Inpatient Communication Barriers and Drivers When Caring for Limited English Proficiency Children

J Hosp Med. 2019 Oct 1;14(10):607-613. doi: 10.12788/jhm.3240. Epub 2019 Jul 24.


Background: Achieving effective communication between medical providers and families with limited English proficiency (LEP) in the hospital is difficult.

Objective: Our objective was to identify barriers to and drivers of effective interpreter service use when caring for hospitalized LEP children from the perspectives of pediatric medical providers and interpreters.

Design/participants/setting: We used Group Level Assessment (GLA), a structured qualitative participatory method that allows participants to directly produce and analyze data in an interactive group session. Participants from a single academic children's hospital generated individual responses to prompts and identified themes and relevant action items. Themes were further consolidated by our research team and verified by stakeholder groups.

Results: Four GLA sessions were conducted including 64 participants: hospital medicine physicians and pediatric residents (56%), inpatient nursing staff (16%), and interpreter services staff (28%). Barriers identified included: (1) difficulties accessing interpreter services; (2) uncertainty in communication with LEP families; (3) unclear and inconsistent expectations and roles of team members; and (4) unmet family engagement expectations. Drivers of effective communication were: (1) utilizing a team-based approach between medical providers and interpreters; (2) understanding the role of cultural context in providing culturally effective care; (3) practicing empathy for patients and families; and (4) using effective family-centered communication strategies.

Conclusions: Participants identified unique barriers and drivers that impact communication with LEP patients and their families during hospitalization. Future directions include exploring the perspective of LEP families and utilizing team-based and family-centered communication strategies to standardize and improve communication practices.

Publication types

  • Research Support, U.S. Gov't, P.H.S.

MeSH terms

  • Attitude of Health Personnel
  • Child
  • Communication Barriers
  • Empathy
  • Hospitals, Pediatric / organization & administration*
  • Hospitals, Pediatric / standards
  • Humans
  • Inpatients*
  • Limited English Proficiency*
  • Patient Care Team / organization & administration
  • Physician-Patient Relations*
  • Professional Role / psychology
  • Qualitative Research
  • Translating