Language Interpreter Utilization in the Emergency Department Setting: A Clinical Review

Abstract

The emergency department (ED) serves as the entry point into the U.S. health care system for many patients with limited English proficiency (LEP). This paper reviews the literature on language interpreter utilization in the ED setting. We focused on three clinical issues related to professional language interpretation: (1) patient satisfaction, (2) health care delivery, and (3) current interpreter utilization practices. Compared with-English speaking patients, LEP patients report less satisfaction with medical encounters, have different rates of diagnostic testing, and receive less explanation and follow-up. Although professional interpretation has been associated with improvements in patient satisfaction, communication, and health care access, these services are largely under-utilized in ED settings. Reliance on untrained ad hoc interpreters, perceived time and labor associated with obtaining and working with an interpreter, and costs of implementing professional interpreter services serve as barriers to implementation and utilization.

Use of Interpreters by Physicians for Hospitalized Limited English Proficient Patients and Its Impact on Patient Outcomes

“…[7][8][9][10] Most studies to date have focused on the impact of interpreters in the outpatient and emergency department (ED) settings. 11,12 Few studies have explored the relationship between in-hospital physician use of interpreters and patient outcomes measured by length of stay (LOS) and readmission rates. Five prior studies have analyzed the outcomes of LEP hospitalized patients compared to English speakers, but only two of these studies examined the impact of interpreter use with conflicting results.…”

“…14 The second study found that the use of professional interpretation at admission or both admission and discharge was associated with an increased LOS and decreased readmission rates compared to those LEP patients without professional interpretation. 11 However, this study was limited by not having an English speaking comparison group.…”

Organizing Language Interpreting Services in Elderly and Emergency Healthcare

“…Earlier studies in somatic emergency healthcare have shown how language barriers increase risk of misdiagnosis (Hampers et al 1999), lead to limited access to diagnoses, diagnostic testing and treatment (Ramirez et al 2008;Ventriglio et al 2014;) as well as longer stay for the patients at the emergency department (Mahmoud et al 2013;Njeru et al 2015). In psychiatric emergency healthcare, Bauer and Alegria (2010) found that errors by untrained interpreters affected healthcare professionals' ability to understand patients' disordered thoughts or delusional content.…”

“…The use of professional interpreters in emergency healthcare promotes the best quality of communication and increase patient satisfaction (Ramirez et al 2008;Bagchi et al 2011), it also leads to better services and reduces return rates (Bernstein 2002). However, professional interpreters are underutilized in emergency healthcare context (Ramirez et al 2008;Ginde et al 2009;Ginde et al 2010), one reason could be the use of friends and family members as interpreters, which many patients were comfortable with (Ginde et al 2010).…”

“…However, professional interpreters are underutilized in emergency healthcare context (Ramirez et al 2008;Ginde et al 2009;Ginde et al 2010), one reason could be the use of friends and family members as interpreters, which many patients were comfortable with (Ginde et al 2010). …”