All Graduates
All Graduates | 24 Jun 2022

Ongoing collaboration between All Graduates Interpreting and Translating Service and Northern Health’s Virtual Emergency Department has resulted in successful health consultations for multicultural patients seeking emergency medical support.

Video interpreting has become increasingly popular as a service platform since the onset of the COVID-19 Pandemic in March 2020, with many services being provided on a pre-booked basis. However, in late 2021, Northern Health sought an ‘on demand’ interpreting solution to cut wait times and provide interpreting needs on a reliable, real-time basis.

All Graduates has a large pool of trained video interpreters across a wide range of languages spoken within the Northern Health and surrounding catchment areas. As an early adopter of video interpreting technologies, All Graduates has spearheaded service delivery via video platforms for a decade, and offers an established and highly capable interpreting cohort to support client needs.

From December 2021, Northern Health and All Graduates articulated an On Demand Video Interpreting workflow and implemented a pilot arrangement to the end of February 2022, which achieved an effective fill rate of 98.5% of confirmed bookings, which exceeds common industry benchmarks.

The workflow includes the use of customised online bookings forms which are actioned immediately by All Graduates on receipt, with connection times being 10 minutes for Arabic interpreters and 20 minutes for all other languages, as agreed key performance indicators. All Graduates communicate responsively with Clinicians by telephone and email to provide booking confirmation status, and to connect the video call.

During the pilot, 66 video-interpreted services were delivered in the following languages:


Services were available across a broad span of hours ranging from 8:30am to 11:30pm Monday to Sunday.* During the trial, nearly 70% of services were requested between the hours of 2pm and 8pm, and over 95% of services went for more than 20 minutes (with 40% of these interactions lasting for between 50 and 120 minutes). Feedback on the service has consistently been positive, with doctors citing ease of use and rapid response times:


I have used it twice now and has worked well both times!
They were very quick (got one in under 5 mins) and the online form was easy to use.


In addition, these services are valued as they are able to be arranged at short notice, and a wider range of interpreting professionals can be sourced from metropolitan and regional locations around the country. Video interpreting technology has enormous potential to improve service access, delivery and flexibility, and reduce costs. Over time, the further rollout of this capability will make consultations between any health professional, patient and interpreter in any location around the country a real possibility.

As has been found in earlier initiatives in health settings1, in situations when onsite interpreting is not possible, culturally diverse patients prefer accessing interpreters via video conferencing rather than telephone, as they value the ability to see and interact with their interpreter rather than relying on voice communication only. Interpreters have also expressed their satisfaction with the user-friendly technology and ease of access to the video platform, with no additional software, effort or expertise required to connect to the video conference.

The trial is ongoing, and as the default service provider for meeting on-demand video requests, All Graduates looks forward to continued collaboration with Northern Health to support the healthcare needs of diverse clients.

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1Melbourne Health (Royal Melbourne Hospital) Telehealth Initiative: Schulz TR, Leder K, Akinci I and Biggs B-A (2015), Improvements in patient care: videoconferencing to improve access to interpreters during clinical consultations for refugee and immigrant patients, Australian Health Review 39(4), pp395-399, 23 March

*UPDATE: Following the success of the trial, the virtual ED service is now available 24 hours, 7 days a week.


All Graduates
All Graduates | 24 Jul 2019


Have you ever noticed how listening to audio-recorded content can make complicated ideas feel more accessible?

As it turns out, providing audio recordings to supplement written health materials may lead to better understanding and outcomes for patients. A study made in 2019 found that recording health education content in audio format, in addition to standard written materials, can improve patients’ comprehension and motivation.

The research followed two groups of culturally diverse Australians with chronic health conditions. One group received standard written education materials about their condition and treatment.

The other group received the same written information along with an audio recording of the content. The group with audio supplements reported a better grasp of the health concepts and felt more empowered to manage their condition. For patients with language barriers or learning challenges, audio content proved an effective way to boost engagement and understanding.

The implications are clear: if we want patients to get the most from health education, offering info in a mix of formats is key. When it comes to learning about health, hearing is believing.


Audio-Recorded Content Improves Discharge Instruction Comprehension for Limited English Proficiency Patients


Providing discharge instructions in a patient’s native language and preferred communication style is crucial for comprehension and adherence. A study named “Audio-Recorded Discharge Instructions for Limited English Proficient Parents: A Pilot Study” aimed to determine if audio-recorded discharge instructions improved understanding for patients with limited English proficiency.

The said study found that:

  1. Audio-recorded content in a patient’s native language increases comprehension of discharge instructions. Patients could replay the recording as often as needed to fully grasp important details about medications, wound care, diet, activity levels, and follow-up appointments.
  2. Both patients and healthcare workers reported high satisfaction with the audio-recorded content approach. Patients felt more at ease caring for themselves or their child at home, knowing they had a reference to return to if they had questions. Nurses appreciated that condensing instructions into a short recording forced them to focus on the most critical information.
  3. Providing real-time translation and recording was feasible but required adequate time. Occasionally, the process caused minor discharge delays. However, when successful, patients are left with a useful resource to share with other caregivers.

While the study was limited to a single children’s hospital and predominately Spanish-speaking families, the findings show promise for the approach. Prerecording standardized instructions and utilizing remote interpreters could help scale the intervention to more locations and languages.

Overall, linguistically and culturally appropriate discharge instructions are vital for patient education and empowerment. For limited English speakers, audio-recorded content in their native language is an easy, inexpensive solution with significant benefits.

By ensuring comprehension, patients can properly care for themselves at home, follow up as directed, and stay out of the hospital.


By ensuring comprehension, patients can properly care for themselves at home, follow up as directed, and stay out of the hospital.


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Study Tests Feasibility and Acceptability of Providing Recordable Cards With Audio Instructions

Recordable cards are a simple yet innovative way to provide language-specific discharge instructions to patients with limited English proficiency. A recent study tested whether these cards were helpful and acceptable for families after their child’s day surgery.

The study found that families loved receiving discharge instructions on recordable cards in their native language. Nearly half of families listened to the card more than five times, allowing multiple caregivers to understand the important details about properly caring for the child at home. Parents said the cards made them feel more at ease knowing they had the information they needed.

Providing the audio recordings in real time was challenging but feasible. Interpreters worked to efficiently translate the instructions into a 3-minute recording that was then reviewed with the family. On a few occasions, the process took too long for families waiting to be discharged, but usually, the cards were ready without delaying the discharge process.

The study was done at a single children’s hospital, mostly with Spanish-speaking families, so the results may differ for other populations. However, the overwhelmingly positive feedback shows that linguistically and culturally competent health care like recordable cards leads to increased patient satisfaction.

When patients can understand their discharge instructions, they are more likely to properly care for themselves or their children at home. Recordable cards represent an easy, low-cost solution to improve health literacy and outcomes. More research on their impact is still needed, but this pilot study suggests recordable cards in the patient’s language could reduce health disparities and benefit both patients and healthcare organizations.


The Majority of Patients Report High Satisfaction With Personalized, Audio Instructions


Studies show that when patients receive discharge instructions in their preferred language, they report higher satisfaction with their care experience. A recent pilot study found that most limited English proficient (LEP) parents were delighted with receiving personalized, audio-recorded content with discharge instructions for their child’s day surgery.

Over six months, researchers offered LEP parents either standard written discharge instructions or the standard instructions plus an audio recording of the instructions in their native language. Parents who received the audio recording were given a greeting card they could replay as often as needed to review the details of their child’s after-care.

Two to seven days after being discharged, parents were surveyed about their experience. Nearly all said the audio card was “helpful” or “very helpful.”

The study showed that this simple, low-tech solution empowered LEP families by overcoming language barriers and addressing health literacy issues. Parents felt more at ease caring for their child at home knowing they had the instructions at their fingertips in a familiar language and format.

While a larger follow-up study is still needed, these promising initial findings suggest that providing language-specific audio discharge instructions leads to greater patient satisfaction and comfort during recovery. For hospitals and healthcare organizations, this intervention could significantly improve overall patient experience scores and support better health outcomes, especially for culturally and linguistically diverse populations.


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Audio Instructions Allow Patients to Review Key Information Multiple Times and Share With Other Caregivers


 a healthcare professional is showing a parent how to access discharge instructions through the audio-recorded contentAudio instructions allow patients and their caregivers to review key discharge information as often as needed. Rather than relying on written materials alone, an audio recording ensures patients fully understand what they need to know to properly care for themselves or a loved one once they leave the hospital.

As a patient, receiving audio instructions in your preferred language provides reassurance that you comprehend the necessary next steps. You can play the recording for family members and friends who will be helping with your recovery. Hearing the information aloud, especially in your native tongue, promotes understanding and allows you to ask any follow-up questions before you head home.

For healthcare workers, providing audio-recorded content or resources demonstrates a commitment to clear communication and the well-being of all patients, regardless of language or literacy level. Though time-consuming, recording instructions with the help of an interpreter builds trust and improves outcomes by lowering the risk of confusion or errors in aftercare. Patients who feel heard and cared for tend to have higher satisfaction with their experience.

While this study looked specifically at recordable cards for pediatric day surgery patients with limited English proficiency parents, the benefits of audio instructions apply to patients of all ages, languages, and medical needs. With advancements in technology and translation services, this simple yet impactful solution can be expanded to reach a larger audience, ensuring safe and effective discharges among diverse populations.

Overall, audio recordings lead to:
  • Improved comprehension through repetition
  • Increased confidence in managing aftercare
  • Better continuity of care between providers and caregivers
  • Higher patient satisfaction

By providing patients a voice, healthcare systems take an important step towards equitable, compassionate treatment for all. Audio instructions represent an easy, affordable way to dramatically improve outcomes and experiences. Though feasibility may vary, the rewards of overcoming any challenges are well worth the effort.


Implementing Audio Discharge Instructions Requires Planning But Shows Promise for Improving Outcomes


Providing audio-recorded discharge instructions in the patient’s preferred language is proving to be an effective way to improve health literacy and outcomes. A study found that giving Limited English Proficient (LEP) parents a greeting card with language-specific, audio-recorded content with discharge instructions for their child’s day surgery was feasible and led to high satisfaction.

This study aimed to determine if it was possible to give families these types of cards, see how they used and felt about them, and find out if the cards helped parents better understand the instructions and feel more at ease caring for their child at home. Parents with kids having day surgery between April and September 2016 could join the study. 

Two groups were randomly divided: one received standard discharge instructions, while the other received the same instructions along with a three-minute audio card in their language for replay.

Two to seven days after leaving the hospital, parents did a phone survey. Those with the audio cards said they used them a lot, were happy to have them, and felt the instructions were clear and helpful. The cards let multiple caregivers get the details and parents could listen as often as they wanted.

While the study was too small to prove the cards improved understanding or comfort, the results suggest they have promise.

Providing real-time, language-matched audio discharge instructions is possible. Many hospitals have trouble translating medical instructions into other languages before patients leave. It often takes too long to translate everything accurately.

Not all medical centers have the resources to offer translations either. So some patients may leave without fully understanding their care instructions. Having interpreters record the instructions could be an easy fix.

For the study, it was key that interpreters had enough time to make and review good recordings and that families understood them. Most of the time, they made and explained the cards without delaying the discharge.

a female physician is discussing discharge instructions with her patientThis pilot study gives useful information for bigger studies on how to provide and assess language-appropriate discharge instructions. Options could include standardized prerecorded instructions and using phone or video interpreters.

The study found that recording discharge instructions in patients’ languages is a good idea. It helps make sure people facing language or reading barriers can still get important info they need before leaving the hospital.

Recording the instructions seems to work well and be a promising way to help communicate important time-sensitive details. Future research should explore their impact and usefulness for various groups.


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You’ve learned how recording patient conversations and sharing them can have significant benefits. Patients comprehend their conditions and care plans better when they review the discussed information. This leads to better compliance, follow-through, and health outcomes.

Healthcare providers also benefit from being able to listen back to consultations. When patients look over what was talked about, they can see where talking could get better. They may notice things they didn’t catch before. And they’ll have what they agreed on with the doctor written down to remember later.

Recording and sharing audio with patients can help both doctors and those seeking care. It’s an easy and affordable way for practitioners to connect with people and help them out. Win-win!

While change can be difficult, the advantages of this approach are clear. Patients experience a sense of ownership over their health journey. Doctors can have more effective and meaningful discussions. And the healthcare system as a whole benefits from better outcomes and reduced readmissions or errors.

If we want a patient-centered approach to medicine, audio content should be an essential component. 

The future is calling – perhaps it’s time we start recording.

We, All Graduates, help doctors and nurses communicate better with their patients. Making sure healthcare providers understand their patients is important, no matter where they come from.

We’re experts in healthcare translation and are committed to patient-centered care. Let us be your partner in achieving better patient outcomes.

Contact us today to learn how All Graduates can help you bridge the language barrier and enhance patient care.


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Melbourne Health and All Graduates connecting Health Professional with multicultural patients across Victoria.

All Graduates
All Graduates | 5 Apr 2019

In 2018, Melbourne Health (Royal Melbourne Hospital [RMH]) expanded its use of video interpreting to facilitate telehealth consultations with multicultural patients. The initiative was supported under the Department of Health and Human Services – Language Services Innovation Grants program It followed research published in 2015[1] by Dr Thomas Schulz, Infectious Diseases Physician at RMH, which showed that patients from culturally and linguistically diverse communities preferred accessing interpreters via video conferencing rather than telephone, in situations when onsite interpreting was not possible.

RMH had worked with All Graduates on the earlier trial and approached them to be involved in this project as the supplier of interpreters via video.  All Graduates took the role of training and supporting the interpreters to use the video platform and ensured the video connections were appropriate and the delivery of the service was of high quality.

Patients from over 100 language backgrounds make up over 50% of RMH patients, indicating an obvious and growing need to:

  • ensure improved access to services
  • remove communication barriers
  • reduce costs and inconvenience for patients/interpreters located in regional/rural Victoria
  • increase efficiency of service delivery through use of technology.

From April 2018 to January 2019 123 requests for video interpreters were made, 57% of these were secured with an interpreter. The most frequently requested language was Karen – 36 requests were made of which 53% were fulfilled . As had been found in the earlier study, patients in particular valued the ability to see and interact with their interpreter rather than being reliant on telephone communication only. The sessions were delivered in 26 languages [see below] involving patients in Melbourne and interpreters located in Melbourne and remotely throughout Victoria, and across NSW, Qld, and WA.

Video interpreting is currently delivered using the Commonwealth Government’s Health Direct telehealth platform, which enables browser-enabled videoconferencing accessible by any phone, tablet or computer. Using Health Direct, any health service can link to patients or interpreters in any location, and experience a high-quality audio-visual connection. In collaboration with RMH, All Graduates used administrator-level access to:

  • allow customisation of the interpreter’s virtual waiting room
  • undertake triage in relation to conference connections
  • quality assure the connection prior to bringing the interpreter into the consultation.

Throughout the period, patients and interpreters alike enjoyed the user-friendly technology and ease of access to the video platform via the internet. One highly experienced Maltese interpreter commented that the video interpreting platform far surpassed any system used previously in his work interpreting with the courts, as no additional software, effort or expertise was required to connect to the videoconference. A Rohingya interpreter was able to successfully provide eight video interpreting sessions over two months while situated overseas. In another instance, an interpreter from a rare language located in regional Victoria, delivered an interpreting session via video which potentially saved RMH over $700 in anticipated travel expenses.

The project has been successful in embedding video as a standard means of improving access to interpreter’s for the significant refugee/immigrant populations living in Victoria, across a range of language backgrounds. It has demonstrated that any hospital that is enabled, through Health Direct, can engage interpreters from remote locations to provide interpreting services to their CALD patients .  A benefit of the approach is the access to a nation-wide pool of interpreters, which is much larger than that which can be realistically supplied in onsite interpreting situations in Melbourne. During the initial period, Interpreter locations ranged from metro Melbourne (Hungarian), to Yackandandah and Nhill (Karen), to the suburbs of Sydney (Indonesian, French), Canberra (Amharic), Queensland (Kirundi) and WA (French and Malay). In these early stages, patients were all located in Melbourne with their healthcare professional, and the interpreters, remotely located, provided services via video.

Following success of the initial period, demand for the service has grown and includes the following languages:   Amharic, Arabic, Burmese, Hakka, Karen, Kiswahili, Lao, Malay, Maltese Rohingya, Samoan, Tamil, Thai, Tibetan and Urdu.

Feedback from the patient and healthcare professional experience has been very positive, and it is particularly valued when it is able to be arranged at short notice, and a wider range of interpreting professionals can be sourced from metropolitan and regional locations around the country. Video interpreting technology has enormous potential to improve service access, delivery and flexibility, and reduce costs. Over time, the rollout of this capability will make consultations between any health professional, patient and interpreter in any location around the country a real possibility.


Telehealth consultations were delivered using interpreters in the following languages:

Amharic, Arabic, Burmese, Chin (Mizo), Finnish, French, Gujarati, Hungarian, Indonesian, Karen, Kirundi, Macedonian, Malay, Malayalam, Min Nan, Rohingya, Samoan, Somali, Spanish, Tamil, Tibetan, Tigre, Timorese Hakka, Turkish, Urdu and Vietnamese.

[1] Schulz TR, Leder K, Akinci I and Biggs B-A (2015), Improvements in patient care: videoconferencing to improve access to interpreters during clinical consultations for refugee and immigrant patients, Australian Health Review 39(4), pp395-399, 23 March