall well short of meeting these during critical stages of childbirth.

What does the paper add? Collaborative approaches to quality improvement in hospitals can significantly improve the engagement of interpreters to facilitate communication between health professionals and women with low English proficiency.

What are the implications for practice? This language services initiative has potential for replication in services committed to improving effective communication between health professionals and patients.


References

[1]  Small R, Roth C, Raval M, Shafiei T, Korfker D, Heaman M, McCourt C, Gagnon A. Immigrant and non-immigrant women’s experiences of maternity care: a systematic and comparative review of studies in five countries. BMC Pregnancy Childbirth 2014; 14 152
Immigrant and non-immigrant women’s experiences of maternity care: a systematic and comparative review of studies in five countries.Crossref | GoogleScholarGoogle Scholar | 24773762PubMed |

[2]  Mander S, Miller YD. Perceived safety, quality and cultural competency of maternity care for culturally and linguistically diverse women in Queensland. J Racial Ethn Health Disparities 2016; 3 83–98.
Perceived safety, quality and cultural competency of maternity care for culturally and linguistically diverse women in Queensland.Crossref | GoogleScholarGoogle Scholar | 26896108PubMed |

[3]  Yelland J, Riggs E, Szwarc J, Casey S, Duell-Piening P, Chesters D, Wahidi S, Fouladi F, Brown S. Compromised communication: a qualitative study exploring Afghan families and health professionals’ experience of interpreting support in Australian maternity care. BMJ Qual Saf 2016; 25 e1
Compromised communication: a qualitative study exploring Afghan families and health professionals’ experience of interpreting support in Australian maternity care.Crossref | GoogleScholarGoogle Scholar | 26089208PubMed |

[4]  Australian Institute of Health and Welfare (AIHW). Australia’s mothers and babies 2013 – in brief. Catalogue no. PER 72. Canberra: AIHW; 2015.

[5]  Yelland J, Riggs E, Small R, Brown S. Maternity services are not meeting the needs of immigrant women of non-English speaking background: results of two consecutive Australian population based studies. Midwifery 2015; 31 664–70.
Maternity services are not meeting the needs of immigrant women of non-English speaking background: results of two consecutive Australian population based studies.Crossref | GoogleScholarGoogle Scholar | 25823755PubMed |

[6]  Flores G. The impact of medical interpreter services on the quality of health care: a systematic review. Med Care Res Rev 2005; 62 255–99.
The impact of medical interpreter services on the quality of health care: a systematic review.Crossref | GoogleScholarGoogle Scholar | 15894705PubMed |

[7]  Parsons J, Baker N, Smith-Gorvie T, Hudak P. To ‘get by’ or ‘get help’? A qualitative study of physicians’ challenges and dilemmas when patients have limited English proficiency. BMJ Open 2014; 4 e004613
To ‘get by’ or ‘get help’? A qualitative study of physicians’ challenges and dilemmas when patients have limited English proficiency.Crossref | GoogleScholarGoogle Scholar | 24902724PubMed |

[8]  Wilkinson H, Trustees and Medical Advisers. Saving mothers’ lives. Reviewing maternal deaths to make motherhood safer: 2006-2008. BJOG 2011; 118 1402–4.
Saving mothers’ lives. Reviewing maternal deaths to make motherhood safer: 2006-2008.Crossref | GoogleScholarGoogle Scholar | 21906238PubMed |

[9]  Newbatt E, Beckles Z, Ullman R, Lumsden MA, Guideline development Group Ectopic pregnancy and miscarriage: summary of NICE guidance. BMJ 2012; 345 e8136
Ectopic pregnancy and miscarriage: summary of NICE guidance.Crossref | GoogleScholarGoogle Scholar | 23236034PubMed |

[10]  Flenady V, Wojcieszek AM, Middleton P, Ellwood D, Erwich JJ, Coory M, Khong TY, Silver RM, Smith GC, Boyle FM, Lawn JE, Blencowe H, Leisher SH, Gross MM, Horey D, Farrales L, Bloomfield F, McCowan L, Brown SJ, Joseph KS, Zeitlin J, Reinebrant HE, Ravaldi C, Vannacci A, Cassidy J, Cassidy P, Farquhar C, Wallace E, Siassakos D, Heazell AE, Storey C, Sadler L, Petersen S, Frøen JF, Goldenberg RL, Lancet Ending Preventable Stillbirths study group Lancet Stillbirths In High-Income Countries Investigator Group Stillbirths: recall to action in high-income countries. Lancet 2016; 387 691–702.
Stillbirths: recall to action in high-income countries.Crossref | GoogleScholarGoogle Scholar | 26794070PubMed |

[11]  Phillips CB, Travaglia J. Low levels of uptake of free interpreters by Australian doctors in private practice: secondary analysis of national data. Aust Health Rev 2011; 35 475–9.
| 22126952PubMed |

[12]  Ogrinc G, Davies L, Goodman D, Batalden P, Davidoff F, Stevens D. SQUIRE 2.0 (Standards for QUality Improvement Reporting Excellence): revised publication guidelines from a detailed consensus process. BMJ Qual Saf 2016;
SQUIRE 2.0 (Standards for QUality Improvement Reporting Excellence): revised publication guidelines from a detailed consensus process.Crossref | GoogleScholarGoogle Scholar | 27076505PubMed |

[13]  Yelland J, Riggs E, Szwarc J, Casey S, Dawson W, Vanpraag D, East C, Wallace E, Teale G, Harrison B, Petschel P, Furler J, Goldfield S, Mensah F, Biro MA, Willey S, Cheng IH, Small R, Brown S. Bridging the Gap: using an interrupted time series design to evaluate systems reform addressing refugee maternal and child health inequalities. Implement Sci 2015; 10 62
Bridging the Gap: using an interrupted time series design to evaluate systems reform addressing refugee maternal and child health inequalities.Crossref | GoogleScholarGoogle Scholar | 25924721PubMed |

[14]  Australian Commission on Safety and Quality in HealthCare (ACSQHC). National safety and quality health service standards. Sydney: ACSQHC; 2011.

[15]  Commonwealth Ombudsman. Use of interpreters. Canberra: Commonwealth of Australia; 2009. Available at: http://www.ombudsman.gov.au/__data/assets/pdf_file/0013/26221/investigation_2009_03.pdf [verified 2 March 2016].

[16]  Yelland J, Riggs E, Fouladi F, Wahidi S, Chesters D, Casey S, Szwarc J, Duell-Piening P, Brown S. Having a baby in a new country: the experience of Afghan families and stakeholders. Final Report. Melbourne: Murdoch Childrens Research Institute; 2013.

[17]  Langley G, Moen R, Nolan K, Nolan T, Norman C, Provost L. The improvement guide: a practical approach to enhancing organizational performance. San Francisco: Jossey-Bass; 2009.

[18]  Damschroder LJ, Aron DC, Keith RE, Kirsh SR, Alexander JA, Lowery JC. Fostering implementation of health services research findings into practice: a consolidated framework for advancing implementation science. Implement Sci 2009; 4 50
Fostering implementation of health services research findings into practice: a consolidated framework for advancing implementation science.Crossref | GoogleScholarGoogle Scholar | 19664226PubMed |

[19]  Greenhalgh T, Robert G, Macfarlane F, Bate P, Kyriakidou O, Peacock R. Storylines of research in diffusion of innovation: a meta-narrative approach to systematic review. Soc Sci Med 2005; 61 417–30.
Storylines of research in diffusion of innovation: a meta-narrative approach to systematic review.Crossref | GoogleScholarGoogle Scholar | 15893056PubMed |

[20]  Greenhalgh T, Robert G, Macfarlane F, Bate P, Kyriakidou O. Diffusion of innovations in service organizations: systematic review and recommendations. Milbank Q 2004; 82 581–629.
Diffusion of innovations in service organizations: systematic review and recommendations.Crossref | GoogleScholarGoogle Scholar | 15595944PubMed |