Hospital language services: Quality improvement and performance measures

Document Type


Publication Date



Advances in Patient Safety: New Directions and Alternative Approaches. Vol. 2 - Culture and Redesign


Volume 2


Health Reform


For a growing segment of the U.S. population, language barriers affect patients’ ability to communicate effectively with health care providers. “Speaking Together” is the first national quality improvement (QI) collaborative focusing on improving operations of hospital-based language services. We employed a multistage process to develop quality performance measures for Speaking Together participants to use throughout the collaborative. The measures, which are grounded in the Institute of Medicine’s six domains of quality, underwent multiple levels of review prior to pilot testing. Early experiences with the measures highlight challenges with collecting information on patient care that has not previously been collected and the importance of engaging staff, including registration staff and senior management. Speaking Together hospitals have shown that QI efforts to measure and advance the delivery of high-quality language services represent challenging but important tasks for improving delivery of care for patients with limited English proficiency.


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Open Access