The experience of interpreter access and language discordant clinical encounters in Australian health care: a mixed methods exploration

• Published in: International journal for equity in health 2018-09, Vol.17 (1), p.151-151, Article 151
• Main Authors: White, Jennifer, Plompen, Trish, Osadnik, Christian, Tao, Leanne, Micallef, Emily, Haines, Terry
• Format: Article
• Language: English
• Subjects: Access to care; Adult; Analysis; Attitude of Health Personnel; Australia; Communication; Communication Barriers; Data processing; Deafness; Discordance; Drought; Electronic health records; Electronic medical records; Exploration; Families & family life; Female; Focus Groups; Health care; Health care access; Health care policy; Health services; Health Services Accessibility - organization & administration; Health Services Accessibility - standards; Hospitals; Humans; Inpatient medicine; Interpreters; Language; Language discordance; Male; Medical personnel; Medical records; Medical research; Medical students; Middle Aged; Mixed methods research; Natural disasters; Nursing; Parents & parenting; Patient care; Patient Satisfaction; Patients; Physician-Patient Relations; Physicians; Practice; Professionals; Qualitative; Quality; Quality of care; Quality of Health Care - standards; Retrospective Studies; Sign language; Systematic review; Translating
• ISSN: 1475-9276; 1475-9276
• DOI: 10.1186/s12939-018-0865-2

Current evidence highlights that language discordant clinical encounters seriously compromise patient quality of care and health outcomes. We aimed to characterise patterns of interpreter service use in medical inpatient wards use and explore clinician experience of language discordance. Participants included medical students, residents, attending physicians, nursing and allied health professionals working in General Internal Medicine wards across two tertiary referral hospitals servicing a large Australian health care area. This study involved a retrospective electronic medical record audit of interpreter use. Six focus groups were conducted with 32 participants. Data were analysed using an inductive thematic approach with constant comparison. Allied health professionals were identified as the largest users of interpreter services, followed by medical doctors. Distinct themes emerged regarding clinician experiences of language discordant encounters including: (1) Negotiating care when unable to get an accurate assessment; (2) Over servicing to fill in the gaps; (3) Using family members instead of professional interpreters: a vexed solution; (4) Disparities in care provision; and (5) Communication drought: broken by a flood. Patients with low English proficiency are at risk of being less informed of care processes, and having a very large volume of information given in a shorter period of time when an interpreter is present. There is a need for systematic and transformative change that addresses utilisation of professional interpreters as well as embedded healthcare culture and practices leading to less interaction with patients with limited English proficiency and reliance on family members as informal interpreters.