Bilingual clinicians and limited-English proficient patients
By Lidia Puga, Platte Valley Patient Experience and Language Services Coordinator
NHeLP, the National Health Law Program, published a report, The High Cost of Language Barriers in Medical Malpractice, in which it demonstrates the negative outcomes of not utilizing qualified interpreters. When a limited-English proficient (LEP) patient chooses a language that is not English as their preferred spoken language, it is an indication they are not fluent in English and require an interpreter. Even when a patient is speaking English ‘well enough’ and you think they are responding appropriately, we must provide an interpreter to avoid a breakdown in communication.
By not depending on family or friends to interpret and by providing a qualified interpreter, even if the patient refuses and says they are understanding without an interpreter, you are:
Ensuring the patient and family understand all information.
Providing the patient the opportunity to ask questions without the stress of, ‘What if I don’t know how to ask what I want or how to respond?’ Some patients do not want to admit they need an interpreter and might even get frustrated or upset for ‘no reason’ because of this reason.
Removing well-intentioned loved ones from the communication chain. Those who interpret for their loved ones might not relay ALL the information to the patient. Some cultures have different views on pain and comfort levels and might shield the patient from information and respond for them without relaying what you’ve said. In this scenario, you might unknowingly disregard the patient’s needs.
Understanding clearly and fully your patient’s needs and concerns. Even when a patient refuses an interpreter, YOU still need to know what the patient/family is saying. The interpreter is present for your understanding as much as for your patient’s.
Protecting your license. When documenting in the medical record that you’ve used an interpreter, you can demonstrate and be confident all information was relayed to the patient/family.
Clinicians who are not bilingual but still converse with their patients and/or family without an interpreter are not complying with federal regulations, which places the hospital and the patient at risk. Platte Valley offers the services of two vendor-interpreter services: AMN and Certified Language Services. All PVH phones have both vendors added to the contact list for easy access. You also can find additional vendor information on this link in MyIntermountain.
A communication barrier also can build when a clinician and patient both speak a language other than English, but one speaks only just enough of the other language to get by. This includes patients who are hearing-impaired.
Bilingual clinicians who wish to communicate with their patients in their preferred language must show proof of language proficiency or utilize a qualified interpreter. This especially applies to informed consents for any treatment.
Bilingual clinicians have two options:
Take the language proficiency exam to communicate with your patients without the need of utilizing an interpreter.
Don’t take the language proficiency exam, but then you MUST utilize a qualified interpreter for all complex clinical discussions and consents.
The language-proficiency exam
Platte Valley Language Testing (at no cost) – Complete the form on this link in MyIntermountain and you will be contacted to schedule a convenient time.
Third-party vendor testing (charges apply) – Click on this link in MyIntermountain for additional information.
Taking the language proficiency exam is NOT the only step needed for bilingual staff to begin interpreting. There are additional requirements.
Thank you for your clear and thoughtful communication with our patients. Please contact me at lidia.puga@imail.org or at 303-498-1905 with any questions or concerns.