Pharmacists, nurses, and physicians' perspectives and use of formal and informal interpreters during medication management in the inpatient setting

Abstract

Objective: Language barriers during inpatient medication management can occur during medication reconciliation on admission and discharge, and during the hospitalization. Understanding inpatient clinicians' experiences with language barriers and use of interpreters can help inform interventions aimed at improving medication management with Limited English Proficient (LEP) patients. Our objective was to examine clinicians' experiences with language barriers around inpatient medication management.

Methods: We used semi-structured interviews with pharmacist technicians, pharmacists, nurses, and physicians working in a tertiary care hospital. We used the constant comparison method to guide data collection and analysis.

Results: We interviewed 14 providers. Nurses and physicians perceived lack of time to use formal interpreters, particularly during busy or night shifts. Clinicians strongly preferred virtual and in-person interpreter services over telephonic services, and highlighted communication challenges with patients with low health literacy, concerns about the quality of interpretation, and inconsistencies in the use of translated materials.

Conclusions: Ensuring access to formal interpreters during all shifts, translation of materials into the patient/caregiver's language, and access to in-person/virtual services would improve quality of care for LEP patients.

Practice implications: Current laws require use of interpreters, but do not provide for their reimbursement, resulting in suboptimal use. Reimbursement for interpreter services may increase their availability.

Keywords: Hospital; Interpreters; Language Barriers; Limited english proficiency; Medication management.