HCIS 410 Week 1 Health IT Project Initiation and Stakeholders Example

Relatives Interpreting at the Bedside: Initiating a Video Remote Interpreting Project for a Community Hospital and Nine Clinics, From Business Case to Stakeholder Map

[Student Name]

University of Phoenix

HCIS/410: Project Planning and Implementation in Health Care

Week 1 Assignment

[Instructor Name]

[Date]

The hospital, its clinics and its figures are composites written for a model paper; research findings and federal rules come from the sources listed.

A quality audit at a composite 210-bed community hospital reviewed 180 encounters with patients whose preferred language was not English. In 31% of them, including discharge teaching and two consent discussions, a relative had interpreted. Staff said phone interpreters took too long to reach, averaging nine minutes during busy hours, and that the phone line did not offer sign language at all. The chief nursing officer asked for a project to fix the problem across the hospital's inpatient units, emergency department and nine outpatient clinics. This paper describes the project's initiation.

The Problem

About 14% of the hospital's patients prefer a language other than English, mostly Spanish, Vietnamese and Arabic, and about 60 deaf patients a year use American Sign Language. The hospital employs four staff interpreters, all for Spanish, working weekday hours. Other languages and all evening and weekend needs go to a phone service. The audit, delays and complaints from two deaf patients show the current approach is not meeting need.

Why It Matters

Karliner et al. (2007), in a systematic review, compared trained interpreters with untrained stand-ins such as relatives and reported that the trained interpreters were linked, across the studies, to clearer communication with fewer mistakes, patients who understood more, more appropriate use of care, better clinical results and more satisfied patients, and that with a trained interpreter present, the care these patients received came near the level enjoyed by patients who share their clinician's language. A relative can explain a meal tray; a relative should not be interpreting a consent form.

The Legal Requirement

A 2024 federal rule implementing the health care nondiscrimination provision of the Affordable Care Act obliges covered health programs to make language assistance genuinely available to people who do not speak English well, including qualified interpreters, generally without relying on family members, and sets standards for video remote interpreting (U.S. Department of Health and Human Services, 2024). The hospital's current reliance on relatives creates legal risk as well as clinical risk.

Three Options

Option one, hiring staff interpreters for more languages and hours, would cost about $780,000 a year and still leave rare languages uncovered. Option two, improving phone interpreting with dedicated handsets, would cost less but not solve sign language or the visual cues that help in complex conversations. Option three, video remote interpreting on tablets connected to a vendor's interpreter network, would provide spoken and sign languages at any hour for an estimated $210,000 in the first year and $150,000 a year after, with staff interpreters kept for Spanish during the day.

The Recommendation

The team recommends option three, supported by the existing staff interpreters. It covers the most languages and hours at the lowest cost per encounter and meets the federal standards for video interpreting if the connection and image quality are maintained.

Sponsor and Project Manager

The chief nursing officer is the sponsor, responsible for the business case, funding and decisions beyond the project's authority. A project manager from the information technology department will lead the work, with a clinical lead from nursing education and the language services coordinator, following the usual division in which the sponsor owns the business case and the project manager owns delivery (Project Management Institute, 2021).

Stakeholders by Influence and Interest

The team identified 11 groups. High influence and high interest, to be closely involved: nursing leadership, the emergency department director, the clinic operations director and the language services coordinator. High influence and lower interest, to be kept satisfied: the chief financial officer, the chief information officer and the compliance officer. High interest and lower influence, to be kept informed and consulted: bedside nurses, physicians, patients and families through the patient advisory council and the deaf community liaison. Lower on both, to be informed: environmental services, who will clean tablets, and the biomedical engineering team, who will maintain the carts.

Feasibility

Technically, the hospital's wireless network covers all patient areas, though the emergency department needs two additional access points. Financially, the first-year cost fits within the language services budget with a one-time transfer from the patient experience fund. Operationally, the main risk is adoption: staff accustomed to phones or relatives must learn to use tablets during busy shifts.

Lessons From an Earlier Project

The hospital tried tablets for interpreting once before, in 2019, in the emergency department only. The pilot ended within three months. Tablets were kept in a locked office, batteries were often dead, no one owned cleaning and nurses were never trained. The team reviewed that failure before writing this plan and drew three lessons: devices must live where care happens, each unit needs a named owner for charging and cleaning and training must happen on every shift, not once at a staff meeting. These lessons shaped the scope and the stakeholder list, which is why environmental services and unit charge nurses appear on it.

Assumptions and Constraints

The business case assumes the vendor can supply interpreters within two minutes for the hospital's five most common languages and sign language at all hours, which references from similar hospitals support. It also assumes the wireless network upgrade in the emergency department can be finished before go-live. Constraints include a fixed first-year budget, a union contract requiring notice before changes to nurses' work and a go-live window that avoids the winter respiratory season.

Measures of Success

Within six months of go-live: relatives interpreting in fewer than 5% of audited encounters, median time to reach an interpreter under two minutes, 100% of deaf patients offered sign language interpreting and staff satisfaction with interpreting access above 80%.

Conclusion

The project starts from a measured problem, relatives interpreting in nearly a third of encounters, supported by research on professional interpreting and a current federal rule. Three options were compared, video remote interpreting was chosen, a sponsor and project manager were named and stakeholders were mapped by influence and interest. Next week, these decisions become the project charter and scope statement.

References

Karliner, L. S., Jacobs, E. A., Chen, A. H., & Mutha, S. (2007). Do professional interpreters improve clinical care for patients with limited English proficiency? A systematic review of the literature. Health Services Research, 42(2), 727-754. https://doi.org/10.1111/j.1475-6773.2006.00629.x

Project Management Institute. (2021). A guide to the project management body of knowledge (PMBOK guide) (7th ed.). Project Management Institute.

U.S. Department of Health and Human Services. (2024). Nondiscrimination in health programs and activities. Federal Register, 89, 37522. https://www.federalregister.gov/d/2024-08711