Posters

Telephone interpreting in cataract surgery

Poster Details

First Author: N.Finer UK

Co Author(s):    B. Paul   G. Sayer                 

Abstract Details

Purpose:

Patients not sharing a common language with their surgeon are at a potential disadvantage. Most units address this problem using one of four main approaches (i) Face-to-face professional interpreter in theatre; (ii) Interpreting by a friend or relative in theatre; (iii) General anaesthetic; (iv) Proceed without ability to communicate. We adapted existing wireless technology to allow patient, surgeon, and other members of the team to communicate in real time via a remote interpreter through use of wireless headsets and microphones. Our intention was to emulate the gold standard of face-to-face interpreting, while reducing its associated costs and risks.

Setting:

Barking, Havering and Redbridge University Hospitals NHS Trust (BHRUT), London

Methods:

As a baseline, we audited the mean cost per patient of face-to-face interpreting for cataract surgery over a one-year period. Working with our Trust�â�€�™s interpreting contractor, we identified the most appropriate hardware solutions for telephone interpreting, and designed patient eligibility criteria. Ten patients underwent cataract surgery under the care of a single surgeon. Telephone interpreting was provided during pre-operative consent, in the anaesthetic room and operating theatre. Cumulative interpreting time was recorded, and mean cost per patient was calculated. Written feedback at the end of every case was provided by surgeon, anaesthetist, scrub team and patient.

Results:

Considerable cost savings were achieved by the use of telephone interpreting. Face-to-face interpreting: Adjusted mean interpreting cost per patient = �Â�£68.63 Telephone interpreting: Capital spending on equipment: �Â�£668.00 Mean interpreting time per patient: 40 min @ �Â�£0.80/min Mean interpreting cost per patient: �Â�£32.00 All survey respondents rated the technology as highly reliable, simple to use, comfortable, hygienic, and suitable for senior and trainee surgeons alike. No respondent identified any domain of inferiority compared with face-to-face interpreting.

Conclusions:

COST: Assuming 100% of patients were suitable for telephone interpreting, the mean financial saving per patient (versus face-to-face interpreting) would be 53.4%. More realistically, a 70% eligibility would give an overall saving of 37.5%. These savings can be achieved without loss of quality in the service provided to the patient. NON-FINANCIAL CONSIDERATIONS: Telephone interpreting allows clinicians to order their list logically according to clinical priority, without placing interpreter-dependent patients first on the list to avoid cost overruns. It avoids the risk of interpreter delays and �â�€�œno-shows�â�€�, and the risk of the patient�â�€�™s interpreter or companion feeling unwell in theatre.

Financial Disclosure:

NONE