Ecosystem for credentialing and supporting a bilingual provider workforce

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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.