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What you should Read: Informative Healthcare Language Services Articles of 2011

2011 was a productive year in healthcare language services research, and many pertinent topics were covered. The articles below discuss some of the issues I believe are most central to language services today. I hope the information presented will be of use to language services decision-makers in the healthcare space as they wrestle with these issues daily. Enjoy.

1. Interpreter Perspectives of in-person, telephonic, and videoconferencing medical interpretation in clinical encounters , Patient Education and Counseling. 2011 Sep 17 [Epub ahead of print]

What do professional medical interpreters think about the effectiveness of different interpretation methods (in-person, telephonic, video conferencing)? It’s a good question to ask, seeing as “Interpreters are uniquely positioned to address relative merits of in-person and remote modalities … given their broad interpreting experience.”

That’s what this article seeks to do – explore the effectiveness of different interpretation methods in hospital and ambulatory settings from the interpreter perspective.

After assessing 52 interpreters (a 73% response) concerning a range of medical scenarios, all interpretation modalities were deemed “equally satisfactory for conveying information.” However, in-person interpretation was preferred, over both telephonic and video conferencing interpretation, for situations involving more in-depth conversation and other scenarios.

2. A Framework to Identify the Costs of Providing Language Interpretation Services, Journal of Health Care for the Poor and Underserved. 2011 May 22(2): 523-31

While healthcare organizations are required to provide language assistance, allocating the funding to do so has been less prescribed. This paper is a must read because it “establishes a conceptual framework [for language services] that identifies program costs, can be used across health care entities, and can be understood by administrators, researchers, and policymakers to guide research and analysis and establish a common ground for informed strategic discussion of payment and reimbursement policy.”

3. A Framework for Cultural Competence in Health Care Organizations, The Health Care Manager. 2011 Jul-Sep;30(3):205-14.

Yes, we all know that cultural competency is important in healthcare. However, how does one go about making cultural competency a part of an organization’s fabric?

In this article, authors Richard J. Castillo and Kristina L. Guo take cultural competency from the theoretical to the practical, giving “a framework to guide health care organizations as they focus on establishing culturally competent strategies and implementing best practices aimed to improve quality of care and achieve better outcomes for minority populations.” A great read if you’re looking to improve your cultural competency program.

4. Examining Effectiveness of Medical Interpreters in Emergency Departments for Spanish-Speaking Patients with Limited English Proficiency: Results of a Randomized Controlled Trial, Annals of Emergency Medicine 2011 Mar;57(3):248-256.e1-4.

Does in-person interpretation improve communication satisfaction for patients and health providers? This study takes a fresh look at that question. After assessing numerous patients and health providers over a seven-month period, it was determined that the “… provision of professionally trained, in-person medical interpreters … greatly increased patients’ and providers’ satisfaction [in the ED].”

5. Patterns of Interpreter Use for Hospitalized Patients with Limited English Proficiency, Journal of General Internal Medicine. 2011 Jul;26(7):712-717. Epub 2011 Feb 19

Are interpreters being used appropriately in hospitals? Not quite, as this study indicates. At two urban hospitals that encounter a large percentage of Limited English Proficient (LEP) patients, 234 LEP patients were interviewed concerning interpreter usage. Of the patients interviewed, “57% reported that any kind of interpreter was present with the physician at admission, 60% with physicians during hospitalization, and 37% with nurses since admission.”

What does this show? Essentially, LEP patients are still receiving substandard access to language services, which can pose a variety of problems including misdiagnoses and other errors.

A limitation of the study is that it only examines two hospitals, and its results “may not generalize to other hospitals and settings.” However, the authors point out that “both sites in this study serve large numbers of patients with LEP and are located in a diverse area of the US … [so] It is likely that patients’ experiences may be worse in settings with less linguistic diversity or resources allocated to interpreter services.”

This article demonstrates an important point: while language access has improved for LEP patients, it is still not where it needs to be. The information presented in this study can serve as a wake-up call for organizations to re-evaluate their language access programs and identify areas of improvement.



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