A study recently published in JAMA Pediatrics showed that parents who have limited English proficiency (LEP) are less likely to feel comfortable asking doctors and other hospital personnel follow-up questions about their child’s care or treatment.

In the study, researchers from pediatric departments across the United States set out to look at ways in which English proficiency may impact a patient’s safety in the hospital — that is, the chances of experiencing adverse outcomes. While the disparity in health outcomes between LEP patients and English-speaking patients in the U.S. is fairly well-documented, the current study looks at a potential reason why patients and families with LEP are more likely to experience poor health outcomes than their English-speaking counterparts.

“Nobody knows a child better than their parents, we should be listening to them,” Nancy Spector, a physician at Drexel University and member of the research team, told STAT, a news publication covering health and life sciences.

Input from family members is considered an important aspect of hospital safety, as they may be better suited than doctors to recognize behavioral abnormalities that indicate when something has gone awry. Communication failures in the hospital have been shown to significantly increase the risk of medical errors.

For the study — during which the researchers surveyed families and patients in 21 different hospitals over the course of nearly one year — the researchers focused on Spanish- Chinese- and Arabic- speaking families. Compared to English-speaking families, the LEP families were half as likely to speak up when something seemed wrong and about one-fifth as likely to question the decisions of healthcare professionals.

The researchers called on hospitals and other healthcare facilities to make more of an effort to communicate effectively with families who have LEP, so as to improve the overall health outcomes of their children.

“Most communications with patients with LEP occur without an interpreter, including high-risk interactions like medication administration and procedure,” the paper reads. “In addition, healthcare professionals may take communication shortcuts for patients with LEP that make it harder for patients and families to ask questions, question decisions, and speak up.”

One of the researchers on the team told STAT that hospitals have a tendency to underutilize the services of medical interpreters. In order to make families feel more comfortable speaking up about their child’s care, the researchers believe that hospitals must make more effort to ensure that families understand their right to an interpreter and encourage them to make full use of this right. 

They also recommend mandating that interpreters be present for all interactions between doctors and patients or families with LEP, in order to ensure that individuals feel more comfortable asking questions and speaking out.

“This policy change can help reduce communication barriers and make it easier and more comfortable for families to speak up and ask their healthcare professionals questions,” the researchers write.