Assessment of Interpretation Modality and Patient Comprehension in Spanish-speaking Limited English Proficiency (LEP) Patients Presenting to the Emergency Department

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.

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Comparison of Throughput Times for Limited English Proficiency Patient Visits in the Emergency Department Between Different Interpreter Modalities

Journal of Immigrant and Minority Health ◽

10.1007/s10903-011-9532-z ◽

2011 ◽

Vol 14 (4) ◽

pp. 602-607 ◽

Cited By ~ 10

Author(s):

Amy Grover ◽

Sara Deakyne ◽

Lalit Bajaj ◽

Genie E. Roosevelt

Keyword(s):

Emergency Department ◽

Limited English Proficiency ◽

English Proficiency

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Rural Hospitals and Spanish-Speaking Patients with Limited English Proficiency

Journal of Healthcare Management ◽

10.1097/00115514-200803000-00007 ◽

2008 ◽

Vol 53 (2) ◽

pp. 107-119 ◽

Cited By ~ 10

Author(s):

Myriam Torres ◽

Deborah Parra-Medina ◽

Jessica Bellinger ◽

Andrew O. Johnson ◽

Janice C. Probst

Keyword(s):

Limited English Proficiency ◽

English Proficiency ◽

Rural Hospitals ◽

Spanish Speaking

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Limited English Proficiency and the Rate of Unscheduled Return Pediatric Emergency Department Visit and Subsequent Hospitalization at a Community Hospital

Annals of Emergency Medicine ◽

10.1016/j.annemergmed.2005.06.117 ◽

2005 ◽

Vol 46 (3) ◽

pp. 31

Author(s):

R. Tajian ◽

R. Crupi ◽

D. Di John

Keyword(s):

Emergency Department ◽

Emergency Department Visit ◽

Limited English Proficiency ◽

Community Hospital ◽

English Proficiency ◽

Pediatric Emergency ◽

Pediatric Emergency Department

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Spanish-Speaking Limited English Proficiency Patients and Call Light Use

Hispanic Health Care International ◽

10.1177/1540415316645919 ◽

2016 ◽

Vol 14 (2) ◽

pp. 65-72 ◽

Cited By ~ 2

Author(s):

Mary Montie ◽

Jose Gabriel Galinato ◽

Lance Patak ◽

Marita Titler

Keyword(s):

Limited English Proficiency ◽

English Proficiency ◽

Spanish Speaking

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

Annals of Otology Rhinology & Laryngology ◽

10.1177/00034894211061996 ◽

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.

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