scholarly journals The impact of limited English proficiency and physician language concordance on reports of clinical interactions among patients with diabetes: The DISTANCE study

2010 ◽  
Vol 81 (2) ◽  
pp. 222-228 ◽  
Author(s):  
Yael Schenker ◽  
Andrew J. Karter ◽  
Dean Schillinger ◽  
E. Margaret Warton ◽  
Nancy E. Adler ◽  
...  
Keyword(s):  
Limited English Proficiency ◽  
English Proficiency ◽  
Language Concordance ◽  
Patients With Diabetes ◽  
Clinical Interactions ◽  
The Impact

scholarly journals The power of language-concordant care: a call to action for medical schools

2019 ◽  
Vol 19 (1) ◽  
Author(s):  
Rose L. Molina ◽  
Jennifer Kasper
Keyword(s):  
Global Health ◽  
Health Outcomes ◽  
Health Equity ◽  
Limited English Proficiency ◽  
English Proficiency ◽  
Medical Schools ◽  
Dental Students ◽  
Language Concordance ◽  
The World ◽  
The U.S

Abstract We live in a world of incredible linguistic diversity; nearly 7000 languages are spoken globally and at least 350 are spoken in the United States. Language-concordant care enhances trust between patients and physicians, optimizes health outcomes, and advances health equity for diverse populations. However, historical and contemporary trauma have impaired trust between communities of color, including immigrants with limited English proficiency, and physicians in the U.S. Threats to informed consent among patients with limited English proficiency persist today. Language concordance has been shown to improve care and serves as a window to broader social determinants of health that disproportionately yield worse health outcomes among patients with limited English proficiency. Language concordance is also relevant for medical students engaged in health care around the world. Global health experiences among medical and dental students have quadrupled in the last 30 years. Yet, language proficiency and skills to address cultural aspects of clinical care, research and education are lacking in pre-departure trainings. We call on medical schools to increase opportunities for medical language courses and integrate them into the curriculum with evidence-based teaching strategies, content about health equity, and standardized language assessments. The languages offered should reflect the needs of the patient population both where the medical school is located and where the school is engaged globally. Key content areas should include how to conduct a history and physical exam; relevant health inequities that commonly affect patients who speak different languages; cultural sensitivity and humility, particularly around beliefs and practices that affect health and wellbeing; and how to work in language-discordant encounters with interpreters and other modalities. Rigorous language assessment is necessary to ensure equity in communication before allowing students or physicians to use their language skills in clinical encounters. Lastly, global health activities in medical schools should assess for language needs and competency prior to departure. By professionalizing language competency in medical schools, we can improve patients’ trust in individual physicians and the profession as a whole; improve patient safety and health outcomes; and advance health equity for those we care for and collaborate with in the U.S. and around the world.

Minimizing Variability in Interpretation Modality Among Spanish-Speaking Patients With Limited English Proficiency

2019 ◽  
Vol 18 (1) ◽  
pp. 32-39
Author(s):  
Seiichi Villalona ◽  
Christian Jeannot ◽  
Mery Yanez Yuncosa ◽  
W. Alex Webb ◽  
Carol Boxtha ◽  
...  
Keyword(s):  
Limited English Proficiency ◽  
English Proficiency ◽  
Cross Sectional ◽  
Time Points ◽  
Spanish Speaking ◽  
History Of ◽  
Vas Scores ◽  
Communication Modalities ◽  
The Impact

Introduction: Provider–patient language discrepancies can lead to misunderstandings about follow-up care instructions and decreased adherence to treatment that may contribute to disparities in health outcomes among patients with limited English proficiency (LEP). This observational study aimed to understand how emergency department (ED) staff went about treating patients with LEP and examine the impact of consistent interpretation modality on overall patient satisfaction and comprehension. Method: A cross-sectional study was conducted among Spanish-speaking patients with LEP presenting to the ED. A survey was administered at two different time points: after patients provided their history of present illness and after the patient received information regarding follow-up treatment. Results: Analysis of average visual analog scale (VAS) scores by consistency of interpretation suggested higher overall scores among participants that received care via the same communication modalities during both the history of present illness and at disposition, when compared with patients that did not. At both time points, video-based interpretation was associated with higher VAS scores in comparison to other modalities, whereas phone-based interpretation was associated with lower VAS scores. Conclusion: Providing consistent modes of interpretation to patient’s with LEP throughout their ED visits improved their overall satisfaction of care provided and understandings of discharge instructions.

The impact of limited English proficiency on asthma action plan use

2013 ◽  
Vol 51 (2) ◽  
pp. 178-184 ◽  
Author(s):  
Antonio Riera ◽  
Aledie Navas-Nazario ◽  
Veronika Shabanova ◽  
Federico E. Vaca
Keyword(s):  
Limited English Proficiency ◽  
English Proficiency ◽  
Action Plan ◽  
The Impact ◽  
Asthma Action Plan

Outcome Disparities and Resource Utilization Among Limited English Proficient Patients After Tonsillectomy

2021 ◽  
pp. 000348942110619
Author(s):  
Michal Plocienniczak ◽  
Batsheva R. Rubin ◽  
Alekha Kolli ◽  
Jessica Levi ◽  
Lauren Tracy
Keyword(s):  
Emergency Department ◽  
Resource Utilization ◽  
Limited English Proficiency ◽  
English Proficiency ◽  
Surgical Care ◽  
Adverse Outcomes ◽  
Utilization Rate ◽  
Increased Risk ◽  
Significant Difference ◽  
The Impact

Objective: There is evidence to suggest adverse outcomes on patients’ medical and surgical care when there is language discordance in patient-physician relationships. No studies have evaluated the impact of limited English proficiency (LEP) on complications after common surgical procedures in otolaryngology. Furthermore, no studies have evaluated how patients with LEP utilize remote resources to connect with otolaryngology providers to better triage such complications. The purpose was to evaluate the incidence of post-tonsillectomy hemorrhage (PTH) comparing patients with LEP to those with English proficiency (EP). Patients with PTH were retrospectively evaluated to identify preceding telephone encounters, a marker of resource utilization. Methods: Demographics, English proficiency, and PTH management (surgical vs non-surgical) were evaluated in addition to PTH-associated triage telephone encounters with otolaryngology providers. Results: Of 2466 tonsillectomies, there were 141 episodes of reported hemorrhage (50 LEP vs 91 EP) in the 5 years studied. Rates were not significantly different between LEP and EP patients (4.9% vs 6.3%, P = .127). There was no statistically significant difference in rate of preceding telephone encounters between LEP and EP patients (24% vs 40%, P = .062). Of patients presenting directly to the Emergency Department without a triage telephone encounter, there was no difference in operative versus non-operative management when comparing LEP versus EP patients. However, patients presenting directly to the Emergency Department were nearly twice as likely to undergo operative intervention compared to patients with preceding telephone encounters (RR = 1.79). Conclusion: Patients with limited English proficiency are not at increased risk for developing PTH. There is equitable access to remote otolaryngologic triage care, although overall the utilization rate of this resource was low for both cohorts.

scholarly journals A Reversed Trend: Care for Limited English Proficiency Patients in the Pediatric Emergency Department

2019 ◽  
Vol 2019 ◽  
pp. 1-7
Author(s):  
David Greenky ◽  
Alyssa Levine ◽  
Scott E. Gillespie ◽  
Brittany Murray
Keyword(s):  
Limited English Proficiency ◽  
Retrospective Cohort ◽  
English Proficiency ◽  
Pediatric Emergency ◽  
Effect Sizes ◽  
Pediatric Emergency Department ◽  
Patient Centered ◽  
Clinical Difference ◽  
English Speaking ◽  
The Impact

Objectives. Previous studies in pediatric emergency departments (EDs) showed patients with limited English proficiency (LEP) had gaps in care compared with English-speaking patients. In 2010, the Joint Commission released patient-centered communication standards addressing these gaps. We evaluate the current care of LEP patients in the Children’s Healthcare of Atlanta (CHOA) EDs. Methods. This was a retrospective cohort study of patients <18 years that presented to our EDs in 2016. Length of stay (LOS), change in triage status, return-visit rates, and hospital disposition were compared between patients who requested an interpreter and those who did not. Results. The population included 152,945 patients from 232,787 ED encounters in 2016. Interpreters were requested for 12.1% of encounters. For ED LOS, a model-adjusted difference of 0.77% was found between interpreter groups. For change in triage status, adjusted odds were 7% higher in the interpreter requested cohort. For ED readmission within 7 days, adjusted odds were 3% higher in the interpreter requested cohort. These effect sizes are small (ES < 0.2). Conclusions. Our study showed low ES of the differences in ED metrics between LEP and English-speaking patients, suggesting little clinical difference between the two groups. The impact of this improvement should be further studied.

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