Increased Access to Professional Interpreters in the Hospital Improves Informed Consent for Patients with Limited English Proficiency

Abstract

BACKGROUND: Language barriers disrupt communication and impede informed consent for patients with limited English proficiency (LEP) undergoing healthcare procedures. Effective interventions for this disparity remain unclear. OBJECTIVE: Assess the impact of a bedside interpreter phone system intervention on informed consent for patients with LEP and compare outcomes to those of English speakers. DESIGN: Prospective, pre-post intervention implementation study using propensity analysis. SUBJECTS: Hospitalized patients undergoing invasive procedures on the cardiovascular, general surgery or orthopedic surgery floors. INTERVENTION: Installation of dual-handset interpreter phones at every bedside enabling 24-h immediate access to professional interpreters. MAIN MEASURES: Primary predictor: pre-vs. postimplementation group; secondary predictor: postimplementation patients with LEP vs. English speakers. Primary outcomes: three central informed consent elements, patient-reported understanding of the (1) reasons for and (2) risks of the procedure and (3) having had all questions answered. We considered consent adequately informed when all three elements were met. KEY RESULTS: We enrolled 152 Chinese-and Spanishspeaking patients with LEP (84 pre-and 68 postimplementation) and 86 English speakers. Postimplementation (vs. pre-implementation) patients with LEP were more likely to meet criteria for adequately informed consent (54% vs. 29%, p = 0.001) and, after propensity score adjustment, had significantly higher odds of adequately informed consent (AOR 2.56; 95% CI, 1.15-5.72) as well as of each consent element individually. However, compared to post-implementation English speakers, post-implementation patients with LEP had

Predicting Elective Orthopaedic Sports Medicine Surgical Cancellations Based on Patient Demographics

“…With the use of professional interpreters, significant improvements have been made in patients' explanations of their symptoms, patient satisfaction, and the ability to obtain informed consent. 16,17 However, these improvements did not eliminate the language disparity, 16 and our data support this issue.…”

The Limited English Proficient Population: Describing Medicare, Medicaid, and Dual Beneficiaries

“…A recent study by Lee et al (2017) showed that among Chinese- and Spanish-speaking patients, a bedside interpreter phone system intervention was associated with greater informed consent; however, a disparity was still observed regarding the care of LEP patients. 26 Evidence has shown a reduction in readmission rates and expenditures when hospitals provide convenient access to interpreters. 27 In addition, dosing errors among Hispanic parents, who may be LEP or have limited health literacy, have been shown to be problematic; however, the ability to better characterize the LEP population may assist in reducing these errors.…”

Hospital discharge preparedness for patients with limited English proficiency: A mixed methods study of bedside interpreter-phones

“…The bedside interpreter intervention has been previously described [24]. In brief, the intervention consisted of a dual-handset interpreter-phone installed at the bedside in every room with programmed buttons enabling 24-hour access to a professional interpreter for more than 100 languages in less than one minute.…”

“…Clinician-reported barriers to use of professional interpreters in the hospital include time constraints and lack of immediate interpreter availability [21]. While best practices to overcome these barriers remain unclear, previous studies by our group demonstrated significant improvements in professional interpreter utilization [22], readmission rates [23], and understanding of informed consent [24] among patients with LEP after implementation of dual-handset phones that provided easy access to bedside professional interpretation. By improving access to professional interpreters, bedside interpreter-phones address barriers cited by clinicians and could be an effective method to increase professional interpretation during hospital discharge counseling [23].…”