Patterns of Interpreter Use for Hospitalized Patients with Limited English Proficiency

Schenker, Yael; Pérez‐Stable, Eliseo J.; Nickleach, Dana; Karliner, Leah

doi:10.1007/s11606-010-1619-z

Cited by 148 publications

(120 citation statements)

References 20 publications

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“…Similar to all prior inpatient studies we found a low use of interpreters by hospital clinicians. 5,6,21 Federal law, the Institute of Medicine (IOM), and hospital guidelines, including the Joint Commission standards, all recommend the routine use of professional interpreters during clinical encounters. 3,[22][23][24] It is possible that our low rate of interpreter use is due to the use of nonprofessional interpreters (i.e., family members or friends) and/or clinical encounters with bilingual physicians or other clinical staff and/or even LEP patients relying on their own limited English language abilities.…”

Section: Mutltivariable Analyses Of Hospital Outcomesmentioning

confidence: 99%

“…3,[22][23][24] It is possible that our low rate of interpreter use is due to the use of nonprofessional interpreters (i.e., family members or friends) and/or clinical encounters with bilingual physicians or other clinical staff and/or even LEP patients relying on their own limited English language abilities. 21 High quality clinical care and patient safety are compromised when there are communication barriers. The use of nonprofessional interpreters is known to cause an increase in interpreter errors that can potentially harm the patient, through the misinterpretation of information 7,25,26 and alteration of key patient details.…”

Section: Mutltivariable Analyses Of Hospital Outcomesmentioning

confidence: 99%

“…7 Clinicians may be 'getting by' without interpreters for a variety of reasons, including a perceived increase in clinical encounter time with the use of interpreters. 4,21,28 There are several high quality studies that demonstrate no clinical encounter time increase with in-person hospital interpreters. 14,29 One important time motion study in a primary care clinic found no difference in visit time with and without interpreters.…”

Section: Mutltivariable Analyses Of Hospital Outcomesmentioning

confidence: 99%

“…The use of nonformally tested bilingual staff has been demonstrated to lead to low quality communication secondary to errors. 4,21,28 LOS is a frequently used measure to assess the efficiency of hospital care delivery. 31 Our study provides unique and complex findings about interpreter use and LOS.…”

Section: Mutltivariable Analyses Of Hospital Outcomesmentioning

confidence: 99%

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Use of Interpreters by Physicians for Hospitalized Limited English Proficient Patients and Its Impact on Patient Outcomes

et al. 2015

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BACKGROUND: Few studies have examined the impact of inpatient interpreter use for limited English proficient (LEP) patients on length of stay (LOS), 30-day post discharge emergency department (ED) visits and 30-day hospital readmission rates for LEP patients. METHODS: A retrospective cohort analysis was conducted of all hospitalized patients admitted to the general medicine service at a large academic center. For patients self-reported as LEP, use of interpreters during each episode of hospitalization was categorized as: 1) interpreter used by non-MD (i.e., nurse); 2) interpreter used by a nonHospitalist MD; 3) interpreter used by Hospitalist; and 4) no interpreter used during hospitalization. We examined the association of English proficiency and interpreter use on outcomes utilizing Poisson and logistic regression models. RESULTS: Of 4,224 patients, 564 (13 %) were LEP. Of these LEP patients, 65.8 % never had a documented interpreter visit, 16.8 % utilized an interpreter with a non-MD, 12.6 % utilized an interpreter with a nonHospitalist MD and 4.8 % utilized an interpreter with a hospitalist present. In adjusted models, compared to English speakers, LEP patients with no interpreters had significantly shorter LOS. There were no differences in readmission rates and ED utilization between LEP and English-speaking patients. Compared to LEP patients with no interpreter use, those who had a physician use an interpreter had odds for a longer LOS, but there was no difference in odds of readmission or ED utilization. CONCLUSION: Academic hospital clinician use of interpreters remains highly variable and physicians may selectively be using interpreters for the sickest patients.KEY WORDS: limited English proficiency; interpreter use; length of stay; thirty-day readmissions.

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Section: Mutltivariable Analyses Of Hospital Outcomesmentioning

confidence: 99%

Section: Mutltivariable Analyses Of Hospital Outcomesmentioning

confidence: 99%

Section: Mutltivariable Analyses Of Hospital Outcomesmentioning

confidence: 99%

Section: Mutltivariable Analyses Of Hospital Outcomesmentioning

confidence: 99%

See 2 more Smart Citations

Use of Interpreters by Physicians for Hospitalized Limited English Proficient Patients and Its Impact on Patient Outcomes

et al. 2015

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“…1,2 Lack of time, interpreter availability, and interpreter accessibility are cited as primary barriers to providers' use of professional interpreters. 3,4 However, even when they perceive the benefits of using professional interpreters and when professional interpreters are readily available, providers in various clinical contexts, including emergency care, primary care, inpatient and outpatient settings, have consistently used professional interpreters for less than 20 % of patients with limited English proficiency (LEP).…”

mentioning

confidence: 99%

Not Just “Getting by”: Factors Influencing Providers’ Choice of Interpreters

Hsieh

2014

J GEN INTERN MED

114

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How Should Clinicians Respond to Language Barriers That Exacerbate Health Inequity?

Espinoza

Derrington

2021

AMA Journal of Ethics

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Patients and families with limited English proficiency (LEP) face barriers to health care service access, experience lower quality care, and suffer worse health outcomes. LEP is an independent driver of health disparities and exacerbates other social determinants of health. Disparities due to language are particularly unjust because LEP is morally irrelevant and a source of unfair, unnecessary disadvantage. Clinicians and health care organizations have duties to intervene, which this article describes. To claim one AMA PRA Category 1 Credit TM for the CME activity associated with this article, you must do the following: (1) read this article in its entirety, (2) answer at least 80 percent of the quiz questions correctly, and (3) complete an evaluation. The quiz, evaluation, and form for claiming AMA PRA Category 1 Credit TM are available through the AMA Ed Hub TM. Case Dr J is a second-year emergency department (ED) resident physician who, during an unusually busy shift, sees MM, a 13-year-old girl, accompanied by her father; this is their third visit to the ED this week. MM, rubbing her belly, appears somewhat uncomfortable but in no apparent distress. After 15 minutes of fumbling with an interpreter via phone, Dr J realizes that MM and her father speak a language or dialect not available via the interpreter phone service. The 3 navigate a broken English dialogue that seems to reveal that, for 5 days, MM has had decreased appetite and abdominal pain, which was most severe yesterday and since then has improved. Dr J's physical examination of MM reveals mild, diffuse, nonspecific abdominal tenderness that seems most consistent with acute gastroenteritis. Dr J leaves MM's room and confers with Dr C about a treatment plan. Dr J returns to MM, suggesting she take acetaminophen for pain, and arranges for MM's discharge from the ED before moving on to another patient. Two days later, MM returns to the ED with an abdominal abscess from a ruptured appendix, in septic shock, and requiring urgent surgical intervention. Dr J wonders what she might have done differently.

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Patterns of Interpreter Use for Hospitalized Patients with Limited English Proficiency

Cited by 148 publications

References 20 publications

Use of Interpreters by Physicians for Hospitalized Limited English Proficient Patients and Its Impact on Patient Outcomes

Use of Interpreters by Physicians for Hospitalized Limited English Proficient Patients and Its Impact on Patient Outcomes

Not Just “Getting by”: Factors Influencing Providers’ Choice of Interpreters

How Should Clinicians Respond to Language Barriers That Exacerbate Health Inequity?

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