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Not being able to speak in the same language as the people around you makes navigating through daily life complicated, but it’s more than a nuisance when you’re not well. Not being able to communicate to your healthcare providers is downright dangerous and potentially fatal. For instance, complications from improperly administered prescription drugs, lack of preventive care and lack of regular access to the medical system are just a few of the negative outcomes resulting from language barriers.
It’s crucial for patient health that communication about medical concerns is conducted in the patient’s language and with cultural knowledge. Professional interpreting and translating results in improved patient care, especially when a mixture of language access services is available in the medical practice.
Currently (as of early 2018) more than 25 million Americans are not fluent in English and more than 60 million don’t speak English at home, according to the U.S. Census Bureau. When faced with medical issues, non-English speaking patients often turn to family members, friends or bilingual staff for interpreting needs, but these ad hoc methods can have serious drawbacks.
Non-professional interpreters may not be aware of the importance of confidentiality or training in the Health Insurance Portability and Accountability Act. Even fluent speakers may struggle with medical terminology. Family members can be embarrassed to interpret intimate questions, and emotional involvement with the patient can hinder the clarity of the interpretation. Many states prohibit using children and young adults as interpreters.
Errors in interpretation have led to missed diagnoses, patients not being able to follow instructions and increased exposure to malpractice suits. For example, in one case, the word “intoxicado” was mistakenly interpreted by medical staff as “drunk” rather than referring to toxicity, ultimately leading to missing the real problem — an intracerebral hemorrhage. That mistake resulted in a malpractice award of $71 million.
Written and online resources are beneficial for boosting health literacy, but translating written information is subject to numerous pitfalls that lead to misunderstanding on the part of the intended reader. Fluency in language isn’t the only requirement for translation. It’s critical to be a subject matter expert, and also important to be culturally knowledgeable and familiar with the medical system in the target culture to ensure concepts are described clearly and accurately. The accuracy of written information also has legal implications for medical practices.
Literal translations that miss the mark can be humorous in advertising or how-to manuals, but when they appear in medical information, the consequences can be serious. For example, physicians in St. Paul, Minnesota, found that Hmong people were refusing radiation treatment for cancer because of errors in translation. The concept of cancer was unfamiliar to Hmong patients and the text explanation was translated as “We’d like to put fire in you.”
It’s also important that patients, family members and lay caregivers receive accurate information about using medical equipment and devices that they may need to use for patient care. Proper labeling, manual instructions and information about risks and benefits of using medical equipment is vital for obtaining patient understanding and consent for their treatment plan. It’s also necessary to ensure that the equipment will be operated properly.
The most impactful positive outcomes are achieved when on-site professional interpreters are used. The interpretation is clearer, fewer errors are made, and patient comprehension and compliance are higher. Hospital stays and readmissions are also reduced and overall patient satisfaction is increased.
The most effective language access programs in healthcare incorporate both on-site and telephone interpreting, establishing the criteria for when one or the other is most suitable, as well as the protocol for each. In addition, making sure that the right partnerships and resources are lined up may be the most important step of all.
Basic information forms, patient’s rights and responsibility forms and/or a simple consent for treatment need to be available in different languages, as well as treatment plans and instructions for prescriptions. That includes accurately translating information and instructions for using and monitoring medical machinery and devices.
Dynamic Languages provides professional interpreting services, both on-site and by telephone. We also translate written medical material for public documents, brochures, websites, and medical machinery and devices in culturally appropriate and accessible language.
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