Case Study: Real-Time Interpretation in Perioperative Care to Improve Consent and Post-Op Compliance

Background

Perioperative care—spanning pre-operative, intraoperative, and post-operative stages—is one of the most communication-intensive areas in clinical medicine. Each moment of this process relies on clear and accurate information exchange, especially when it comes to informed consent and patient education. For patients with limited English proficiency (LEP), however, language barriers can lead to significant risks. In the United States, over 25 million people are classified as LEP, many of whom require medical services but face systemic barriers in accessing quality, understandable care. These challenges are particularly acute in surgical settings where speed, comprehension, and consent are paramount.

A leading academic hospital in Southern California, which serves a highly diverse population including a large percentage of LEP patients, identified critical shortcomings in its perioperative communication model. These included misunderstandings during surgical consent, poor adherence to post-operative instructions, and increased readmission rates. Recognizing the need for a structured solution, the hospital partnered with iCall International, a provider of certified medical interpretation services, to embed real-time, virtual language support throughout the surgical care pathway.

Challenge

Before implementing iCall’s teleinterpretation system, the hospital struggled with inconsistent language support. Interpreter availability was limited, particularly outside of regular hours, and many departments relied on bilingual staff rather than certified professionals. This ad-hoc approach led to delays in patient care and serious compliance concerns, especially when interpreters were unavailable during time-sensitive consent procedures. Surgical teams reported difficulty in coordinating interpretation services, which sometimes resulted in patients signing consent forms without fully understanding the risks or procedure details.

Post-operative communication presented further complications. Nurses and discharge coordinators found it difficult to convey critical care instructions to LEP patients, leading to confusion over medications, wound care, and follow-up appointments. This gap in understanding contributed to an increased rate of readmissions and post-surgical complications. During internal compliance reviews, hospital administrators noted documentation gaps and flagged consent procedures that failed to meet standards set by regulatory bodies such as The Joint Commission and Title VI of the Civil Rights Act. The hospital needed a scalable, compliant, and clinically integrated solution that could offer immediate language access throughout the entire perioperative process.

Solution: Implementing iCall International’s Real-Time Interpretation in Surgical Workflows

In collaboration with the hospital’s leadership, clinical staff, and IT team, iCall International deployed a real-time interpretation infrastructure tailored specifically for surgical environments. The implementation began with a full systems integration, where iCall’s secure video and audio interpretation platform was embedded into the hospital’s existing electronic health record system. Mobile carts and tablet devices were stationed in key locations across the pre-operative, recovery, and discharge units, allowing providers to instantly connect with interpreters in over 200 languages.

A central feature of this deployment was the reengineering of the informed consent process. The hospital introduced a mandatory interpreter-assisted consent review for all LEP patients. These sessions were conducted through secure video conferencing, time-stamped, and recorded in the patient’s chart, ensuring both clinical transparency and legal defensibility. Providers were trained on how to conduct these interpreted conversations effectively, with an emphasis on ensuring patient comprehension and autonomy.

Post-operative care was another focus area for transformation. Nurses used iCall’s services during recovery and discharge to walk patients through complex care instructions in their native languages. Interpreters were available 24/7 to explain medication regimens, activity restrictions, diet changes, and follow-up scheduling. These interpreted conversations were complemented with printed aftercare materials in the patient’s preferred language, reinforcing comprehension and reducing the risk of mismanagement after hospital discharge.

Interpreter Role and Quality Control

To ensure the highest clinical standards, iCall assigned interpreters with formal certifications from nationally recognized organizations such as the Certification Commission for Healthcare Interpreters (CCHI) and the National Board of Certification for Medical Interpreters (NBCMI). These interpreters were not only linguistically proficient but also trained in surgical terminology, cultural sensitivity, and ethics specific to medical environments. Their role went beyond translation—they functioned as essential conduits of clinical clarity during emotionally and physically vulnerable moments for patients.

The interpreters’ familiarity with the pace and pressures of surgical workflows allowed them to integrate seamlessly into operating room protocols, pre-op evaluations, and recovery discussions. Their presence enabled providers to maintain a smooth clinical flow without compromising patient understanding or legal safeguards. Every interaction was HIPAA-compliant and conducted through encrypted, cloud-based platforms, ensuring patient confidentiality and adherence to healthcare privacy laws.

The hospital also introduced standardized interpretation request protocols within the EHR system. These protocols triggered automatic reminders to surgical teams and nurses to engage interpreters at key stages of patient care. Weekly usage reports were reviewed by the hospital’s Language Access Services team, who monitored interpreter quality, response times, and integration into clinical workflows.

Outcomes

The hospital conducted a nine-month evaluation across its general surgery, OB/GYN, and orthopedic departments following the full implementation of iCall’s solution. The results demonstrated significant improvements in both clinical outcomes and operational efficiency. The most notable achievement was achieving 100% compliance with interpreter-supported informed consent for all LEP patients. This marked a substantial improvement from the pre-implementation baseline, where more than one-third of consents were processed without proper language support.

Readmission rates for LEP patients dropped by 19%, a metric attributed to the improved clarity of discharge instructions and greater patient confidence in managing post-operative care at home. The speed and accessibility of interpretation services also led to a 24% reduction in delayed or rescheduled surgeries due to language-related issues. Interpreter access times averaged just 45 seconds, vastly improving upon the previous average of nearly 20 minutes for in-person interpretation.

Staff satisfaction with the system was equally high. Surgeons and nurses reported greater confidence in the consent process and appreciated the reduced risk of miscommunication. Patient satisfaction scores among LEP individuals also saw a marked improvement. More than 85% of surveyed patients said they "fully understood" their care instructions and felt respected and supported throughout their surgical experience.

Conclusion

This case study illustrates how the strategic use of real-time teleinterpretation can eliminate language barriers in one of the most critical areas of hospital care: the surgical journey. By embedding qualified interpreters directly into perioperative workflows, the hospital achieved measurable gains in patient safety, legal compliance, clinical efficiency, and health equity. iCall International’s model transformed language access from a logistical hurdle into a scalable, standards-driven component of surgical care. The result was not only better outcomes for patients with limited English proficiency but also a more streamlined, confident, and compliant healthcare operation. This model provides a replicable blueprint for any health system seeking to modernize its approach to language equity in clinical environments.