During a recent Becker’s Healthcare webinar hosted by Martti, an Equiti Solution, Andy Schwieter, director of language access services at Cincinnati Children’s, made the case that treating it as infrastructure, not an obligation, is what separates organizations that improve from those that stagnate.
Below are four key takeaways from the session.
1. The root cause
Mr. Schwieter reframed the issue and highlighted that when something goes wrong for a patient who uses a language other than English, the default diagnosis is “language barrier.” But that explanation, he argued, is almost always wrong.
Drawing on more than a decade of quality improvement work, Mr. Schwieter described cases where deeper investigation revealed clinicians not following patient identification policies, poorly designed marketing materials, and discharge workflows that assumed English fluency.
“When we looked closer at these problems, language was rarely the cause,” Mr. Schwieter said. “The families who use languages other than English don’t have the same redundancy in systems and communication that English-speaking families have. And so they’re often the first ones to expose what’s not working well for everyone.”
2. More than a requirement
Organizations that treat language access as a clinical infrastructure function by measuring it, integrating it into workflows, and holding it to outcome accountability, consistently outperform those that treat it as a legal requirement.
According to Mr. Schwieter, research backs this up. Professional interpreting at admission and discharge can shorten inpatient stays by nearly a day and a half, with downstream savings compounding through reduced adverse events and malpractice exposure.
Over 18 months, the hospital medicine team at Cincinnati Children’s increased the share of patients receiving discharge instructions in their language from 12% to 77%, and to 96% for Spanish-speaking patients.
3. Why benchmarks matter
One of the session’s most actionable arguments centered on the difference between volume metrics and gap metrics. Tracking interpreter minutes or translation spend tells you what you’re doing. Tracking the gap between what you want to provide and what your systems actually deliver tells you where to improve.
Mr. Schwieter also described a low-cost change with significant upstream impact: adding the term “language barrier” as a contributing factor in safety event reporting. Without that checkbox, organizations have no way to see patterns in language-related harm and no way to address them systematically.
“If you don’t have an answer for how language access works in your organization across registration, inpatient, outpatient, the ED, telehealth, you’re not alone,” he said. “Most health systems can’t answer that question.”
4. Improvements for all
Mr. Schwieter highlighted that improvements made for patients who use languages other than English consistently benefited everyone. He shared the example of signage for weapons detectors in Cincinnati Children’s emergency departments. Spanish-speaking family forum members identified confusing imagery and contradictory messaging that English-speaking staff hadn’t noticed. The revised signs were clearer for all patients.
The same pattern emerged from a different quality improvement project, where implementing teach-back for medication education at discharge — initially for families who use languages other than English — revealed that the same gaps existed for English-speaking patients. Expanding the practice improved outcomes across the board.
Organizations that appoint a system-level owner for language access, build operational metrics, embed language considerations into procurement and change management, and invest in co-design partnerships with patients and families won’t just better serve patients who use languages other than English; they’ll build stronger systems for everyone.
“The solution isn’t more interpreters, more translation,” Mr. Schwieter said. “It’s a focus on communication with patients and families in a way that’s patient and family centered.”
At the Becker’s 11th Annual IT + Revenue Cycle Conference: The Future of AI & Digital Health, taking place September 14–17 in Chicago, healthcare executives and digital leaders from across the country will come together to explore how AI, interoperability, cybersecurity, and revenue cycle innovation are transforming care delivery, strengthening financial performance, and driving the next era of digital health. Apply for complimentary registration now.
Watch the on-demand webinar today.
At the Becker's 11th Annual IT + Revenue Cycle Conference: The Future of AI & Digital Health, taking place September 14–17 in Chicago, healthcare executives and digital leaders from across the country will come together to explore how AI, interoperability, cybersecurity, and revenue cycle innovation are transforming care delivery, strengthening financial performance, and driving the next era of digital health. Apply for complimentary registration now.