Promoting quality care in patients with cancer with limited English proficiency: perspectives of medical interpreters

189 Background: Toronto is a multicultural city with over 160 languages spoken by patients. Since 2010, institutional policy requires that professional medical interpreters are used when obtaining informed consent from patients with limited English proficiency (LEP). The availability and cost of these interpreters can be a deterrent for clinical trial participation, particularly when funding is limited. In order to ensure that patients facing language barriers have equitable access to trials, to protect the rights and safety of LEP patients involved in trials, and to improve patient outcomes, adherence to this policy needs to be ensured. Methods: Through a collaboration with the PM Cancer Clinical Research Unit (CCRU) and Interpretation and Translation Services (ITS) supported by the Princess Margaret Cancer Foundation, a 6-month pilot was initiated with full access to interpretation services for all trial patients in November 2012. The CCRU provided training to interpreters on clinical trials and GCP and interpreters reviewed template consent forms provided by ethics boards to cut back on preparation time and costs when delivering a sight translation of study specific consent forms. Trials staff were trained on the process and given badge tags with instructions. Metrics were collected to monitor the use of professional interpreters. Results: Utilization of professional interpreters in trials increased by 16% during the 6-month pilot and 286 requests have been logged to date. Staff were surveyed and indicate this has streamlined the consent process with 83% of respondents saying the new process is easy/very easy. Care providers feel this has allowed them to approach more patients than before this project. Conclusions: This project ensures that accurate information is provided to all patients contemplating participating in or already enrolled in trials, that all patients have the same level of access to treatment, and that there is equity of access for all patients irrespective of their English proficiency. The increased use of professional interpreters in consent discussions indicates better adherence to policy which has allowed the pilot to continue for another year.

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Establishing the Necessary Conditions for Achieving Language Access and Equitable, Quality Care for Populations with Limited English Proficiency

The Joint Commission Journal on Quality and Patient Safety ◽

10.1016/j.jcjq.2019.04.004 ◽

2019 ◽

Vol 45 (6) ◽

pp. 395-396

Author(s):

Leah Karliner

Keyword(s):

Limited English Proficiency ◽

English Proficiency ◽

Necessary Conditions ◽

Quality Care ◽

Language Access

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Educating Clinicians to Improve Telemedicine Access for Patients with Limited English Proficiency

Challenges ◽

10.3390/challe12020034 ◽

2021 ◽

Vol 12 (2) ◽

pp. 34

Author(s):

Tiffany M. Shin ◽

Pilar Ortega ◽

Karol Hardin

Keyword(s):

Medical Education ◽

Limited English Proficiency ◽

English Language ◽

English Proficiency ◽

Care Delivery ◽

The United States ◽

Patient Portals ◽

Medical Interpreters ◽

Language Needs ◽

Electronic Health Information

The COVID-19 pandemic prompted the rapid incorporation of telemedicine into healthcare systems, resulting in increased access challenges for patients in the United States with limited English proficiency (LEP). Non-English-language speakers face challenges with telemedicine that magnify pre-existing barriers to language-appropriate care, such as difficulty accessing professional medical interpreters and navigating both electronic health information and online patient portals. Improved medical education on telehealth would increase equitable care for linguistic minorities. Medical education targeting telehealth care delivery should include clinician instruction on working with interpreters in telehealth contexts, increasing patient access to telehealth resources, and addressing patients’ language needs for telemedicine.

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Examining Effectiveness of Medical Interpreters in Emergency Departments for Spanish-Speaking Patients With Limited English Proficiency: Results of a Randomized Controlled Trial

Annals of Emergency Medicine ◽

10.1016/j.annemergmed.2010.05.032 ◽

2011 ◽

Vol 57 (3) ◽

pp. 248-256.e4 ◽

Cited By ~ 41

Author(s):

Ann D. Bagchi ◽

Stacy Dale ◽

Natalya Verbitsky-Savitz ◽

Sky Andrecheck ◽

Kathleen Zavotsky ◽

...

Keyword(s):

Randomized Controlled Trial ◽

Emergency Departments ◽

Limited English Proficiency ◽

English Proficiency ◽

Controlled Trial ◽

Spanish Speaking ◽

Randomized Controlled ◽

Medical Interpreters

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U.S. medical school curricula on working with medical interpreters and/or patients with limited English proficiency

Advances in Medical Education and Practice ◽

10.2147/amep.s176028 ◽

2018 ◽

Vol Volume 9 ◽

pp. 729-733 ◽

Cited By ~ 1

Author(s):

Jessica Himmelstein ◽

William S Wright ◽

Michael W Wiederman

Keyword(s):

Medical School ◽

Limited English Proficiency ◽

English Proficiency ◽

Medical Interpreters ◽

School Curricula

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The Premise and Development of CHECK IN—Check-In for Exchange of Clinical and Key Information to Enhance Palliative Care Discussions for Patients With Limited English Proficiency

American Journal of Hospice and Palliative Medicine® ◽

10.1177/1049909120979982 ◽

2020 ◽

pp. 104990912097998

Author(s):

Amelia Barwise ◽

Mei-Ean Yeow ◽

Daniel K. Partain

Keyword(s):

Decision Making ◽

Limited English Proficiency ◽

English Proficiency ◽

Quality Care ◽

Clinical Information ◽

Clinical Encounter ◽

High Quality ◽

Serious Illness ◽

Patient Goals ◽

Medical Interpreter

Communication regarding serious illness is challenging in most circumstances. Patients with Limited English Proficiency (LEP) have unique language and cultural needs that often require collaboration with a trained medical interpreter, especially when the clinical encounter involves serious illness decision making or elucidation of patient goals, preferences, and values. Although there is mounting evidence to support interpreter/clinician huddles before a serious illness communication encounter, no current initiatives exist to operationalize this evidence. We are currently in the process of developing, evaluating, and implementing a formal interpreter/clinician huddle process to promote high quality care for patients with LEP. Our huddle guide, called the Check-In for Exchange of Clinical and Key Information (CHECK-IN), is designed to facilitate collaboration between an interpreter and clinician during a serious illness encounter by prompting exchange of relevant sociocultural and clinical information between clinicians and interpreters.

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