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Project Scope and Plan (PSP) General Information: Project name: Design and Implementation of Interpreter Services.

Project Manager name: Joan Kronlein Site: Birkam Health Center Location: Ferris State University

Project Overview: Describe the product or service of the project, the reason project will be undertaken, and the purpose of the project. Discuss the problem or opportunity this project addresses. Include the quality and safety issue this project will address. Support with current evidence-based practice literature or data specific to the project. I will be addressing the need for medically trained interpreters at my place of employment. I work at a health center for college students. While helping international students fill out required university medical forms, other students (not in the medical field) were utilized as interpreters. For initial assessment and discharge, Speaking Together considers the use of family or friends, untrained interpreters, or unassessed [sic] providers to be identical to the patient receiving no language services whatsoever (Regenstein et.al, n.d., p. 9). Speaking Together, is a coalition of 6 major hospitals working on standardizing interpreting services based on the Institutes of Medicine (IOM) guidelines. The health center does not have a plan for interpreting services when a student with limited English proficiency (LEP) needs health care. I will be developing guidelines for implementing medically trained interpreters. This is an important issue to address because individuals with LEP [limited English proficiency] have poorer health

outcomes, are at greater risk for medical errors, and place a higher financial burden on the system than patients who can communicate fully with their health care providers (Regenstein et.al, n.d., p. 2). It is important also for the educational institution, which prides itself on giving all students a quality education, that quality health care is given to students with LEP so they can thrive in the learning environment. This project will improve health care outcomes for LEP students on the university campus because the medical interpreters will be able to communicate effectively with the patient thus preventing errors from poor communication. Reference
Regenstein, M., Huang, J., West, C., Mead, H., Trott, J., Stegun, M., (n.d.). Hospital

language services: quality improvement and performance measures. Retrieved from http://www.ahrq.gov/downloads/pub/advances2/vol2/AdvancesRegenstein_54.pdf. B. Project Goal(s): Describe the project goal(s) using SMART (specific, measurable, accurate and agreed to, realistic, and time bound) formula. These goals will be used to measure and determine the projects success at its conclusion. The goal of the project is to develop and implement guidelines for implementing medical interpreter services at the health center by Dec 1, 2012. C. Project Objectives/Deliverables: List the specific items or services that must be produced in order to fulfill the goal of the project. Objectives/deliverables should be measurable results, measurable outcomes or specific products or services. List and number in a logical order to complete the project. 1. Identify best practices (medically/nonmedically trained) for interpreting by Oct 5.

2. Identify what interpreting services are available around and on the university campus by Oct 4. 3. Identify training (if necessary) for interpreters by Oct. 26. 4. Develop a budget for interpreting services by Nov 13. 5. Design an internal (within the health center) and external (out to the university) communication system when interpretation is needed by Nov 28. 6. Design and send out a survey for quality and safety to LEP/International students by Nov 26. D. Comprehensive List of Project Requirements/Activities/Tasks: List by corresponding objective the necessary specifications of the objective/deliverable. Example 1.1, 1.2, 1.3, 1.4, etc. This is a breakdown of the objectives/deliverables into their most basic components. Consider this the action plan of the project. 1.1 Show team members (consisting of the Clinical Coordinator, another RN, the Physician, and the Interim Director of the health center) how to do a scholarly information search on the universities library databases using keywords of: interpreting, LEP, quality, health, and disparities. 1.2 Write annotated bibliography of research. To be completed by Oct 4. To be completed by Oct 3. by Oct 5.

1.3 Discuss the findings for best practices and decide on best practice. 2.1Call International Student Office for interpreter information. 2.2 Call Department of Public Safety for interpreter information 2.3 Call Disability Services for interpreter information

Completed by Oct 1 Completed by Oct 1 Completed by Oct 1

2.4 Call Mecosta County Medical Center (or Spectrum Health) for interpreter service information including necessary training. Completed by Oct 1

2.5 Call Sindecuse Health Center (Western Michigan University) for interpreter information, training and comparison. Completed by Oct 1

3.1 Do a database search for best practice training for medical interpreting (if necessary). Completed by Oct 4 3.2 Write a plan for medical training of interpreters for use at the health center. Completed by Oct 24 4.1 Write the budget proposal for implementing and/or training for interpreter services. Completed by Nov 9 4.2 Submit budget to Dean of Academic Affairs for approval (This is an unknown/risk) Completed by Nov 13 5.1 Write internal communication tree (guidelines), including EMR notification. Completed by Nov 22 5.2 Write external communication tree (guidelines). 6.1 Decide on quality/safety measurement tool/survey 6.2 Send survey results to LEP/International students 6.3 Obtain and analyze findings of survey Completed by Nov 28 Completed by Nov 23 Completed by Nov 26 Completed by Nov 28

E. Timeline: Identify time estimates by hours for each objective/deliverable in hours. These are estimates only and will be updated as project progresses. 1.1 Show team members (consisting of the Clinical Coordinator, RN, the Physician, and the Interim Director of the health center) how to do a scholarly information search on the universities library databases using keywords of: interpreting, LEP, quality, health, and disparities. 1.2 Write annotated bibliography of research. Time-7hrs. Time-5hrs.

1.3 Discuss findings (annotated bibliography)for best practices and decide on best practice. Time-3hrs.

2.1Call International Student Office for interpreter information, and document. Time-3hr 2.2 Call Department of Public Safety for interpreter information, and document. Time-3hr 2.3 Call Disability Services for interpreter information and document. Time-3hr 2.4 Call Mecosta County Medical Center (or Spectrum Health) for interpreter service information including necessary training and document. Time-3hrs

2.5 Call Syndacuse Health Center (Western Michigan University) for interpreter information, training and comparison. Document the information. Time-3hrs 3.1 Do a database search for best practice training for medical interpreting (if necessary). Time-8 hrs/0hrs 3.2 Write a plan for medical training of interpreters for use at the health center. Time-10 hrs/0hrs 4.1 Write the budget proposal for implementing and/or training for interpreter services. Time-5hrs 4.2 Submit budget to Dean of Academic Affairs for approval (This is an unknown/risk) Time-1hr 5.1 Write internal communication tree (guidelines), including EMR notification. Time-10hrs

5.2 Write external communication tree (guidelines). 6.1 Decide on a quality and safety tool/survey 6.2 Send survey results to LEP/International students 6.3 Obtain and analyze results of survey

Time-10hrs Time -6hrs Time-5hrs Time-5hrs

F. Assumptions & Constraints: Identify all project assumptions and constraints. Assumptions are about people, resources, places, things, or anything that you presume is going to perform in a certain way, be available at a certain time, and so on (Heldman, 2011). 1. The group is excited and wants to work on the project. 2. Team member performance will be exemplary 3. All telephoned individuals will be available for consult. 4. Time estimates are accurate 5. Time is available to work on the project 6. The university (external) will acknowledge this as a worthwhile project by giving budget approval. Constraints are anything that restricts or dictates the actions of the project team (Heldman, 2011, p. 95). 1. Not enough time available 2. No buy-in by team members 3. The Electronic Medical Record implementation takes precedence. 4. This is a school related project. 5. Budget not approved (a risk). 6. EMR is not capable of addressing interpreting services

7. Technology personnel not available or knowledgeable about EMR Reference Heldman, K. (2011). Project management jumpstart (3rd ed). Indianapolis, IN: Wiley Publishing, Inc. G. Success Criteria: Provide the value of the project. Why is this project important and of what benefit it is? What impact will it have on client care and client outcomes including aspects related to quality and safety? How will you know if the project was a success? Support with evidence-based literature or nursing data. According to the American Nurses Association (ANA), a registered nurse practices ethically by; assisting healthcare consumers in self-determination and informed decision making; speaking up when appropriate to question healthcare practices when necessary for safety and quality improvement; and advocates for equitable healthcare consumer care (ANA, 2010). A registered nurse also contributes to quality nursing practice by participating on and/or leading interprofessional teams to evaluate clinical care or health service (ANA, 2010, p. 52) and analyzing organizational systems for barriers to quality healthcare consumer outcomes; and implementing processes to remove or weaken barriers within organizational systems (ANA, 2010, p. 53). The benefits of this project will be to the patient, by creating healthcare equity and removing barriers, and to nursing by practicing ethically and contributing to quality nursing practice. This project will be successful when the deliverables or goals are completed and the guidelines for interpreting services are implemented. This will be documented by surveys given to LEP/International students before and after implementation of

interpreting services. The essence of success will also be felt in the ease of utilization of the interpreting services. Reference American Nurses Association. (2010). Nursing:Scope and standards of practice (2nd ed.). Silver Springs, MD: Nursesbooks.org. H. Signatures: (no electronic signatures) Project Manager: ________________________________________________ Nurse Manager/Supervisor:________________________________________ Phone: email: