Overcoming language barriers key to providing health-care

Language barriers are becoming an increasingly important consideration when patients from Canada’s diverse and multicultural population are admitted to hospital. As clinicians, we see that for patients facing such barriers, communicating with a primarily English-speaking health-care team can be challenging and can lead to barriers to care.

As far back as 2001, a federal report identified language as a significant barrier for many to access health care. This is intensified when patients are admitted to the hospital. Although large studies show no evidence that patients with limited English proficiency have higher mortality in North America, we know that language barriers can significantly affect a patient’s journey in a hospital setting.

For example, studies show that hospitalized patients with limited English proficiency are more likely to experience medical errors, particularly drug-related errors. In addition, they experience longer lengths of hospital stay and are more likely to be readmitted within a short period of time. Language barriers can cause miscommunication, resulting in delayed treatment, incorrect medications administered, or allergic reactions to foods or medications. These errors could potentially be avoided through investments in interpretation services for patients in the health-care setting.

The use of medical interpreters has been shown to reduce medical errors. This has been primarily demonstrated with professional interpreters, though “ad hoc” translators like health-care workers or family members can still be beneficial. Unfortunately, there is varying access to professional interpreters across Canada.

While many hospitals have phone interpreters available, these services can be difficult to access after hours or in time-sensitive medical emergencies. Additionally, for many elderly patients with memory or hearing impairments, the use of these tools can be challenging. However, access to video interpreters is available only in some practice settings but not others.

We believe family can play a role in helping overcome language barriers. But to best provide support, preparation is key. When visiting the emergency department, up-to-date lists of medications and allergies can be immensely helpful. The same is true for copies of reports or tests, especially for events that took place outside of Canada. Family can help compile these details in advance and bring them with patients.

It is also beneficial for families to be at the bedside with patients when possible and to be easily available by phone (especially by video call). Family are valuable translators, particularly when patients speak less common dialects or have memory or hearing impairments. They can also provide additional insight into how a patient’s condition affects them at home.

To better serve our multicultural patients, we need commitments to improving care for patients with language barriers. During the COVID-19, the delivery of virtual care has been encouraging and we are hopeful that further advancements in technology can be leveraged to shrink the language barrier in the hospital setting.This way, all patients, regardless of their cultural background, are coming to the hospital as supported as possible.

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