Meeting demand: A multi-method approach to optimizing hospital language interpreter staffing

Objective: The objective of this paper is to highlight a study on optimizing the full-time equivalent (FTE) for Spanish and Mandarin interpreters at Christiana Care Health System. In this study, there were multiple challenges that needed to be addressed, and a multi-method approach was taken. Methods: These methods include: (1) time-motion study to quantify interpreter workflow and variability of duration of time needed for each task; (2) an integer program to optimize the number of interpreters needed per hour based on historical demand patterns for interpreter services; (3) Discrete-Event Simulation (DES) to examine the use of agency interpreters in order to meet demand; (4) cost modelling to convert FTEs and the use of agency interpreters into overall costs to the hospital; and (5) sensitivity analysis to evaluate alternative number of interpreter FTEs and their corresponding costs to the hospital. Results: Overall cost to the hospital is predicted to decrease with additional FTE interpreters, up to a threshold level above which the cost will start to increase. Through this innovative methodology used in this paper, we predict that hiring 3.5 more FTEs for Spanish interpreters will result in 9.07% of cost savings, and predict that hiring one FTE for Mandarin interpreters will result in 25.87% in cost savings compared to the current expense of providing Mandarin language interpretation. Conclusions: Contrary to intuition, increasing number of FTEs results in cost savings. Besides the financial benefit, hospitals will also be able to ensure the quality of health services that Limited English Proficiency (LEP) patients and families receive.