Frank C. Mayer III (DO '20) came to PCOM through the Delaware Institute of Medical
Education and Research program and examines demand for Spanish and Mandarin language
interpreters in hospitals.
Frank C. Mayer III (DO ’20) is a husband, father of two and a third-year osteopathic medical student. Currently he is rotating at Christiana Hospital as part of a core clinical campus agreement between the Christiana Care Health System and Philadelphia College of Osteopathic Medicine (PCOM). Prior to starting at PCOM, he received an MBA in healthcare management while conducting research at the Christiana Care Value Institute. Mr. Mayer came to PCOM through the Delaware Institute of Medical Education and Research program, through which PCOM reserves slots each academic year for applicants from Delaware.
We examined the supply and demand for full time in person Spanish and Mandarin language interpreters in the hospital. The goal was to optimize the number of interpreters so that patients who are better served by speaking to their healthcare providers in a language other than English receive the best possible care. Christiana Hospital wanted to determine how many full-time equivalent interpreters were needed and how patients felt about in-person Christiana Care interpreters versus interpretation by phone through 3rd party services. We found that patients preferred in-person interpretation. Our analysis also showed that increasing the number of Spanish and Mandarin interpreters up to an optimal level will result in savings to the hospital.
I was volunteering in the Emergency Department at Christiana Hospital and saw that there was a lot of quality improvement research and a strong focus on improving outcomes and reducing healthcare disparities. I was interested because I could see that the hospital was implementing policy based on the research. I liked that work was quickly having a real-world impact. After speaking to the advisor of my post-baccalaureate program, he was able to connect me with the Value Institute, which initiates or supports a lot of research done at Christiana Care.
While working at the Value institute I had the opportunity to participate in weekly meetings of the Healthcare Delivery Science team and assist with other projects in quality improvement, vascular surgery and emergency medicine. The staff, researchers and statisticians at the Value Institute made it an incredible learning experience.
The two papers came from an initiative at the Value Institute we called “Communication/Language Is Key (CLIK).” My involvement started with the first paper Quantifying Medical Interpreter Activity: A Time-Motion Study where we studied the full time Spanish language interpreters in the hospital. Another student and I followed the interpreters through hospital and tracked what the interpreters did, how long it took them do it and where they were when they did it. This allowed us to create a detailed map with a minute by minute account of the interpreter’s day including how long it took to walk to various areas of the hospital, how much time they spent interpreting and what departments they served most frequently. It quantified how busy the interpreters were and allowed us to quantify the value-added vs non-value added activities imposed on the interpreters due to organizational constraints. It also formed a foundation for parts of the analysis in the subsequent paper Meeting demand: A multi-method approach to optimizing hospital language interpreter staffing.
For most people outside of the healthcare field, understanding the terminology used in medicine or the risks and benefits of procedures is difficult. Now imagine trying to do that in a foreign language. This research helped the hospital better understand how to provide the resources to make sure that patients are receiving the safest and highest quality care possible, while reducing health disparities due to language barriers. There is a perception that cutting staff or patient services is a way of reducing costs, but in this case, we proved that the opposite is true. Meeting demand: A multi-method approach to optimizing hospital language interpreter staffing made such a great impact that the hospital selected the team as the recipients of the “Christiana Care Way—Health Equality Award.” This work was also recently presented (podium and poster) at Academy Health 2018 Annual Meeting.
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