As part of Massachusetts General Hospital's COVID-19 response efforts, 62 Spanish-speaking clinicians—from trainees to full professors across multiple specialties—were recently assembled to assist teams caring for patients with low-English proficiency by relaying condition updates, educating patients and their families about their care plan, and assisting in the daily rounding process, either in person or via telephone, Skype or FaceTime.

Mass General clinicians—including Peter Masiakos, MD, director of Pediatric Trauma Services at MassGeneral Hospital for Children, and Numa Perez, MD, a resident in the Department of Surgery, and Nattaly Greene, MD, a first-year resident in the Harvard Combined Orthopaedic Residency Program—voiced concern about how the virus was disproportionately impacting members of the Latino or Spanish-speaking community.

“I went into medicine to help the underserved and address social justice issues,” says Greene. “There was a crisis in my own back yard and I was compelled to help.”

Greene reached out to Elena Olson, executive director of the Mass General Center for Diversity and Inclusion, and Joseph Betancourt, MD, MPH, vice president and chief equity and inclusion officer at Mass General, both of whom saw the same trend. To support the significant influx of Spanish-speaking inpatients with COVID-19—and suspected cases requiring hospitalization, they launched the Spanish Language Care Group (SLCG)—slated to act as an appendage to the clinical team caring for patients with low-English proficiency—using a multilingual registry Olson created. The SLCG is a supplemental group which works closely with the formal Mass General Interpreter Services Department, made up of nationally trained and certified medical interpreters who provide remote and in-person services—to non-English, limited English proficient, and deaf or hard-of-hearing patients—in more than 200 languages.

"The SLCG was an innovation born out of necessity,” Betancourt says. “When I raised the idea, it was immediately welcomed by Joshua Metlay, MD, chief of the Division of General Internal Medicine, internist Steven Knuesel, MD, and internist Warren Chuang, MD, who have been absolutely committed to this effort, and unwavering in their dedication to assure its success.”

Olson said the Center for Diversity and Inclusion then tapped into its active community to provide ambitious 24/7 coverage—and thanks to an extraordinary response, the group filled the majority of the first week’s shifts immediately.

On average, these providers interact with five patients per shift for about 50 minutes. “When a SLCG clinician communicates with a patient in their native Spanish to tell them, ‘We care about you, and please follow these instructions,’ the patient feels a cultural connection and is more likely to trust in that clinical advice, which leads to better outcomes and patient experience,” Olson says.

Greene’s first shift with the SLCG was April 13. Since then she’s assisted with dozens of cases in the intensive care units, in the Emergency Department and on the telephone. She says she formed a particularly strong bond with a woman who was struggling to understand the complex treatment her son was receiving.

“I started talking to her over the phone about her son, who is a talented musician, loving grandson and the love of her life,” says Greene. “It’s important to provide culturally competent care in a patient’s native language and share in their experience. We have similarities and bonds created by our language and culture. The SLCG helps bridge the gap of distance and of families being unable to see their loved ones.”

As Mass General looks toward COVID-19 recovery efforts, the SLCG initiative plans to shift its focus to the Chelsea HealthCare Center and Boston Hope, an alternative clinical site for COVID-19 patients or unsheltered individuals who no longer need to be hospitalized. Olson says the lessons they have learned from this program will continue to benefit future patients in the years to come.

“The SLCG was a team effort and reinforces the hospital’s mission to diversity the staff and support the most vulnerable,” she says.