Wake Health Services Builds Capacity Through Communication

When it comes to your health, relationships play a big role. You want to be heard, and you want to trust that your needs are understood. Communication is a top priority, and a smile can go a long way! 

Wake Health Services learned exactly that, and so much more, when the organization took the time to step back, assess and improve its capacity to meet the needs of the Spanish-speaking community. What began as an initiative to provide bilingual support grew into so much more as the organization embraced opportunities to improve in other areas along the way.
In 2003, the staff at Wake Health Services faced a communication barrier as they struggled to effectively serve a growing Spanish-speaking population. With grant support from the John Rex Endowment, Wake Health Services set out to add bilingual, Spanish-speaking staff at its pediatric sites. However, they realized over time that they stood to gain so much more through improved communications at all sites coupled with broader cross-cultural understanding to improve interactions between staff, patients and families. Bilingual support, alone, was not the ultimate solution but rather the stepping stone to a four-year transformation.

The Comfort Level of Care

When you’re struggling to communicate, it’s written all over your face. It can make everything that much harder.
Wake Health Services identified this and worked creatively to put solutions in place that now make patients and providers a lot more comfortable.
“It helps a lot that we have bilingual medical office assistants who are trained in both clinical and front desk duties,” said Christine Moore, practice administrator at Apex Medicine and Southern Wake Family Medicine. “Patients get to see the same people every time. Being able to have someone who is there all the time allows patients to build a bond with them – it makes for a much smoother flow.”
Moore, who now has certified medical interpreters on staff, recalls times when they needed to pull a bilingual person from the back to communicate with patients at the front desk. “From a human resources aspect, we’ve benefited from day one,” said Moore. “I know exactly what skills I’m looking for when hiring so everyone feels more comfortable – from scheduling an appointment to diagnosis and treatment. It makes for a better, healthier medical relationship.”
By opening the communication lines from the moment someone calls the office or walks in the door, Wake Health Services establishes a relationship that makes all the difference when it comes to talking to patients and their families about complex health concerns. However, talking is only half of the puzzle. The bilingual staff places a big emphasis on listening, too.       
“You have to really hear what patients are saying,” said Hilsy Kruger, dental assistant at New Bern Ridge Family Dental. When Kruger began working at Wake Health Services, she was the only Spanish-speaking person in the office. “At times, I was doing three jobs in one,” said Kruger. She is from Honduras, and Spanish is her native language. However, she cites the importance of proper training for medical interpretation. “Through training, I learned that I have to be a third person. I need to interpret it exactly. I’m speaking on their behalf,” said Kruger.
There’s a comfort factor that comes into play which may not be as easy to define but is equally important. It’s a familiar face – a relationship – a trust. 

Building Trust and Capacity

In the beginning, there isn’t always trust. Letting someone else communicate on your behalf requires more than just speaking the same language. It requires trust. It takes time. “I was like that at one point in my life when I first came here,” said Kruger. “Now, I feel like I am doing something very important when families come back for different reasons. We’re building trust.”
The entire team has learned quickly that relationship-building benefits reach beyond the walls of Wake Health Services. “People come see us because their friends tell them to,” said Kruger. “They trust us because their friends do.” 
Multiple providers at various Wake Health Services locations have also taken language classes to improve their ability to connect with Spanish-speaking patients. A pediatrician’s ability to speak to a patient on some level in their native language, supported by bilingual medical assistants, helps piece together vital information needed for a child’s accurate diagnosis. 
The word has spread quickly that Wake Health Services has made big changes. On average, they now see an additional 500 Latino pediatric patients each year which is a 98 percent increase.    

Sometimes It’s In the Details

As Wake Health Services transitioned from occasional translation to having a fully integrated bilingual staff trained in clinical and front desk duties, they also identified and removed common barriers for Spanish-speaking patients. From a first appointment call all the way down to the tedious paperwork, they found beneficial ways to change day-to-day business interactions to better serve a specific audience.   
By incorporating a Spanish language option into their phone system, they minimized a lot of hesitation and confusion for both new and returning patients. The rewards have been apparent. Reminder calls are even made now in Spanish which has significantly reduced missed appointments and opened the communication lines even further.   
Professionally translated forms available in Spanish also minimized paperwork hurdles. Both patients and staff needs were met in regards to collecting necessary medical information.

Transformative Change

Through the support of a four-year grant from the John Rex Endowment, Wake Health Services has created permanent, far reaching and lasting change. 
“We are more respectful, more understanding, more culturally sensitive as an organization—with each other and with our patients,” said William Massengill, chief operating officer. “Our bilingual staff has educated us to stereotypes and misunderstandings that we were blind to before we began this initiative.”
The four-year, cultural transformation throughout the organization ultimately resulted from what began as an initiative to improve basic comprehension of patient needs. Greater understanding ensued, organizational changes were made on various levels, and their capacity to provide care for Spanish-speaking patients improved dramatically.