Striving to Create a Welcoming Environment for Limited English Proficiency Clients


Impact Statement: 
The Harford County Health Department used QI to create a more welcoming environment for limited English proficiency populations by focused staff education, training, and standardization of processes, increasing the use translation services three fold.

Harford County Health Department (HCHD) intends to improve its approach for addressing the needs of limited English proficiency (LEP) populations residing in Harford County. Currently, individual HCHD programs are approaching LEP population needs in program-specific ways. This approach has led to a lack of uniformity in procedures and inconsistency in how clients interact with different HCHD programs which, in turn, has resulted in relatively minimal use of LEP language services. HCHD staff believe that by improving the availability and standardization of translation services, it will be able to more appropriately serve LEP clients.

Through a continuous quality improvement (CQI) process, HCHD will improve and standardize the approach that all of its public health programs are taking to better meet LEP population needs. The improvement process will bring together HCHD staff from all of the programs to develop a consistent and more user-friendly protocol which, in turn, will lead to greater use of LEP services. Ultimately, HCHD staff hope that strengthening the approach for meeting LEP needs will lead to improved access to health services for culturally diverse populations and reduce racial and ethnic health disparities in the county.

Organization that conducted the QI initiative: 

McIntosh, L. Public Health Quality Improvement Exchange. Striving to Create a Welcoming Environment for Limited English Proficiency Clients. Wed, 03/08/2017 - 13:15. Available at Accessed July 25, 2024.

Submission Status: 
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Submitted by jbutlerassoc on

A very good example of a department applying one of the 4 basic QI principles "Develop a strong customer focus." First by focusing on their client needs and second by recognizing that to implement this improvement their staff was in fact a customer too. The department also chose to do a training with all staff instead of the train-the-trainer approach which helped to emphasize the importance of everyone in the organizations role in the provision of high quality services. A good example of big QI.

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Submitted by victoria bailey on

An excellent Domain 9 and Domain 11 project with a focus on both external and internal customers. At Austin / Travis County we are updating our 'Bilinqual Pay Procedure' through utilization of the CQI process and looking at best practices for translation services. Thank you.

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Vicky Bailey

Grace Gorenflo's picture
Submitted by Grace Gorenflo on

Congratulations on your significant success! This is a great story of how to work on implementation of policy and procedure. One hallmark of QI is replicability, i.e., that an improvement to one process may be successfully applied to other processes. Has there been any discussion in your health department about the possibility of applying the lessons learned elsewhere in your department?

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Submitted by lcmcintosh on

Grace, thank you for your interest in our project! Our health department is currently focused on workforce development, and is looking into the possibility of using a very similar train the trainer process to help communicate key information to all members of our staff.

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