Until recently, many hospitals and healthcare organizations lacked formal interpreter services for patients with limited English proficiency (LEP). Commonly, these facilities relied on ad hoc methods, such as handwritten lists of bilingual employees willing to interpret pinned to bulletin boards.
Initially, interpreter services departments, often staffed by volunteers, lacked professional certification. This absence of formalized services led to numerous, but frequently unreported, instances of miscommunication, adversely affecting patients with LEP. Typically, these patients brought English-speaking family members to assist or relied on basic language skills shared with healthcare providers.
Now, most major healthcare organizations employ professional interpreters. Additionally, high-quality telephonic and video-based interpreter services are widely available. However, research still indicates significant disparities in the quality and outcomes of healthcare for patients with LEP. This raises an important question: Why is this happening?
A language access case study
Consider a hypothetical case study to understand the complexities of providing language access to patients with LEP. A 68-year-old Guatemalan woman visits an urgent care center with upper abdominal pain. She speaks some English but cannot express anything beyond basic symptoms and ideas. The triaging nurse, with rudimentary Spanish skills, categorizes her as low-risk. Although a telephone-based interpreter service is available, it goes unused. The patient later receives a diagnosis of acute myocardial infarction.
This scenario highlights the critical importance of in-depth communication in the patient's native language. An effective language access plan could have prevented this misdiagnosis and improved the patient's care and outcome.
What is a language access plan?
So, what is a language access plan? It ensures that patients with LEP receive necessary care in their preferred language. While high-quality professional interpreter services in multiple languages are crucial, more is needed. Healthcare providers must also be aware of and adept at utilizing these services.
An effective language access plan typically includes five key elements:
- Needs Assessment: Determining the preferred written and spoken languages of patients with LEP, including their typical interactions within the organization.
- Language Services: Outlining available services, such as in-person and remote interpretation.
- Notices: Informing patients about language services through various means, like multilingual signage and forms.
- Training: Educating staff on policies and procedures for providing language assistance, including frequency and responsibility.
- Evaluation: Regularly reviewing and updating the plan, policies, and procedures to meet needs and facilitate continuous quality improvement.
Every organization should appoint a language access coordinator, either as an individual or a committee, to implement and monitor the language access plan.
Benefits of language access plans
In our hypothetical case, study an effective language access plan could have significantly altered the patient's experience:
- Visible signage might have prompted the patient to request an interpreter.
- A patient coordinator at check-in could have identified the need for an interpreter, initiating language services as per protocol.
- The nurse, understanding the limitations of their language skills, would have accessed interpreter services, either telephonically or in person.
- All healthcare providers would have been trained to collaborate efficiently with a professional interpreter, ensuring seamless communication and preventing the delayed diagnosis of the patient's condition.
Implementing a language access plan
Implementing a robust language access plan may seem daunting, but making language access a routine part of patient care is feasible and essential. With consistent practice and standardization, adhering to an effective language access plan will become second nature, improving patient care significantly.
For more on language access for patients with LEP, read our posts:
- Effective Communication with LEP Populations
- Best Practices for Working with Patients with LEP in Healthcare
