April 2006

Research is a driving force enabling health care providers and organizations to strive to reach the cutting edge in health care quality. Unfortunately, there is a dearth of research on language barriers within the health care field, according to a new report in the Milbank Quarterly. The limited information currently available is too scarce to support sound policymaking choices.

The report, entitled The Need for More Research on Language Barriers in Health Care: A Proposed Research Agenda, highlights the absence of both the quality and quantity of relevant information about language barriers, and calls for a more rigorous and scientific approach to gather and analyze data on language access. The report identifies the following gaps and weaknesses in the current research literature:

• No clear explanation on how language barriers contribute to the differences between LEP and English-speaking patients.
• Little guidance on which interventions best reduce language barriers.
• Lack of research on how to best establish and use interpreter services.
• Lack of research on the costs of ensuring linguistic access.

Quality research on language barriers is necessary to inform the health care industry on the best solutions and practice. It is also used to provide health care providers and policymakers with the evidence they require to design and effectively develop linguistically accessible services for LEP patients. This is especially crucial as more frontline clinicians care for LEP patients.

To address this critical need for research, Hablamos Juntos is partnering with the Society of General Internal Medicine (SGIM) to focus attention on language access. Editors from SGIM’s Journal of General Internal Medicine have agreed to publish a special supplement on language barriers in health care next year. The goals of this theme issue include:

• Highlighting research on the effects of language barriers on access, quality and cost of health care;
• Providing insight for researchers, administrators and policy makers on addressing language barriers in healthcare settings;
• Drawing attention to unexplored areas of research and education.

Look for a Call for Papers in JGIM’s June issue. Submissions from clinician investigators, clinician educators, social scientists and policy makers are encouraged between now and October 2, 2006.

For further information on the types of submissions being accepted and contact information, click here.

"Foreign language skills are not only perishable but also crucial for U.S. national security and for its commercial, academic and government leadership throughout the world”

The rate of bilingualism in India, Japan and other countries outpaces the United States. A new initiative recently unveiled by President Bush is designed to change that. The National Security Language Initiative (NSLI) is a plan designed to increase the number of Americans who speak Arabic, Chinese, Russian, Hindi, Farsi and several Central Asian languages, spurring the growth of language development programs beginning in grade schools. The effects of this initiative are far reaching and may have spin-off benefits for health care.

While increased language competency is a national security issue for the United States, it is an economic and education priority in many countries such as China and European Union nations, where students begin learning a second language before age 10. The result is increased numbers of individuals able to function across languages and develop new business relationships in countries other than their own.

In health care, increases in immigration have led to an enormous growth in the number of cross-linguistic medical encounters taking place throughout the United States. As a result, the need for interpreters has become a fact of contemporary medical practice. One study of 83 U.S. public and private hospitals found that 11 percent of all patients required the services of an interpreter.

Currently, there is no standard form of certification in the U.S. for translators or interpreters. The American Translators Association, The Translators and Interpreters Guild, and the National Association of Judiciary Interpreters and Translators all offer different accreditation and certification programs. National attention on cross language communication and federal investments to grow language resources will be an added boost to these voluntary efforts.

Another promising strategy, developing a registry of national language resources has been taken on by the newly established National Virtual Language Center (NVTC). The database of translators and interpreters and other NVTC activities aim to create national connectivity among elements of the U.S. Government, academia, and private sectors that need ongoing or intermittent language experts. Hospitals and other health providers currently on their own to find qualified interpreters for their growing numbers of LEP patients, could learn from these efforts.

For more information on this initiative, please click here or here.

Frontline health care clinicians are increasingly caring for patients who speak who speak Spanish as their primary language. In fact, 11 percent of patients seeking medical care in the U.S. primarily speak Spanish. Nurses and physicians on the front line of health care are the most visible to patients seeking medical advice and treatment.

University of Kentucky researchers interested in reducing frustration and stress for front-line level staff tested the benefits of a low-tech solution with English-speaking clinicians caring for Spanish-speaking patients. With input from both nurses and physicians the researchers developed pocket-cards with translations of commonly used phrases. The researchers developed cue cards that measure 128 mm x 77 mm, small enough to be held in a pocket known as FAST (Focused Accessible Spanish Translator). These portable and accessible cue cards contain the most widely used phrases by front-line staff.

The results of the study found that overall, 91 percent of nurses and 72 percent of physicians found that the simple translated sentences met their needs when interacting with LEP patients. This seems to indicate that there is need for low-tech translation tools within the health care field and their impact upon the quality of care for LEP patients cannot be diminished.

As part of a series of Joint Commission on Accreditation of Healthcare Organizations (JCAHO) symposia addressing major public policy issues, JCAHO is examining language implications on the delivery of medical care in June. Health Literacy: The Foundation for Patient Safety, Empowerment, and Quality Health Care will present a broad spectrum of solutions developed by leaders in various health care settings.

This event is scheduled to be held on June 26-27, 2006 at Sofitel Chicago O’ Hare in Rosemont, IL. To register click here.

Hablamos Juntos (Spanish for “We Speak Together”) is a national program of the Robert Wood Johnson Foundation to eliminate language barriers that can lead to medical errors and compromise the quality of care. Building on the work of ten demonstration sites around the country Hablamos Juntos is committed to developing practical solutions health care organizations can use to improve the care delivered to limited English proficient patients.

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