Story image
How On-Site Interpreters Improve Healthcare For Non-English Speaking Patients | via Stratus Video
The use of qualified on-site interpreters has been shown to improve healthcare for the limited English proficient patient population.
Posted Jan 2, 2018
David Fetterolf

By David Fetterolf


Thanks to increased globalization and immigration over the last century, today’s hospitals face the challenge of meeting the needs of a very diverse patient population. To ensure that all patients have access to language services, they typically use a combination of on-site, over-the-phone and video remote interpretation, with on-site interpreters staffed in the most frequently encountered languages.


The use of these qualified on-site interpreters has been shown to improve healthcare for the limited English proficient (LEP) patient population, emphasizing the importance of having these valuable individuals on staff. Here’s how they make an impact:


Trained to Make a Difference

Medically qualified on-site interpreters are highly trained and competent, undergoing extensive training in the interpreter code of ethics and professional interpreting standards. They are well informed of the impact of language barriers on patient care; the dynamic of the triadic relationship between patient, provider and interpreter; ethical and legal issues; and cultural nuances within health and communication. In addition, they possess the necessary core skills, knowledge and code of ethics to convey the full message of what is being said, while maintaining both impartiality and confidentiality of both patient and provider.


Reduce Communication Errors

Not surprisingly, linguistically diverse LEP patients are one of the most vulnerable patient populations when it comes to experiencing communication errors in healthcare. According to the 2003 National Assessment of Adult Literacy (NAAL), only 12% of adults in the United States have proficient health literacy. And, unfortunately, limited literacy patients are more likely to mistake medications, miss preventative care and disengage in care plans.


The National Institutes of Health’s intramural research program conducted a study on the level of care of LEP patients who were provided the services of a qualified interpreter. The primary finding was that trained interpreters raise the level of care for LEP patients so that it is equal to the level of care given to patients who are English proficient. A second major finding was that both providers and patients rated the quality of overall communication higher with trained interpreters, and less communication errors that could have potentially affected diagnosis and treatment occurred.

Communication errors in healthcare can be detrimental to both the patient and the facility, leading to inadequate care and patient harm. By simplifying both written and spoken communication of healthcare information and providing language services for the LEP patient population, providers can decrease the likelihood of these detrimental errors.


Ensure that Informed Consent is Truly Taking Place

Informed consent is vital in healthcare, enabling patients to make knowledgeable decisions about their own care and medical conditions. The patient must have the ability to understand the information provided, make a decision, and grant consent without persuasion by part of the provider. The decision-making capacity of the patient can be greatly impacted by language barriers, hearing loss and/or impairment. Without a firm grasp of the English language, LEP patients are unable to understand options, implications, risks or benefits surrounding the disclosed information.


A recent study by the National Institutes of Health revealed that English speaking patients were significantly more likely than LEP patients to have full documentation of informed consent. Less than 45% of LEP patients were provided with interpretation, sight translation and/or document translation of the consent form in their preferred language, indicating an underutilization of language services in healthcare.


While obtaining informed consent from LEP patients can be challenging, it is achievable with the assistance of a medical interpreter who is trained, qualified and bound by a professional code of conduct. Deaf and Hard of Hearing (HoH) patients may require the use of an American Sign Language (ASL) and/or Certified Deaf Interpreter (CDI) to ensure that meaningful access to healthcare information is taking place. When patients are informed about their healthcare options, they are more likely to actively engage and make diligent decisions with providers in their healthcare plans.


Increase Patient Satisfaction and Engagement in Care

Unfortunately, within the limited English proficiency (LEP) patient population, patient satisfaction is significantly lower than for English speaking patients, 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. The use of trained interpreters, however, is associated with greater patient satisfaction and an increased utilization of health care services.


One way to greatly increase patient satisfaction within the LEP patient population is by providing quick access to an on-site medical interpreter when requested. LEP patients who are provided with a medically qualified interpreter have been shown to attend more outpatient visits, fill more prescriptions and experience a higher delivery of care.


In order to meet the growing demand for on-site interpretation, facilities are implementing interpreter management systems to expand their access to qualified medical interpreters in the surrounding area. Post implementation, facilities are finding significant improvement in interpreter workflow and accessibility as well as patient satisfaction with language services.


Author Bio: David Fetterolf leads the overall strategic direction of Stratus Video’s Language Services division. David brings over 26 years of experience working for healthcare information technology and service companies. Prior to joining Stratus Video, he was president and founder of MDeverywhere, revenue cycle management software tailored to the healthcare industry. In 2011 MDeverywhere made the coveted Inc. 500/5000 fastest growing companies list. 


Prior to MDeverywhere, David was a division president for Datamedic, a leading provider of computer-based patient records and business management software and services for medical practices and clinics. As division president, he was responsible for strategy and financial performance, which included leading the marketing, sales, implementation, support, and manufacturing and development teams. David has a Bachelor’s degree in Electrical Engineering from Cornell University and a Masters of Business Administration from The Wharton School at the University of Pennsylvania.