Across Languages: A Gap Analysis

Nicole Crellin-Parsons, Siddharth Gandhi, Amar Mamone, Tenisha Takhar,Mehal Vedantham

The University of Western Ontario
 INTRODUCTION
It has been noted that language barriers in healthcare result in miscommunication
between medical professionals and patients, thereby reducing the quality of healthcare delivery,
patient safety, and each parties’ overall satisfaction with the healthcare process (Al Shamsi et
al., 2020).
Quesnel-Vallée et al. (2010) have also noticed that new immigrants to Canada have
better health when compared with the average Canadian-born age matched control; yet, upon
repeated exposure to the cultural, social, physical, and environmental effects of the country,
immigrants start to lose their health advantage and become more similar to the Canadian
average. Quesnel-Vallée et al. (2010) suggest that immigrants to Canada lose their health
advantage because of economic instability, linguistic problems, and other cultural issues that
decrease healthcare access. Without proper communication with medical professionals,
immigrants cannot adequately express or receive care for their needs.
Thus, interpreter organizations—like Across Languages—play an important role in
society, acting as a liaison between medical professionals and immigrants to help overcome
language barriers in healthcare and improve health outcomes in immigrants. From this, several
benefits can be derived. A major one is that by helping immigrants communicate with healthcare
professionals earlier, interpreters can help prevent them from letting simple issues develop into
serious healthcare outcomes that require hospitalization—something that also serves to directly
decrease the financial burden on the healthcare system (Pitkin Derose, 2009).
The impact of Across Languages on the community is contingent on several factors. The
first is interpreter satisfaction and retention, so that the financial investment of training
interpreters is worth the time investment. The second key factor is that awareness of the
organization is increased so that Across Languages can get sufficient business and enough
people can access it (Bains, 2019). This could be done through increasing the media used for
interpretation (e.g., online, by phone, in-person, etc.). The final major factor is that Across
Languages is able to manage the workload it receives. Without being able to handle the large
volume of requests Across Languages may receive, it is likely that the stress of workers and
interpreters within the organization increases, thereby decreasing employee satisfaction with the
company.
Therefore, our objective with this project was to create a gap analysis for Across
Languages that identifies and suggests solutions to overcome deeper foundational issues to
increase interpreter retention, employee satisfaction, and financial stability needed for further
growth. While we initially started with the goal of creating a gap analysis that focused on
discovering ways to increase interpreter retention and improve their well-being, the project
pivoted based on interview results and discussions with the organization upon realizing financial
instability was a key higher-level issue inhibiting organizational growth and causing the
aforementioned issues. Thus, to address the finances more directly, we pivoted a final time to
create a gap analysis identifying organizational finance structure, how it impacts the perspective
of interpreters on their job satisfaction, and improvements to better support the organization’s
growth.

METHODS
This study utilized a mixed-method design to conduct a gap analysis on Across
Language’s current foundational weaknesses and to suggest improvements in their interpreter
services. From November 1st to November 27th 2021, data was collected from staff and
interpreters working with Across Languages.

Sampling and Data Collection - Qualitative Data

Phase 1 consisted of interviews with administrative staff to collect qualitative data on the
preliminary thematic information about Across Languages (n=4). A semi-structured interview
guide (Supplementary Material 1) was developed to identify any gaps within the organization.
After obtaining written consent, all interviews were conducted through Zoom and transcribed in
English. Each interview lasted for up to 60 minutes. Data saturation was identified when
thematic saturation was reached, which is when one can no longer identify new themes from the
data. Data collected were kept de-identified.

Sampling and Data Collection - Quantitative Data

Using the themes analyzed from phase 1, phase 2 conducted a survey on the interpreter
population and Across Languages to further confirm and analyze theories and assumptions
related to the organization's finances (n=24). A semi-structured survey guide (Supplementary
Materials 2) created on Google Form was developed based on the findings from the qualitative
analysis of Across Language. The gap analysis included open-ended questions, Likert scales,
and dichotomous questions. Each survey would take about 10 minutes of participants' time.
Consent forms were provided to participants and all surveys were conducted anonymously for
better participant confidentiality.
Ethical considerations
To inform participants of confidentiality, written consent forms were obtained from
participants conducting interviews and the survey.

Data analysis
Thematic analysis of qualitative data from phase 1 was conducted. The themes were
manually identified, reviewed, and addressed for utilization for survey questions. Quantitative
data conducted in phase 2 was analyzed according to the type of data collected from each
question type. Non-Likert scale questions were presented as averages or proportions of the
individuals who participated. Likert questions were analyzed by grouping the ratings and
presenting them as a count. Written responses were analyzed and presented in an anonymized
format to prevent identification.

RESULTS

Fig 1. Interpreters want more training, advertising, communication, and pay. Survey respondents’
views on various gaps at Across Languages were accessed using a Likert scale (n=25). With 1
representing none/not at all, and 10 representing a lot/very much. Questions were designed based on
gaps reported during interviews.
Communication Between Interpreters and Admin
Our interviews uncovered issues with communication between interpreters and admin.
Of the 4 interviewees, 75% either reported concerns regarding communication or suggested
improved communication.
When asked to provide suggestions for Across Languages 50% of survey respondents
requested better communication between interpreters and admin. Survey respondents raised
concerns regarding administrative response times and feeling ignored when raising concerns to
the organization. A “faster and more efficient way of communication”, returning “calls promptly
or ASAP”, “replying to e-mails faster” and “starting debriefing sessions” were noteworthy
suggestions for improvement by staff. Some respondents reported that their concerns had been
“brushed off”, others would like their “suggestions and opinions to be heard and taken
seriously.” Finally, improved transparency in communication was requested. Some survey
respondents want “more transparency” in the “distribution of assignments”, possibly through the
“use online platforms to manage assignment distribution.”
These findings were supported by the quantitative survey data. When respondents were
asked if they had the opportunity to voice their needs within Across Languages the responses
varied widely (Fig 1). Of the 24 respondents, 15 (62.5%) ranked their perceived ability to voice
concerns as 5 or below on a 1-10 Likert scale (1 being none and 10 being a lot). When
respondents were asked if they would like more meetings or a liaison person to act between
interpreters and admin, the majority were in favor (Fig 1). Of the 24 respondents, 13 (54%)
ranked their desire for more meetings/a liaison as 6 or above on a 1-10 Likert scale.
Furthermore, 9 respondents (37.5%) were neutral, and only 2 respondents (8%) were opposed
to more meetings/a liaison.

Interpreters’ Wage
Concerns regarding interpreters’ wages were also uncovered during our interviews. Of
the 4 interviewees, 50% brought up concerns regarding interpreters’ satisfaction with their pay.
When asked to provide suggestions for Across Languages, 67% of survey respondents
requested increased pay and benefits for interpreters. Respondents requested “higher wages
especially in medical settings”, and more “work related benefits.” Multiple respondents also
requested compensation for time outside of direct interpretation like being “paid an hour for
conference calls”, to be “paid full for the duration of the assignment which was originally
booked” and a “cancellation policy” that is implemented in all jobs.
 These findings were supported by the quantitative survey data. When respondents were
asked if they felt their pay was adequate for their work, the results were skewed towards no (1
on the 1-10 Likert scale) (Fig. 1). Of the 24 respondents, 15 (62.5%) ranked the adequacy of
their pay 5 or below on a 1-10 Likert scale.

Training and Professional Development

A desire for more training and professional development was mentioned in multiple
interviews. Of the 4 interviewees, 50% felt additional training and/or professional development
would benefit them, and those they work with.
When asked to provide suggestions for Across Languages 22% of survey respondents
requested additional training. Some interpreters feel “more training in medical and criminal
fields” would be beneficial. Other respondents mentioned issues with the availability of current
training programs. Issues with booking a time to finish current training modules and registering
for new modules were reported by multiple respondents.
These findings were supported by the quantitative survey data. The majority of
respondents reported interest in professional development at Across Languages (Fig. 1). Of the
24 respondents, 16 (67%) ranked their interest in professional development 6 or above on a 1-
10 Likert scale. Furthermore, when respondents were asked if they had any interest in
additional training, the results were more distributed. However, 15 of the 24 respondents
(62.5%) ranked their interest in additional training 6 or above on a 1-10 Likert scale.

Number of Clients
In our interviews, we discovered that an insufficient number of clients may be reducing
employee satisfaction at Across Languages. Of the 4 interviews conducted, 50% believe the
current number of clients is insufficient. We found that Across Languages has recently lost a
number of clients/contracts due to COVID-19 and that interpreters want to work more hours.
When asked to provide suggestions for Across Languages, 39% of survey respondents
reported a need for more clients. Several survey respondents reported that “more assignments”
and “more clients” would help improve Across Languages and employee satisfaction. Some
respondents were also disappointed to hear about the lost contracts, as they feel interpreting “is
a great job that many would like to do full time if remunerated enough to make a living.”
These findings aligned with the quantitative survey data, which suggested that out of 24
respondents, only 2 (8%) were content with their current hours with the remaining 92% reporting
that their current hours were less than their desired hours (Fig. 2a). Additionally when
respondents were asked if they were interested in working for Across Languages full time
62.5% (15/24) said “yes” (Fig. 2b). In comparing the results of those who provided numerical
values for both current and desired hours, we found that 14%, 19%, 14%, 43%, or 10% of the
21 respondents wanted an additional 31-40, 21-30, 11-20, 1-10, or 0 hours, respectively (Fig.
2c).

A. B. C.

Fig 2. Interpreters at Across Languages want more hours. (a) The current vs desired hours of
survey respondents were compared to determine each respondent’s satisfaction with their current
hours (n=24). (b) The proportion of survey respondents interested in working at Across Languages full
time. (c) The difference between current and desired hours of survey respondents who provided
numerical values for both current and desired hours (n=21).

Networking/ Advertising
Insufficient networking and advertising was another gap uncovered in our interviews. Of
the 4 interviewees, 75% felt that additional networking or advertising would benefit them in their
position at Across Languages. Most felt additional advertising and networking were needed to
recruit more clients and build the organization.
When asked to provide suggestions for Across Languages, 22% of survey respondents
mentioned issues with networking and advertising. Multiple respondents reported a need for
more engagement with stakeholders and “more effective marketing & advertisement” as they
felt “multiple communities & agencies” were unaware of Across Languages and its services.
These findings were supported by the quantitative survey data. When respondents were
asked if they thought Remote Interpretation Ontario (RIO) was well advertised, the results were
skewed towards no (1 on the 1-10 Likert scale) (Fig. 1). Of the 22 respondents, 16 (73%)
ranked the advertisement of RIO a 5 or below on a 1-10 Likert scale. Additionally, 7 out of 24
respondents (29%) had never even heard of RIO.
Administrative Staff Size
The small administrative staff size was a large concern raised in our interviews. Of the 4
interviewees, 75% reported that their work-related stress and conflict was partially due to the
small size of the administrative team.
When asked to provide suggestions for Across Languages 16% of survey respondents
requested a need for more administrative staff, specifically intake workers. Multiple respondents
reported that hiring “more permanent intake workers” is one way Across Languages could better
support them.
How Additional Funding will Benefit Interpreters

Fig 3. Suggestions for Across Languages proposed by survey respondents. Feedback was
gathered from three long answer questions; regarding how Across Languages can better support its
employees, any suggestions respondents had for Across Languages, and where additional funding is
needed. The area of each rectangle represents the proportion of respondents who mentioned each
issue/suggestion (n=18).

Summary of Qualitative and Quantitative Findings

 Fig 4. Summary of gaps at Across Languages addressed in interviews and surveys. The
percentage of interviewees who addressed each gap is depicted in grey (n=4). The percentage of
survey respondents who addressed each gap is depicted in purple (n=24). All gaps were either
mentioned by the respondent as qualitative feedback or ranked below 5 out of 10 on the Likert scale.
The radar graph is depicted on a 0-80% scale.

DISCUSSION

The initial scope of this project was to find gaps in the organization which needed
improvement with an initial focus on the training program that was provided to interpreters upon
hire. We decided to investigate this through the form of confidential interviews of staff members
at Across Languages, where we prepared a set of questions heavily focused on their work life
and training. However, through these interviews, we realized that the main themes we were
encountering all led back to financial issues as the root of the problem. This was affecting job
satisfaction, administrative communication, and accessibility of provided services. Thus, the
focus of our project was changed as we decided to look further into how the organization's
financial stability, rather than training curriculum, impacts the quality of the Across Languages
organization. However, we still faced issues regarding maintaining confidentiality throughout
interviews, as staff members had very niche roles and the administrative team was very small
making it difficult to present data without revealing staff identities. Additionally, interviews had a
low response rate resulting in our decision to shift towards using anonymous surveys to
continue gathering data with a deeper focus on financial issues rather than training. Through the
surveys, we were able to learn how many hours staff at Across Languages hope to work, ways
in which they hope funding can improve the organization, and staff suggestions to improve job
satisfaction and organizational growth. We organized these results from the Likert data by
grouping them together (rankings of 1 - 5 in a group and 6 - 10 in a group). This was done to
show contrasts in opinions to better understand the staff’s opinions, and to make all gaps clearly
visible in our results for this gap analysis.

Overall, the interpreters, other staff at Across Languages, clients, as well as the overall
healthcare system and community will benefit from this project which focuses on Across
Languages’ growth as an organization. Through resolving financial issues, staff will have an
improved work-life balance, interpreters will have more clients and work hours, the organization
can offer more cost-effective prices, and increase service accessibility through expansion and
better advertising of their services. Improved accessibility will in turn better healthcare in the
local London area and broader community as well through smoother healthcare experiences for
patients and healthcare workers, greater accessibility to healthcare services, and a reduced
burden of progressive diseases in the immigrant population on the healthcare system. These
positive experiences for immigrants receiving healthcare in our society will benefit the
community as a whole since accessibility to improved interpretation services will impact our
society's overall health, equity in services, inclusivity, and promotion of diversity.

Additionally, as many of the issues within the organization stem from low finances, this
gap analysis can identify details regarding how finances are impacting the company and how
funding can help the organization grow. Thus, this gap analysis can serve as a way to present
the need for greater finances when applying for funding through grant proposals.

Next Steps
The following plan for Across Languages prioritizes the use of funding from ongoing
grants to lead to sustainable increases in revenue, the target consumer audience, and staff
satisfaction.

Policy Changes
From the survey data collected it becomes apparent that interpreters at Across
Languages desire increased pay security and benefits — 67% of survey respondents desire
increased pay and benefits while 62.5% of respondents ranking the adequacy of pay below 5
out of 10 on a Likert scale. Organizational changes could increase interpreter satisfaction by
increasing financial security and generating further revenue for Across Languages. The survey
data suggests that no cancellation policy exists for interpreter services, and that interpreters are
paid for the time an appointment takes to complete rather than the amount of time an
appointment is booked for. By creating a 24-hour cancellation policy which charges clients for
missed appointments, Across Languages can increase their revenue and interpreter job
satisfaction by allowing staff to have more stability in their source of income. For similar reasons
interpreters would like to be compensated for the amount of time clients book appointments for
with a minimum booking time of 1 hour. Doing so will allow interpreters to feel more fairly
compensated for the time they allocate for services and generate further revenue for the
organization needed to fund further changes below.

Hire Liaison Staff

Both interpreters and administrative staff expressed that improved communication would
be beneficial in giving all staff members a platform to voice their concerns. From our interviews
we concluded that no formal liaison staff position exists, and interpreters report most likely to
training staff. 54% of survey responses indicated a desire (a ranking above 5 out of 10 on the
Likert scale questionnaire) for more communication with administration. 62.5% of staff have a
negative perception (below 5 out of 10 on the Likert scale questionnaire) of their ability to voice
concerns in the organization. A formal communication or liaison position would improve a
criticized delayed response time from administration to interpreter requests, which are often felt
to be ignored, while decreasing the workload on training staff allowing them to focus on tasks
within their job descriptions. Proper communication between interpreters and administration will
be crucial when facilitating further changes in the organization to ensure all perspectives are
considered equally.
Expand Remote Services
Our survey data illustrated that a large proportion of staff members are interested in
increased work hours (92%), clients (39%), working full time (62.5%), and a potential online
interpreter service platform (74%). Staff feel like Across Languages’ current online interpretation
platform RIO is undervalued, under-advertised (73% with a skew towards 1 out of 10 on the
likert scale equating to poorly advertised), and is a missed revenue opportunity. Staff suggest
that RIO is only advertised on the Across Languages web page suggesting that investing money
in RIO advertising could lead to sustainable increases in clients. Thus remote interpreter
services allow for Across Languages to broaden their target audience from the local London
community to provincial or national services increasing the number of potential clients, revenue
sources, and work hours for interpreters.

Hire Intake Staff

16% of survey responses indicated a need for more administrative staff with an
emphasis given to client and interpreter intake roles. Given that the direction for our suggested
changes hope to increase clients for Across Languages, investing in more intake staff before
the current system becomes overburdened will allow Across Languages to be best prepared for
growth and have a better distribution of workload among intake staff.

Hire Training or Professional Development Staff

From our survey data it is apparent interpreters at Across Languages (67% ranked
above 5 out of 10 on a Likert scale) would like professional development opportunities with
62.5% of staff seeking further specialized training. Across Languages should hire training staff
to facilitate the desire for specialized training and professional development. By increasing the
quality of interpreter services Across Languages will further their reputation which will translate
to increased clients and revenue, and distribute the training workload as currently one primary
staff member trains almost all incoming interpreters
Fig 5. Infographic summary depicting suggestions for Across Languages.
The following suggestions are recommended to improve job satisfaction, administrative communication,
and accessibility of the services provided at Across Languages. The suggestions prioritize the use of
fundings from ongoing grants to lead to sustainable changes in financial stability.
 APPENDIX
Supplementary Material 1: Interview questions for Interpreters

Questions Purpose

What is your job title and responsibilities? - Gain insight into their roles

1. What are your day-to-day tasks/

describe a day in your life

Why did you join Across Languages? - Job satisfaction vs initial expectations
- Context
2. Has the job met your expectations?

How long have you been working at the - Why have they changed roles; issues
company? in previous roles?
- Job satisfaction
3. Have you changed roles and why? - Unmet needs
- Career growth
4. How has each role changed during - Does previous training need to be
your career? updated?

What were your long-term career goals when - Is high turnover due to future goals
you first joined the organization - Are changing goals a trend?
- Does the company offer room
5. How have they changed to meet these goals?

6. What are your future steps to reach

your career goal

What was your experience with training? - Gaps in training?

- Is it impacting performance
7. How has it impacted your experience

8. Do you think your training is outdated

for your current role?

9. If you were to change or add

 something to training what would it
be?
Could you describe the work-life balance in
your role?
10. Do you feel you are able to manage
your time effectively given your
responsibilities?
11. Is there any way your role supports
across languages beyond your job
description?
What autonomy/independence do you have in
your role?
12. What room for career development
have you had so far?
What issues have you faced while working
with clients or co-workers?
13. Can you describe a time when you
have faced a challenge with an Across
Language Project?
What issues have you faced in your own
professional development?
How can Across Languages better support
your well-being?
Supplementary Material 2: Survey for Interpreters
1. Why did you join Across Languages?
2. What type of interpreter services do you provide?
3. How long have you been working with the company?
- Stressors on well-being
- Non-work factors could impact job
satisfaction
- Is the company supporting employees
- Is the company overworking
employees?
- Are tasks beyond what they
initially signed up for
- Could lack of autonomy leads to poor
job satisfaction
- Could room for career develop help
workers meet their future goals
- Work environment
- Could Across Languages better
support employees
- Support
- Meeting goals
- Support
 a. Less than a year
b. 1-3 years
c. 3-5 years
d. Greater than 5 years
4. On a scale from 1-10 (1= not at all/none, 10= very much/a lot)
a. Did you enjoy your training? Why or why not?
b. Do you feel your training was effective for your role?
i. What could be improved?
c. How much independence do you have in your role?
d. Do you have a healthy work-life balance?
e. Does Across Languages support your well-being?
f. Does Across Languages continue to support you in your career?
g. Do you have the opportunity to voice your needs or concerns within Across
Languages?
h. Are you satisfied with your current role?
5. What are your long-term career goals?
a. How does Across Languages fit into these goals?
b. What are your next steps?
6. Are you interested in professional development within the organization?
a. Do you feel like this is obtainable?
7. How can Across Languages better support you?

References

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Bains, C. (2019, November 4). Non-english speaking patients need equal access to interpreters,
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english-speaking-patients-need-equal-access-to-interpreters-doctor-says-1.4668994.
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