Improving health outcomes for patients with limited-English proficiency (LEP) starts with language access in healthcare.
However, organizations that encourage provider education regarding cultural competence and language access for LEP patients make an even more profound difference among at-risk populations. Below is a look at how investing in provider education further improves health outcomes for LEP patients.
A Population at Risk
LEP populations are at risk in several respects when it comes to healthcare. Research indicates that LEP patients not only face the risk of longer hospital stays after admission, but also increased instances of medical errors and misdiagnosis. A 2010 report found that out of 1,373 medical malpractice claims, 35 were directly related to lacking language access.
Another report published by the JAMA Network disclosed that patients with limited-English proficiency are also more likely to be readmitted within 30 days after being released from a hospital. Out of 9,881 LEP patients assessed, 12.5% were readmitted within 30 days and 22% within 90 days.
A lack of language access can also prove detrimental to patient satisfaction rates. For example, a review of palliative care services in 2016 found that LEP patients without access to an interpreter experienced more anxiety and pain during end-of-life care.
Addressing Disparities Through Provider Education
The key to addressing the disparities for LEP patients and creating a greater level of health equity comes down to provider education. Three important areas can be addressed to effectively improve health outcomes.
Cultural Competence Training
Cultural competence involves implementing policies and monitoring behaviors to support adequate, comfortable communication and experiences during cross-cultural scenarios. To achieve cultural competence, a health system must strive to:
Make effective communication possible with all patients no matter their native language
Predefine principles regarding behaviors, structures, and attitudes where cultural diversity and cultural awareness are concerned
Integrate cultural knowledge to support community diversity in everyday practice efforts
In healthcare, cultural competency means functioning efficiently while remaining cognizant of things like the cultural beliefs, needs, and behaviors of patients. The benefits of this type of training can be profound. Not only do care models become more efficient, but patient satisfaction scores go up and LEP patients are more satisfied with pain control and staff responsiveness.
Accessing Language Services
Language access is an important part of improving health outcomes for LEP patients. Studies have shown that interpreter access lowers 30-day readmission rates and length of stay for LEP patients, as well as overall hospital expenses. A study conducted in 2017 of dental school students found that 46% did not feel empowered to treat LEP patients. There was a close link between these feelings and language access, as only 44% of the students surveyed had formal interpreter services available in their dental school clinics.
In order to see the substantial benefits brought about by language support, part of provider education must be geared toward understanding how to access and use these language support services. For example, a language support service may offer telephone interpreting, video interpreting, document translation, and more. Therefore, an important component of provider education is teaching care providers how to access the different language support services available. Providers should also be able to easily discern which type of service would work best for specific situations.
Best Practices for Working With an Interpreter
Providers and staff members must know the best practices for working with an interpreter for the services to be most valuable for improving patient experiences. Several approaches can help, such as:
Learning to speak directly to the patient and not the interpreter
Using short phrases and sentences
Keeping background noise to a minimum
Pausing often to allow time for the interpreter to catch up
Remaining aware of cultural communication differences
Education in any arena is the stepping stone to empowering individuals. When speaking of a broader entity like healthcare, educating providers and staff in care settings empowers them to ensure patient safety and better health outcomes for entire populations of limited-English speakers. Provider education empowers providers because:
Providers become more aware of cultural differences and how to navigate through them during care scenarios
Providers know how to deliver communications in a way that is most effective for the patient
Providers understand how to use language access tools in the most efficient ways to achieve clear communication
Read to Improve the Cultural Competency of Your Organization?