As globalization intensifies, healthcare providers encounter increasingly diverse patient populations. Language barriers can significantly hinder the delivery of high-quality healthcare, affecting patient safety, treatment efficacy, and overall health outcomes. Ensuring language access in healthcare settings is crucial for addressing these challenges and we believe it is an essential human right.
The Scope of the Problem
Over 25 million individuals in the United States have limited English proficiency (LEP). However, given the issue of limited language comprehension, studies show that LEP patients are significantly less likely to have a regular source of care and fewer physician visits than English-proficient individuals. These studies consistently show that LEP patients are more likely to forgo necessary medical care, receive less preventive care, lack a usual source of care, and, in some cases, miss preventive care visits more frequently than EP populations.
Impacts on Patient Safety and Quality of Care for LEP Patients
- Misdiagnosis and Treatment Errors. LEP patients are more susceptible to misdiagnosis and incorrect treatments due to communication gaps. A study highlighted in The Joint Commission's report, "Hospitals, Language, and Culture: A Snapshot of the Nation," found that 43% of hospitals across 32 states acknowledged a clear connection between patient safety issues and the need for language support. However, none of these hospitals had systems to track adverse events based on patients' linguistic needs. When it comes to LEP patients, critical symptoms might be misinterpreted or neglected, potentially leading to severe health consequences. For instance, a language barrier might prevent a patient from accurately describing the symptoms of a heart attack, delaying life-saving medical intervention.
- Malpractice Claims. Communication breakdowns are a major factor in medical malpractice claims. One study revealed that out of 23,000 malpractice claims, 7,000 (approximately 30%) were due to communication failures. These failures contributed to 2,000 preventable deaths and resulted in over $1.7 billion in malpractice settlements. This underscores the importance of effective language access in saving lives.
- Medication Mismanagement. Clear communication about medication usage is essential to prevent errors. Surveys have shown that LEP patients are up to nine times more likely to misunderstand medical information compared to English speakers. Patients need precise instructions on how to take their medications, understand dosages, and be aware of possible side effects. Language barriers can result in improper medication use, leading to adverse health outcomes.
- Reduced Patient Compliance. Patients who do not fully comprehend their healthcare providers' instructions are less likely to adhere to prescribed treatment plans. This non-compliance can lead to deteriorating health, increased hospital readmissions, and higher healthcare costs.
- Patient Satisfaction and Trust. Trust and satisfaction are foundational to effective healthcare. Patients who feel understood and respected are likelier to engage actively in their care. Language barriers can erode this trust, leading to frustration and decreased patient satisfaction.
Legal and Ethical Considerations
- Regulatory Requirements. In the U.S., Title VI of the Civil Rights Act of 1964 mandates language assistance for LEP individuals to prevent discrimination based on national origin. Executive Order 13166 provides guidelines on implementing meaningful access, and Section 1557 of The Affordable Care Act further strengthens these requirements, emphasizing the need for accessible healthcare services.
- Ethical Obligations. Healthcare providers are ethically bound to deliver equitable patient care. This includes providing language assistance to ensure patients can make informed healthcare decisions. Ethical principles such as beneficence, non-maleficence, and justice underscore the necessity of effective communication.
Strategies for Improving Language Access
- Professional Medical Interpreters. Using trained medical interpreters in person or via telehealth is a reliable way to mitigate language barriers. These interpreters should be trained in interpretation skills in addition to being fully proficient in at least two languages and medical terminology, along with being culturally aware of the patients they assist. A 2017 study demonstrated that providing interpretation throughout all stages of hospital treatment (even if only by phone)reduced readmission rates for LEP patients from 17.8% to 13.4%. This reduction in readmissions resulted in cost savings of more than US $160,000 for hospitals, despite the expenses associated with language services.
- Bilingual Healthcare Providers. Employing bilingual staff who can communicate directly with LEP patients can improve care efficiency and patient comfort as long as these individuals are tested for their language proficiency. This strategy helps build trust and facilitates clearer communication.
- Translation of Written Materials. Providing translated healthcare documents, such as consent forms, discharge instructions and other essential documents, ensures that patients can access and understand critical information in their preferred language.
- Technology Solutions. Technological tools, including interpretation apps with live interpreters for telephonic and video remote services, offer immediate and constant language support, especially in emergencies where timely communication is vital.
- Language Access Training. Language access training equips healthcare professionals to better understand and address the diverse needs of their LEP patients. This training should be either a stand-alone training or part of any DEI initiative.
For businesses and individuals committed to improving language access in healthcare, Equal Access Language Services offers comprehensive solutions tailored to meet your needs. Whether you are a healthcare provider seeking to enhance communication with LEP patients or an individual looking to ensure your loved ones receive the care they deserve, Equal Access Language Services can help. Empower your healthcare practice today by prioritizing effective communication and ensuring equitable patient care. Check out our services page and get in touch for more information.
