Medical Interpreters Improve LEP Patient Care: A Study Review

By David Fetterolf, Stratus Video President

Communication is a cornerstone of care, the channel by which patients explain symptoms, access their healthcare information and make meaning of new diagnoses or ongoing conditions. Maintaining open communication with patients during transitions of care is particularly important. It is also the means by which providers collaborate with one another and convey meaning to patients. When patients and providers do not speak the same language, qualified medical interpreters are essential for effective communication to take place. Studies demonstrate the use of qualified medical interpretation yields improved outcome, better satisfaction and reduced readmission rates for patients with limited English proficiency (LEP).

Improved Patient Outcome

Section 1557 of the Affordable Care Act, among other federal regulations, expressly prohibits ad-hoc interpreters, e.g. untrained family members or bilingual staff, from facilitating communication for LEP patients. The act specifically requires hospitals to inform patients about their health condition, medication, post discharge plan and follow up plans in a way they can understand.

Communication errors are associated with the majority of adverse effects in patients, particularly for those who do not speak English or who have limited English proficiency. By taking steps to ensure interpreters are qualified, hospitals not only comply with federal regulations but also greatly reduce the risk of communication errors resulting in adverse effects for LEP patients.

Featured study: Researchers at the University of California conducted a systematic review of literature to determine if professional interpreters indeed improve clinical care for patients with Limited English Proficiency. In all four areas examined, the use of professional interpreters was associated with improved clinical care.

The study noted that the use of professional interpreters appeared to raise the quality of clinical care for LEP patients to approach or equal that for patients without language barriers. In addition, when qualified interpreters were used, there were less communication and comprehension errors than when ad hoc or untrained bilingual individuals were used to facilitate communication. Read additional study findings here.

Improved Patient Satisfaction

For the limited English proficiency (LEP) patient population, patient satisfaction is significantly lower than for English speaking patients. This is primarily due to a lack of meaningful access to healthcare information. Healthcare professionals who are unable to communicate effectively with their patients tend to utilize more diagnostic resources, invasive procedures and overprescribe medications. LEP patients who are provided with a medically qualified interpreter, on the other hand, have been shown to engage more in care plans, attend more outpatient visits, fill more prescriptions and experience a higher delivery of care.

Featured study: Research conducted by the Division of Health, Mathematica Policy Research in Princeton, NJ, found the use of professionally trained medical interpreters significantly increased both LEP patients’ and their health providers’ satisfaction with care.

Nearly 250 patients participated in the study in two emergency departments of two central New Jersey hospitals. Some had access to a medical interpreter at times of treatment, others did not. Both patients and providers with access to a professionally trained medical interpreter, reported being “very satisfied” with care while those who did not have access reported a range of “somewhat satisfied” to “very dissatisfied”.

Lower Risk of Readmission

By speaking the same language through the use of an interpreter, LEP patients display an increased level of trust in their provider. Once the patient-provider relationship is strengthened, LEP patients not only engage more with providers in the hospital but also are more likely to follow through with health care plans post discharge.

Featured study: An investigation by researchers at the University of California and the National Institute of Minority Health and Health Disparities analyzed over one thousand hospital encounters to determine if increasing access to professional interpreters would improve hospital outcomes for older patients with LEP. There was a significant decrease in observed 30-day readmission rates for the LEP group that was provided with qualified medical interpretation services in comparison to those who were not.

The study concluded “comprehensive language access represents an important, high value service that all medical centers should provide in order to achieve equitable, quality healthcare for vulnerable LEP populations.”

LEP patients who are provided the services of a medical interpreter can more easily understand their medical condition, healthcare plans and other important information pertaining to their well-being. Not only are they able to communicate in a way they can understand, but they are also able to communicate via a medical interpreter who is both culturally competent and qualified to clarify any miscommunication that may arise from cultural differences. This greatly increases the patient’s confidence in their care, reduces patient stress and improves patient outcome. Discover more tips to provide patient centered care for LEP patients in the Joint Commission’s Roadmap for Hospitals.  

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