The evidence that professional interpreters improve patient health is overwhelming — so why don’t more American health care facilities provide interpreters? Two new studies in this month’s issue of Pediatrics — the official journal of the American Academy of Pediatrics – seek to answer. Specifically, the studies examine the underuse of professional medical interpreters for children treated in hospital emergency rooms (ER).
The first — “Addressing Health Inequities for Limited English Proficiency Patients” — was performed by the University of California’s Division of Pediatric Critical Care Medicine. The second — “Patterns and Predictors of Professional Interpreter Use in the Pediatric Emergency Department” — was a joint study conducted by the Center for Child Health, Behavior and Development and the Center for Clinical and Translational Research at Seattle Children’s Research Institute.
In Seattle, researchers discovered doctors and nurse practitioners were significantly more likely to work with a professional when the interpreter could be accessed over video as opposed to by phone (OPI). Researchers monitored 50 different ER visits, seeing 312 different “communication events” between providers and limited English proficient (LEP) patients. An interpreter was only used 36 percent of the time. Interpreters were relied on most frequently for taking down patient health history and least frequently during actual medical procedures.
The California study also reported higher rates of interpreter access for history taking and lower use for procedures, adding physicians and nurse practitioners were more likely to work with professionals than registered nurses — a job that in the United States requires less education. It too found interpreters were only used around one-third of the time.
Of interest, the California study also pointed out that American data collection methods may keep us from understanding how often interpreters really are — or aren’t — relied upon. Just because providers worked with an interpreter for part of an interaction doesn’t mean the interpreter was there the entire time she was needed: “Dichotomous terms, such as ‘interpreter used’ and ‘interpreter not used,’ do not accurately encapsulate interpreter use and frequently overestimate time spent with an interpreter.” In other words, the interpreter could show up, the practitioner checking ‘yes,’ then potentially leave before the end of the conversation.