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Language

Barriers in Healthcare

Bianca Garcia

Indian River State College

PRESENTER

Bianca Garcia, RN

Hi my name is Bianca Garcia. I am currently a Registered Nurse at Cleveland Clinic Indian River. I graduated from Indian River State College in 2019. This policy to tackle language barriers within the healthcare system is important to me because of my hispanic background as well as what I've witness during my nursing career.

IN DETAIL

POLICY

With an increasing growth of population diversity within the United States, an increase in language diversity follows. Rise in language diversity creates a challenge within the healthcare setting to maintain the quality of care provided. Healthcare facilities lack the necessary resources and bilingual staff to keep up with the demand of spanish speaking patients. Communication barriers put the patient at risk for adverse outcomes. Therefore, a policy that advocates for patients who don't speak English and requires facilities to accommodate the care provided to meet their communication needs is required.

STATISTICS

HISPANIC POPULATION

The United States Census Bureau (2019) reports the hispanic population makes up 18.5% of the total population and continues to rise.

LANGUAGE BARRIER POLICY

PROPOSAL

Patients with a limited English proficiency (LEP) receive a decreased quality of healthcare delivery and patient safety. By implementing a policy that requires LEP patients to receive equal quality of care within the healthcare system, LEP patients will experience an increase in the quality of care provided as well as an increase in patient satisfaction.

AFFECTS OF LANGUAGE BARRIERS IN HEALTHCARE

PROBLEM

  • Adverse outcomes for patient
  • Incorrect diagnosis or medications administered
  • Patients have trouble understanding diagnosis and treatment options
  • Increase healthcare cost
  • Decreased patient satisfaction with healthcare provided
  • Increase stress on healthcare providers

CIVIL RIGHTS ACT OF 1964

LEGISLATION

Under the Civil Rights Act of 1964 "Title VI prohibits discrimination on the basis of race, color, or national origin in any program or activity that receives Federal funds or other Federal financial assistance (HHS, 2013)." Health care facilities are required to provide free oral and written language assistance to LEP patients. Failure to do provide services can lead to loss of federal funding as it is a a form of discrimination.

COMMUNICATION BARRIERS

IMPACT

Communication is a vital part of healthcare; obtaining the signs and symptoms of patients in order to diagnosis, obtain a medical history and explain diagnosis and treatment. Language barriers can inhibit the delivery of quality care affecting the patients human rights.

RESPONSE

LEP

Despite the importance of communication when asked LEP patients reported:

  • Adverse health events that resulted in detectable physical harm 49.1%
  • Failure in communication with medical providers 52.4%
  • 70.7% of limited English proficiency patients reported limited availability of interpreter services

HANDOUT

POLICY POINTS

  • All nurses to attend an educational in service regarding cultural competence as a nurse, learn about different resources available to them within their healthcare facility, and role playing scenarios
  • Implement a requirement to use certified translators only
  • Healthcare providers to actively apply learned concepts to daily care
  • Managers are to follow up with staff in 30 days to gather their feedback on the educational course and if they have any additional ideas
  • Managers to follow up with limited English proficient patients to ensure resources have been offered and request any feedback from patients

IMPLEMENTATION OF CHANGE

CHANGE

Language barriers within the hospital can be improved by providing handouts with information regarding medication, diagnosis and treatment options in the native language of patients. Diamond (2019) reports "one in five people in the USA speaks a language other than English at home." Facilities are required to provide a trained interpreter for patients, a system to implement certification requirements in order to translate for patients will reduce translation errors. Studies on language- concordant care resulted in "positive findings identified included patient-reported measures, such as patient satisfaction and understanding of diagnosis, and objective measures (Diamond, 2019)

TELEHEALTH

FUTURE

Telehealth allows patients to have "access to services especially general practice

consultation from home via telephone or by using technology for video conferencing (Javanparast (2020)." A future idea would be to expand the availability and staff of telehealth and offer patients to be consulted by a healthcare provider that is fluent in their native language. Expanding telehealth to different states and possibly one day other countries can open several opportunities such as extended time availability and an increase in available staff.

REFERENCES

REFERENCES

Bureau, U. (n.d.). Census.gov. Retrieved April 15, 2021, from https://www.census.gov/

Diamond, L., Izquierdo, K., Canfield, D., Matsoukas, K., & Gany, F. (2019). A systematic review of the impact of patient–physician non-english language concordance on quality of care and outcomes. Journal of General Internal Medicine, 34(8), 1591-1606. doi:10.1007/s11606-019-04847-5

Javanparast, S., Roeger, L., Kwok, H., & Reed, R. (2020). The experience of Australian general practice patients at high risk of poor health outcomes With telehealth during the COVID-19 PANDEMIC: A qualitative study. doi:10.21203/rs.3.rs-123146/v1

Secretary, H., & (OCR), O. (2013, July 26). Civil rights Requirements Title VI of the civil Rights Act. Retrieved April 10, 2021, from https://www.hhs.gov/civil-rights/for-individuals/special-topics/needy-families/civil-rights-requirements/index.html

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