Ecosystem for credentialing and supporting a bilingual provider workforce

英语水平有限（LEP）的患者很难理解他们的护理提供者，他们在管理和临床程序上都有困难，这导致了比英语水平高的患者更差的结果。尽管许多联邦和州要求提供足够的语言协助，但医疗保健组织在实施适当服务方面取得的成功有限。由于缺乏合格的医疗口译员，医院经常使用临时或“双重角色”口译员，其中许多是自我报告医疗流利的双语工作人员。虽然方便，有时是不可避免的，但这种临时口译员更有可能犯严重的翻译错误，从而可能导致可预防的临床并发症；事实上，已经发现20%的双重角色口译员不适合进行医学口译。尽管越来越多地依赖于自我报告双语流利的人员向弱势患者群体提供关键的健康信息，但目前还没有严格和可扩展的方法来评估医疗保健中的双语交际能力。这一赤字不仅使语文服务的改进变得困难，而且也使合格的双语人员得不到应有的承认和职业晋升证书，因为他们的技能是应有的。这项语言知识专题评估（TALK）计划旨在为双语医疗保健人员提供全面的支持生态系统，包括医学双语能力考试、计分工作流程管理门户和有资格的双语医疗保健人员的可搜索目录。此外，根据熟练程度考试的结果，TALK将针对考生的薄弱环节提供额外的语言培训建议，从而建立一种持续提高他们宝贵技能的机制。这种系统的方法将为促进双语医疗交流的标准化、增加透明度和质量保证提供必要的支持。将通过与管理人员、卫生保健工作者、评估测试评分者和其他相关利益相关者的实施来评估这种方法的有效性。

Limited English proficient (LEP) patients who struggle to understand their care providers report difficulty navigating both administrative and clinical procedures, leading to poorer outcomes than their English-proficient counterparts. Despite numerous federal and state mandates requiring adequate language assistance, healthcare organizations have had limited success in implementing appropriate services. Facing a shortage of certified medical interpreters, hospitals frequently utilize ad hoc or “dual role” interpreters, many of whom are bilingual staff with self-reported medical fluency. While convenient and sometimes unavoidable, such ad hoc interpreters are more likely to make critical translation errors that can potentially lead to preventable clinical complications; in fact, it has been found that 20% of dual role interpreters are unfit to perform medical interpretation. Despite the increasing reliance on personnel with self-reported bilingual fluency to deliver critical health information to vulnerable patient populations, there is no rigorous and scalable method for assessing bilingual communicative competence in healthcare. This deficit not only renders improvements upon language services difficult, but also deprives qualified bilingual personnel the due recognition and career-advancing credentials they deserve for their skills. This Topical Assessment of Language Knowledge (TALK) initiative aims to deliver a comprehensive support ecosystem for the bilingual healthcare workforce, consisting of a medical bilingual proficiency exam, a scorer workflow management portal, and a searchable directory of credentialed bilingual healthcare personnel. Further, based on proficiency exam results, TALK will offer recommendations for additional language training matched to a test-taker's areas of weakness, creating a mechanism for continued improvement of their valuable skillset. This systematic approach will provide the necessary support for fostering standardization, increased transparency, and quality assurance in instances of bilingual medical communication. The effectiveness of this approach will be evaluated through implementation with administrators, healthcare workers, assessment test scorers, and other pertinent stakeholders.