Clinical Workflow Associated with Spanish-Speaking Patient Encounters at JayDoc Community Clinic-Wichita: A Quality Improvement Project

Abstract

Introduction. JayDoc Community Clinic-Wichita is a student-run free clinic serving a predominantly Spanish-speaking patient population. Authors of this study evaluated whether interpreter staffing represents a potentially modifiable systems-level factor associated with clinic workflow.

Methods. This retrospective observational quality improvement evaluation included 715 patient encounters nested within 128 clinic sessions at JayDoc from November 2023 to July 2025. Encounter-level workflow differences by Spanish-speaking status were evaluated using linear mixed-effects models accounting for clustering within clinic sessions and adjusting for clinic day. Clinic-session-level multivariable linear regression evaluated associations among Spanish-speaking patient volume, in-person interpreter staffing, and clinic workflow.

Results. After accounting for clustering and clinic day, Spanish-speaking encounters were 5.3 minutes longer than non-Spanish-speaking encounters, although the difference was not statistically significant (p=0.065). Spanish-speaking encounters had significantly longer medical preparation time (adjusted mean difference, 2.57 minutes; 95% CI, 0.83 to 4.31; p=0.004) and wait-to-present time (adjusted mean difference, 3.46 minutes; 95% CI, 0.47 to 6.45; p=0.024). At the clinic-session level, each additional Spanish-speaking patient was associated with a 6.7-minute increase in clinic-session duration after controlling for total patient volume and interpreter staffing (p <0.001). Each 1-unit increase in the Spanish-speaking patient-to-interpreter ratio was associated with a 3.72-minute increase in clinic-session duration (p=0.052).

Conclusions. Spanish-speaking encounters had longer medical preparation and wait-to-present times, while greater Spanish-speaking patient volume was associated with longer clinic-session duration. In-person interpreter staffing was not independently associated with session duration. These findings support further evaluation of strategies to better align interpreter resources with patient needs.