Creating a Professional Ladder for Interpreters for Improvement of Care

Jt Comm J Qual Patient Saf. 2016;42(10):466-478. doi: 10.1016/s1553-7250(16)42063-5.


Background: Children's Hospital Los Angeles (CHLA), a metropolitan academic medical center, recognized limitations in how the professional interpreters from the Diversity Services Department were used to support effective patient-provider communication across the organization. Given the importance of mitigating language and communication barriers, CHLA sought to minimize clinical and structural barriers to health care for limited English proficiency populations through a comprehensive restructuring of the Diversity Services Department. This approach entailed a new delivery model for hospital language assistance and cultural consultancy resources.

Methods: The intervention focused on restructuring the Diversity Services Department, redefining priorities, reallocating resources, and redefining the roles of the language staff positions in the department. The language staff role was redesigned to fit a four-level professional career ladder modeled after the professional career ladders commonly used in hospitals for the RN role and other professional disciplines. The approach involved creating new levels of language specialist, each with progressive requirements for performance, leadership, and accountability for patient care outcomes. Language staff in the inpatient, clinic, and emergency department settings worked alongside nurses, physicians, and other disciplines to care for a specific set of patients.

Results: The result of this work was a positive culture change resulting in service efficiencies, care improvements, and improved access to language services.

Conclusions: A professional career ladder for language staff contributed to improving the quality and access of language services and advancing the interpreting profession by incorporating care coordination support, vital document translation, and cultural consultancy.

MeSH terms

  • Academic Medical Centers
  • Communication Barriers*
  • Cultural Competency
  • Hospitals, Pediatric
  • Humans
  • Los Angeles
  • Professional-Patient Relations
  • Quality Improvement*
  • Translating*