Friday, November 4, 2011

Improving care for limited-English proficient patients

From left, Ring, Meyer, Nunes and Betancourt

Approximately 25 million people in the United States are described as having limited-English proficiency (LEP) and are at risk for adverse events because of barriers associated with language ability. To encourage staff to think carefully about how they communicate with and care for such patients, the Center for Quality and Safety and the Mongan Institute for Health Policy’s Disparities Solutions Center (DSC) held an Oct. 19 Quality and Safety Forum, “Improving Care for Limited-English Proficient Patients at MGH.” Gregg Meyer, MD, senior vice president for the Center for Quality and Safety, welcomed attendees, and Joseph Betancourt, MD, MPH, director of the DSC, offered background information about health care disparities among LEP patients.

“Communication is such an incredibly important part of the care process,” said Betancourt. “We know, from some initial research, that adverse events affect limited-English  proficient patients more frequently and severely than their English-speaking counterparts.”Betancourt shared ways the MGH is addressing this problem, including collaborations between the DSC, Center for Quality and Safety and Interpreter Services on new initiatives – such as training caregivers on LEP patient safety issues and how to use an interpreter; quality and safety rounds with interpreters; and interpreter training on how to better identify and address patient safety concerns. In partnership with Abt Associates and with funding from the U.S. Agency for Healthcare Research and Quality, the DSC also is finalizing a hospital guide with recommendations on how to prevent errors in caring for LEP patients.

David Ring, MD, PhD, an orthopædic surgeon and director of research for the Hand and Upper Extremity Service, discussed a surgical error in which the inability of team members to communicate with a Spanish-speaking patient and the misuse of staff as translators played a significant role. Ring has been applauded by colleagues for sharing his experience and publishing an article about the case in the New England Journal of Medicine.

Ring’s story helped emphasize the message of Anabela Nunes, manager of Interpreter Services, who provided information about the crucial role of medical interpreters in reducing errors. “I want to stress that a medical interpreter is not just anyone who is bilingual,” said Nunes. “I can be a native speaker, but I might not know medical terminology, and there are specific professional standards and ethics that I need to be trained in.”  

Nunes said MGH policy strongly discourages use of bilingual staff or family members to interpret information to patients. She asked attendees to instead utilize the resources available through Interpreter Services.

Read more articles from the 11/04/11 Hotline issue.


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