Language-Concordant Health Care: Implementation of a Bilingual Competency Program.

Abstract

Background: Language proficiency among health care professionals is essential for delivering equitable, high-quality care to patients with a non-English language preference (NELP). This study examines how implementing a Bilingual Competency Program (BCP) for diverse clinical staff enhances patient-centered care and improves the health care experience for NELP patients.

Methods: This quality improvement initiative describes implementation of the BCP at an urban cancer center. Staff self-assessed their language skills using the adapted Interagency Language Roundtable Scale for Healthcare (ILR-H) and recorded this in the organization's human resources platform. Those self-rating as excellent attested to their proficiency and enrolled by signing an electronic statement. Those rating themselves as very good or good took an oral proficiency test. Those who passed joined the BCP, while those self-assessing as fair or poor were not included.

Results: A total of 935 employees joined the program, representing 1,087 unique language entries across 67 languages, with Spanish, Mandarin, Russian, and Hindi being most common. Out of 1,087 unique entries, 641 (59.0%) self-assessed as excellent, 269 (24.7%) as very good (75.0% of whom [60/80] passed the proficiency test), and 130 (12.0%) as good (58.8% of whom [20/34] passed). Most participants (71.8%) were in patient-facing roles, and 68.7% held clinical positions. Of 1,087 unique entries, 721 (66.3%) were verified for language proficiency, 641 through self-assessment and 80 through formal testing.

Conclusion: The BCP enhances linguistic competency by integrating validated assessments and evidence-based methods, addressing prior program limitations, and setting a new standard for improving health equity, care quality, and outcomes for NELP patients.