Purpose
The purpose of this project is to enhance resident education related to caring for patients with limited English proficiency (LEP) and/or disabilities which will contribute to improved health care equity and health outcomes for these patient populations. According to the CDC, people with physical, intellectual and developmental disabilities constitute up to 27% of the US adult population, yet recent studies show that medical education programs do not regularly provide sufficient education tailored to caring for people with disabilities. Similarly, recent data from the  U.S. Census Bureau's American Community Survey shows that 8% of the US population has limited English proficiency and studies show that language-discordant medical encounters frequently result in limited access to health information, decreased care satisfaction and poorer health outcomes.

Methods
In 2023, an interprofessional team embarked on a 5-year project to address the aforementioned gaps in medical education through enhancements to their internal medicine residency program. Through resident education, the project aims to improve health equity for patients served across 7 counties in northeast Pennsylvania, USA. A baseline practice assessment was conducted to identify specific gaps in the knowledge, skills, attitudes and behaviors of internal medicine residents and survey results informed the list of training topics. To address barriers to care, the organization is partnering with a local non-profit organization with a 70-year history of serving and advocating for patients with disabilities and an environmental scan was conducted to improve access to the clinical facilities. Resident training will be enhanced through online didactic and outpatient clinical training experiences as well as virtual collaborations on quality improvement projects designed to improve health equity and health outcomes for patients with disabilities and/or limited English proficiency.  

Results
Now in the second year, more than 100 internal medicine residents will benefit from the project. Several residents are leading quality improvement projects that address care disparities for patients with LEP or disabilities. The project is fueling organization-wide advancements as it enhances both the clinical environment by addressing physical barriers to care, and healthcare delivery-related tools, such as the development of an After Visit Summary in the patient’s preferred language. 

Conclusion
Best practices and strategies exemplified in this project can be applied globally to enhance the patient experience, reduce care-team burnout and improve healthcare equity and health outcomes for patients with disabilities and limited English proficiency. Key drivers of success include the organization’s mission and values, organizational support, online and local partnerships with experts in the field and enhancing resident education through a virtual and longitudinal approach.