In 2023, the U.S. Census Bureau revealed a staggering statistic: An estimated 68–71 million people in the U.S. communicate in a language other than English at home, representing around 23% of households.
This linguistic diversity reflects the rich tapestry of communities across the U.S., but it also presents significant challenges, particularly in healthcare. The importance of language access — ensuring that patients and families who speak languages other than English receive equitable care in their preferred language — remains steadfast.
When interpreting services are underused, especially for children from families with a non-English language preference (NELP), these children face higher risks of medical errors, misunderstandings, and ultimately, worse health outcomes.
A recent article by Lena Oliveros, MSN, CPNP-AC, and colleagues at Seattle Children’s Hospital explores a groundbreaking study that sheds light on — and offers solutions to — this issue.
The findings of the study, which analyzed 882 patient encounters over the 4-year study period, highlight the importance of effective interpreter use in pediatric intensive care units (PICUs). Let’s take a closer look at what the authors found in terms of language barriers and the interventions that ultimately bridged those gaps in language access to improve patient care.
Overcoming the Barriers to Language Access in the PICU
Healthcare systems must be equipped not just to recognize the needs of NELP patients and families but to actively accommodate them. The inconsistent use of interpreting services within PICUs has been a significant barrier.
Despite the availability of phone and video interpretation services, these tools were often overlooked due to inadequate visibility and standardization within clinical settings. This underuse can have serious implications for patient care, as clear communication is critical in high-stakes medical environments like the PICU.
The multidisciplinary team at Seattle Children’s developed a strategy to improve the use of interpretation services in the PICU. They involved various stakeholders, including healthcare providers, family advisors, and language services teams, to identify barriers to care and implement targeted interventions.
Increasing Interpreter Usage with 3 Strategic Interventions
The team’s approach consisted of 3 key interventions aimed at improving the visibility and accessibility of interpretation services in Seattle Children’s Hospital PICU:
1. Device Standardization
Laminated cards with simplified instructions were attached to interpreting devices, which were strategically placed in standard locations within the PICU. This step made it easier for staff to access and use these devices promptly.
2. Bedside Optimization
Within 24 hours of a patient’s admission, a video remote interpreting (VRI) device was placed in the room of each patient who needed interpreting services. Additionally, user instructions placed next to the patients’ beds helped healthcare staff understand how to effectively use the VRI devices, ensuring they were fully equipped to communicate with NELP families.
3. Accountability
To foster a culture of usage, the language spoken by the NELP patient and/or their family was prominently posted on their room door alongside a tally board that tracked the frequency of interpreter use. This visibility and element of accountability encouraged staff to prioritize and engage with interpreter services.
See also: The Language Access Materials You Need to Know About
The Results of Interpreting Interventions
Over time, the cumulative effects of these interventions were profound.
Each individual interpretation modality (i.e., phone, video, and in-person) increased in use. The monthly rate of interpreting services used almost doubled, climbing from 1.4% to 2.7% per patient per day.
On average, the duration of phone interpreting sessions increased from 8 to 10.5 minutes per patient per day, and the duration of video interpreting sessions increased from 9.5 to 22 minutes per patient per day.
These results indicate that pointed intervention can work in creating a clear cultural shift towards staff embracing interpreter services as an integral part of patient care, rather than as a secondary consideration.
Key Takeaways for Increasing Interpreter Services Use
Other hospitals can learn a lot from the findings of this study and take cues from the interventions that Seattle Children’s Hospital implemented. And while this study was focused on a PICU, these interventions can easily be adopted by many other departments within a hospital.
Effective strategies and interventions for successfully improving language access include:
- Getting buy-in from hospital stakeholders before rolling out new interventions.
- Standardizing technology and the placement of interpreting devices in NELP patient rooms.
- Ensuring that both interpreting devices and user education materials are highly visible and accessible.
- Training healthcare staff on language access plans (how and when to use various interpreting modalities).
- Creating accountability systems of interpreter use by care providers.
- Instilling a culture around language access to ensure widespread and sustained adoption.
Improving access to interpreters doesn’t have to be an all-or-nothing endeavor, and every hospital ecosystem might need different interventions in different units. It’s never too late to start incorporating some of these strategies into your hospital’s language access plan.
Related: How to Create a Realistic Language Access Plan
The Path Forward to Equitable Language Access
While the study yielded useful insights, the journey toward equitable healthcare for NELP families is ongoing. Understanding the underlying reasons for care gaps is essential for creating effective solutions that center language access.
The research by Oliveros and her colleagues provides a valuable framework for addressing one significant barrier faced by NELP families, but it also highlights the need for continued effort and innovation in healthcare delivery to ensure that every patient can get the same high quality of care, regardless of their language preference.
Language access is not just a regulatory compliance issue; it’s a moral imperative for healthcare providers. As the U.S. continues to become increasingly multilingual, healthcare systems must adapt to meet the needs of all patients. The findings from studies like this serve as a crucial reminder that proactive measures can substantially improve communication, reduce disparities, and ultimately enhance patient outcomes.
To help our clients bridge language gaps with their patients, CLI offers free language access training services, educational and usage materials around accessing interpreting services, and resources to help make interpreters more accessible.
If you want to learn more about how we can help your organization improve language access, please get in touch with us.
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