An Implementation Science Approach Improves Language Access in the Emergency Department

J Immigr Minor Health. 2021 Dec;23(6):1214-1222. doi: 10.1007/s10903-020-01127-x. Epub 2021 Jan 2.

Abstract

Background: The underuse of interpreters for limited English proficiency (LEP) patient encounters is pervasive, particularly in the emergency department (ED).

Objective: To measure the outcome of strategies to improve the use of interpreters by ED providers.

Methods: Pre- and post- intervention evaluation of the unmet need for language assistance (LA) in a public ED. Informed by the Behavior Change Wheel (BCW), strategies included: education, training, technology-based facilitators, local champions and environmental cues.

Results: Pre-intervention, of the 110 patient charts with interpreter requests, 17 (15.5%) had documentation of an interpreter-mediated encounter or were seen by a certified bilingual provider (unmet need = 84.5%). Post intervention, of the 159 patient charts with interpreter requests, 47 (29.6%) had documentation of an interpreter-mediated encounter or were seen by a certified bilingual provider (unmet need = 70.4%), difference + 0.14 (95% CI = 0.03-0.23).

Conclusion: In this pilot study, we found a statistically significant increase in the met need for language assistance.

Keywords: Communication Barriers; Implementation Science; Interpreters; Language Services; Limited English Proficiency.

MeSH terms

  • Communication Barriers
  • Emergency Service, Hospital
  • Humans
  • Implementation Science*
  • Language*
  • Physician-Patient Relations
  • Pilot Projects
  • Translating