What happens when a non-English speaking patient needs treatment in the US?
Unless you have a Qualified Bilingual Staff (QBS) member nearby, you find an interpreter, if one is available.
While there is a growing body of research on the impact of concordant care and the elevation of patient outcomes, there is relatively little written about the impact of the language barrier for emergency service workers.
One recent study (2023) led by Kathryn Stadeli (UC Davis), et al, helps close that gap and sheds light on a troubling problem pervasive throughout healthcare: providing quality, timely care for patients with limited English proficiency (LEP).
The study (and outcomes)
In the study, researchers surveyed 39 EMS workers, including 26 firefighters and 13 paramedics on the conditions and outcomes of treatment with patients with limited English proficiency and determined that the quality of care was significantly worsened by three main factors:
Simply put: the study concludes that language barriers hindered patient-provider communication, which made it harder for EMS workers to assess patient conditions.
Currently there are over 25 million patients with limited English proficiency (LEP) in the US. And not a lot of support to address the language barrier in health care.
While interpreters remain the gold standard in language services for patients, there are often not enough available to fill the need, or do so in a timely manner. The result is that healthcare workers frequently operate within a "gray area" of compliance to meet the needs of patients.
This is especially true in emergency scenarios.
Patient-Clinician Relationships Matter (a lot)
EMS workers in the study indicated that trust in the relationship between the patient and provider were important and negatively impacted by the language barrier, problems exacerbated by inherent biases and cultural differences carried by both parties.
Mistrust often worsened already poor communication to create a situation where EMS workers, in order to "play it safe," transported the majority of patients to a hospital, even when they felt it was unlikely that they needed to admit.
The result is unnecessary cost and stress accumulated by the patient and provider and fewer available beds for those in most need.
Learn how Canopy is breaking down the language barrier in healthcare.
Interpreters are needed, but can't be everywhere at once
Many participants in the study had positive reviews about experiences with interpreters, but indicated they needed a lot more. Further, for emergency workers, time is of upmost importance and waiting for interpreter services can result in catastrophic delays for patients.
The researchers explained: “The time from initial call to connection with the interpreter was the primary delay, and a previous study demonstrated that telephonic interpreting during 911 calls led to increased time to dispatch of paramedics and increased time to initiation of bystander cardiopulmonary resuscitation.”
EMS Workers: We need more diversity; bilingual staff
One core solution suggested by EMS workers: hire a more diverse, bilingual staff that can speak directly with patients and better understand the cultural nuances that serve as a barrier to providing high quality care.
The researchers note: “The EMS workforce is also mostly composed of white males and diversification would improve prehospital care through improved communication, trust, and interpersonal interactions...While the underlying causes for these problems are multifactorial and complex, the first step in working toward equitable high-quality care is recognition that this problem exists.”
Want to learn how you can develop your own bilingual workforce within your organization, and save limited language interpreter minutes for the most critical communications?
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