Ecosystem for credentialing and supporting a bilingual provider workforce

英语水平有限(LEP)的患者难以理解他们的护理提供者，他们报告难以驾驭行政和临床程序，导致比他们精通英语的同行更差的结果。尽管许多联邦和州的规定需要足够的语言援助，但医疗保健组织在实施适当服务方面取得的成功有限。由于缺乏经过认证的医学口译员，医院经常使用临时口译员或“双重角色”口译员，他们中的许多人都是自称医疗流利的双语工作人员。虽然这样的临时口译员很方便，有时不可避免，但他们更有可能犯严重的翻译错误，这可能会导致可预防的临床并发症；事实上，已发现20%的双重角色口译员不适合进行医学口译。尽管越来越依赖自我报告的双语流利程度的人员向脆弱的患者群体提供关键的健康信息，但在医疗保健领域还没有严格和可扩展的方法来评估双语沟通能力。这一不足不仅使改善语言服务变得困难，而且还剥夺了合格的双语人员因其技能而应得的应有的认可和职业发展证书。这项语言知识专题评估(Talk)计划旨在为双语医护人员提供全面的支持生态系统，包括医疗双语熟练程度考试、计分员工作流程管理门户和可搜索的认证双语医护人员目录。此外，Talk将根据熟练程度考试的结果，为与考生的薄弱领域相匹配的额外语言培训提供建议，为继续提高他们宝贵的技能创造一种机制。这一系统的方法将为促进双语医学交流的标准化、提高透明度和质量保证提供必要的支持。这种方法的有效性将通过与管理员、医护人员、评估测试评分员和其他相关利益相关者一起实施来评估。

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.