Minimizing Variability in Interpretation Modality Among Spanish-Speaking Patients With Limited English Proficiency

Abstract

Introduction: Provider–patient language discrepancies can lead to misunderstandings about follow-up care instructions and decreased adherence to treatment that may contribute to disparities in health outcomes among patients with limited English proficiency (LEP). This observational study aimed to understand how emergency department (ED) staff went about treating patients with LEP and examine the impact of consistent interpretation modality on overall patient satisfaction and comprehension. Method: A cross-sectional study was conducted among Spanish-speaking patients with LEP presenting to the ED. A survey was administered at two different time points: after patients provided their history of present illness and after the patient received information regarding follow-up treatment. Results: Analysis of average visual analog scale (VAS) scores by consistency of interpretation suggested higher overall scores among participants that received care via the same communication modalities during both the history of present illness and at disposition, when compared with patients that did not. At both time points, video-based interpretation was associated with higher VAS scores in comparison to other modalities, whereas phone-based interpretation was associated with lower VAS scores. Conclusion: Providing consistent modes of interpretation to patient’s with LEP throughout their ED visits improved their overall satisfaction of care provided and understandings of discharge instructions.

Barriers in Healthcare for Latinx Patients with Limited English Proficiency—a Narrative Review

“…Finally, professional interpretation should be used for all aspects of patient care including disposition conversations. 25,30,54 Communication through interpreters appears to result in interactions that are less open-ended, and contains fewer topics or questions introduced by patients. 21 Whether or not communication and trust would be improved by specific awareness or skill training for use of interpreters remains uninvestigated.…”

A Conduit for a Culturally Competent Consent

“…However, patients with LEP are less likely to use video telemedicine during the pandemic, 37 similar to prepandemic telemedicine findings 38 . Video interpretation has been demonstrated to be better than audio for retention of clinical information, 39 improved comprehension for consent, 40 and higher patient satisfaction 41 . However, a recent narrative review found no consensus about the most effective interpretation mode 27 .…”

“…38 Video interpretation has been demonstrated to be better than audio for retention of clinical information, 39 improved comprehension for consent, 40 and higher patient satisfaction. 41 However, a recent narrative review found no consensus about the most effective interpretation mode. 27 The interpreters in our • "It is good to ask.…”

Discordance Between Satisfaction and Health Literacy Among Spanish-Speaking Patients with Limited English-Proficiency Seeking Emergency Department Care

“…Most recent research among patients with LEP has specifically focused on addressing barriers in the treatment and management of pediatric ED cases (Choe et al, 2019;Gutman et al, 2018;Hartford et al, 2019;Malavé et al, 2019;Marshall et al, 2019;Portillo et al, 2021;Steinberg et al, 2016). Among recent interpretation studies in adult patient populations with LEP, a majority have primarily focused on understanding the influence of different modalities on satisfaction, comprehension, discharge preparedness, and repeated use of ED services (Balakrishnan et al, 2017;Lee et al, 2018;Schulson et al, 2018;Villalona et al, 2020).…”