Language Barriers as a Reported Cause of Prehospital Care Delay in Minnesota

Grow, Robert W.; Sztajnkrycer, Matthew D.; Moore, Brian R.

doi:10.1080/10903120701709878

Cited by 38 publications

(26 citation statements)

References 8 publications

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“…Less is known about the communication between LEP callers and EMS. Research has demonstrated that EMS response times are longer for LEP callers [24]. Communication is particularly difficult at the point of first contact with the EMS operator/dispatcher when calling 9-1-1.…”

Section: Introductionmentioning

confidence: 99%

Barriers and Facilitators to Using 9-1-1 and Emergency Medical Services in a Limited English Proficiency Chinese Community

Ong

Yip

Feng

et al. 2011

J Immigrant Minority Health

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Effective communication during a medical emergency is crucial for an appropriate emergency medical services (EMS) response. This exploratory qualitative study explored intentions to use 9-1-1 in a Chinese speaking community and the barriers and facilitators to accessing EMS. Focus groups with Chinese adults who self-reported limited English proficiency were conducted. An inductive iterative approach was used to categorize and connect themes identified in the discussions. Language difficulties, negative perceptions of EMS, perceived costs of using emergency services, and no previous experience with 9-1-1 were commonly described as barriers to calling EMS during emergencies. Positive past experiences with EMS and encountering an emergency situation perceived as too great to manage alone are common facilitators for calling 9-1-1. Further exploration is necessary to assess barriers to calling 9-1-1 unique to specific communities, test findings, and tailor interventions to improve EMS communication.

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Section: Introductionmentioning

confidence: 99%

Barriers and Facilitators to Using 9-1-1 and Emergency Medical Services in a Limited English Proficiency Chinese Community

Ong

Yip

Feng

et al. 2011

J Immigrant Minority Health

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“…Grow et al reviewed prehospital encounters featuring a delay in the Minnesota State Ambulance Reporting System and found that language barriers were identified as the second most common cause of delay. 10 Intriguingly, however, the on-scene times for calls with a reported delay due to language barrier were actually shorter than the on-scene times for calls with no delay. A significant limitation of the study was that the “no delay” comparison group did not come from the general pool of all EMS encounters and it is unclear if these calls had atypical features that prompted EMS providers to specifically notate “no delay” in the report.…”

Section: Resultsmentioning

confidence: 94%

“…Indeed, the targets by which to evaluate quality of prehospital care in the context of language barriers do not appear to be well-defined. Is a shorter on-scene time for language discordant patients, as demonstrated in two studies, 10 , 32 advantageous or disadvantageous to patients? Prehospital medicine is riven by controversy regarding whether patient care is improved by shorter on-scene times as compared to more prolonged on-scene initiation of care.…”

Section: Resultsmentioning

confidence: 96%

The Need for More Prehospital Research on Language Barriers: A Narrative Review

Tate¹

2015

WestJEM

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IntroductionDespite evidence from other healthcare settings that language barriers negatively impact patient outcomes, the literature on language barriers in emergency medical services (EMS) has not been previously summarized. The objective of this study is to systematically review existing studies of the impact of language barriers on prehospital emergency care and identify opportunities for future research.MethodsA systematic review with narrative synthesis of publications with populations specific to the prehospital setting and outcome measures specific to language barriers was conducted. A four-prong search strategy of academic databases (PubMed, Academic Search Complete, and Clinical Key) through March 2015, web-based search for gray literature, search of citation lists, and review of key conference proceedings using pre-defined eligibility criteria was used. Language-related outcomes were categorized and reported as community-specific outcomes, EMS provider-specific outcomes, patient-specific outcomes, or health system-specific outcomes.ResultsTwenty-two studies met eligibility criteria for review. Ten publications (45%) focused on community-specific outcomes. Language barriers are perceived as a barrier by minority language speaking communities to activating EMS. Eleven publications (50%) reported outcomes specific to EMS providers, with six of these studies focused on EMS dispatch. EMS dispatchers describe less accurate and delayed dispatch of resources when confronted with language discordant callers, as well as limitations in the ability to provide medical direction to callers. There is a paucity of research on EMS treatment and transport decisions, and no studies provided patient-specific or health system-specific outcomes. Key research gaps include identifying the mechanisms by which language barriers impact care, the effect of language barriers on EMS utilization and clinically significant outcomes, and the cost implications of addressing language barriers.ConclusionThe existing research on prehospital language barriers is largely exploratory, and substantial gaps in understanding the interaction between language barriers and prehospital care have yet to be addressed. Future research should be focused on clarifying the clinical and cost implications of prehospital language barriers.

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“…Previous studies have described the complexity of assessing an emergency call [ 3 , 6 , 7 ]. There are also studies identifying possible reasons for not identifying the caller’s need of care; language barriers [ 8 - 10 ] unnecessary questions asked by the EMD during the call [ 11 ], and lack of information from the caller [ 7 ]. Due to some of these difficulties, assessment protocols aiming to support the EMD’s assessment have been developed [ 12 - 14 ].…”

Section: Introductionmentioning

confidence: 99%

Barriers and opportunities in assessing calls to emergency medical communication centre - a qualitative study

Lindström

Heikkilä

Bohm

et al. 2014

Scand J Trauma Resusc Emerg Med

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IntroductionPrevious studies have described the difficulties and the complexity of assessing an emergency call, and assessment protocols intended to support the emergency medical dispatcher’s (EMD) assessment have been developed and evaluated in recent years. At present, the EMD identifies about 50-70 % of patients suffering from cardiac arrest, acute myocardial infarction or stroke. The previous research has primarily been focused on specific conditions, and it is still unclear whether there are any overall factors that may influence the assessment of the call to the emergency medical communication centre (EMCC).AimThe aim of the study was to identify overall factors influencing the registered nurses’ (RNs) assessment of calls to the EMCC.MethodA qualitative study design was used; a purposeful selection of calls to the EMCC was analysed by content analysis.ResultsOne hundred calls to the EMCC were analysed. Barriers and opportunities related to the RN or the caller were identified as the main factors influencing the RN’s assessment of calls to the EMCC. The opportunities appeared in the callers’ symptom description and the communication strategies used by the RN. The barriers appeared in callers’ descriptions of unclear symptoms, paradoxes and the RN’s lack of communication strategies during the call.ConclusionBarriers in assessing the call to the EMCC were associated with contradictory information, the absence of a primary problem, or the structure of the call. Opportunities were associated with a clear symptom description that was also repeated, and the RN’s use of different communication strategies such as closed loop communication.

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Language Barriers as a Reported Cause of Prehospital Care Delay in Minnesota

Abstract: EMS responses troubled by delays in care secondary to language barriers represent a small percentage of total runs in Minnesota. However, approximately 1,370 cases per year occur.

Cited by 38 publications

References 8 publications

Barriers and Facilitators to Using 9-1-1 and Emergency Medical Services in a Limited English Proficiency Chinese Community

Barriers and Facilitators to Using 9-1-1 and Emergency Medical Services in a Limited English Proficiency Chinese Community

The Need for More Prehospital Research on Language Barriers: A Narrative Review

Barriers and opportunities in assessing calls to emergency medical communication centre - a qualitative study

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