Your organization already has a language services provider. Maybe more than one. So why are people still struggling through appointments without interpreters, receiving notices they cannot understand, or unable to get help in their language?
When we encounter this, we find that it’s often not a provider problem. It’s a workflow problem. The language services are in place, but the processes for delivering them are disjointed and disorganized.
How does this happen?
In large organizations, individual departments often make their own arrangements for translation and interpretation, with little coordination across teams. A patient or customer may receive an initial notice in their language, only to get follow-up instructions in English because another department handles that communication.
When language needs are not consistently addressed across departments, people can miss out on essential information or services—even when the organization has the resources to provide them. And without a clear view of how language services are delivered across the organization, leaders struggle to identify where people are being underserved or to demonstrate that they are meeting their language access obligations.
Better language access starts with better workflows.
Here are three common breakdowns that can undermine your language access program, and what you can do about them.
1. Too Many Teams Are Requesting Services Without Shared Oversight
At a hospital, clinical and patient access teams may arrange interpreters, while marketing or communications teams coordinate translations of patient-facing materials. Compliance, legal, and human resources teams have their own language needs. Similar patterns arise in health plans and government agencies, where customer service and other departments might be arranging language support independently.
The possible disconnects are endless: One department may pay to translate a document that another team has already translated or send out the English version because no one shared the translation. When vendors, budgets, and approvals are managed separately, no one person has a reliable picture of overall demand, spending, or where language needs are going unmet.
How to address it: Start with a request inventory. Ask each department which services it uses, how requests begin, who approves them, and where records are kept. Include people who are on the front lines with patients, members, or residents. They are usually the first to know about language access needs and problems.
2. Too Many Systems, Too Many Handoffs
Employees often need translation or interpretation while working in systems that are not connected to their language services provider. Clinicians use electronic health records (EHRs), while communications and training teams work in content management systems or e-learning platforms
Leaving these systems to request language support manually takes time and adds friction. Employees may have to email files, wait for updates, forward approvals, upload finished translations, and the list goes on.
During a patient encounter, switching between systems to reach an interpreter adds another step for your team. Integrating interpreter access into the tools they already use removes that barrier and can improve interpreter utilization.
For example, a 2025 study published in JAMIA Open describes how clinicians at NYU Langone Health previously had to find dedicated devices, use separate vendor tools, and document interpreter details themselves. When a new approach let clinicians call an interpreter from the patient chart and return call information to the EHR, interpreter use went up. By December 2024, monthly audio and video interpreter calls had risen to more than 68,000, compared with an average of 9,700 in 2022.
How to address it: Follow a language service request from start to finish. Identify the systems it passes through, where employees must transfer information manually, and where delays or errors can occur. Look for opportunities to connect existing systems and eliminate unnecessary steps.
For a technical look at how to do that, read How BIG Uses APIs to Connect Language Services to the Tools Your Team Already Uses.
3. Too Little Visibility into What Was Requested and Delivered
Individual departments may have detailed records of the language services they use. But bringing that information together to understand language access across the organization is another matter. Leaders need to see demand by language and location, total spending, and how long services take to deliver. They also need to identify recurring problems accessing services.
A 2026 audit by the New York State Comptroller illustrates the problem. When auditors reviewed the New York City Department of Health and Mental Hygiene’s language access operations from 2019 through 2024, they found that the agency lacked centralized service tracking. Officials could not determine how many interpreter calls had dropped or how often no interpreter was available. Without that information, they could not assess how often people encountered barriers to interpretation or identify recurring problems that needed attention. This also exposes the organization to significant compliance risk.
Oversight extends to written translations, too. Leaders need to know who approved translation requests, which versions of documents were distributed, and whether departments are using consistent terminology. When that information is scattered across departments, it becomes harder to investigate errors, resolve inconsistencies, or demonstrate accountability.
How to address it: Bring together the language service reports your departments and vendors already produce. Compare and aggregate service usage, turnaround times, and spending across locations and languages. AI tools approved for your organization’s data can help consolidate reports in different formats and identify patterns worth investigating. Have your team verify the findings, then establish a regular process for reviewing results and addressing problems.
How Workflow Problems Create Compliance Risk
For organizations with language access obligations, manual handoffs and inconsistent procedures create compliance risk.
A language access policy sets out how support should work and provider contracts make services available. But neither guarantees that staff across departments and locations will consistently identify language needs and arrange the appropriate services, exposing your organization to risk
For example, when departments follow different procedures, leaders have a harder time assessing whether the organization is meeting its obligations. Recurring problems may go unnoticed until someone files a complaint or an audit raises questions about how language services were provided.
Clear ownership and consistent workflows help leaders identify problems earlier, take corrective action, and demonstrate that the organization is meeting its language access responsibilities.
What a Workflow-Based Approach Looks Like
Once you understand how teams request and manage language services, you can establish consistent procedures and make responsibilities clear.
You don’t necessarily have to replace every system or route every request through one department. The following six elements can help you coordinate language services across the organization while giving leaders the oversight they need:
- Central intake and routing: Establish a clear process for requesting and routing translation services. For live interpretation, staff members need direct access to an interpreter without unnecessary approval steps.
- Clear ownership and approvals: Define who oversees language access, who approves requests when necessary, and who is responsible for resolving problems between departments.
- Shared glossaries: Give departments access to approved terminology and current translations so they can communicate consistently.
- Status dashboards: Bring together data on service usage, spending, turnaround times, and unfulfilled requests so leaders can monitor performance across departments and locations.
- Audit logs: Maintain records of requests, approvals, service delivery, and exceptions to support compliance reviews and help teams investigate problems.
- Integrate with existing systems. These processes work best when they fit into the systems employees already use. Connecting those systems with language services can reduce manual handoffs and make it easier for staff to access qualified translators and interpreters.
Five Questions to Assess Your Language Access Workflows
These five questions can help you identify where your current processes may be falling short.
- Can you name every team that requests translation or interpreting services?
- Can staff access interpreting services when they need them, without unnecessary handoffs or approval steps?
- Can you account for unfulfilled requests as well as completed services?
- Do you know your total language services spending and usage across departments?
- Can you produce an audit trail showing what was requested, who approved it, and when the service was delivered?
If you had trouble answering any of these questions, take a closer look at both your internal processes and the support you’re getting from your language services provider. A provider that can work with your existing systems and give leadership a clear view of language services across departments can help you build a more effective program.
BIG Language Solutions helps organizations connect expert translation and interpretation services with their existing systems and workflows. Talk to our team about how we can help you improve language access across your organization.
