DIVERSITY, EQUITY & INCLUSION
Language Accommodations: Best Practices for Working With Interpreters
SAEM PULSE | MAY-JUNE 2023
By Luke Johnson, MD, IV Mirus, MD, and Jason Rotoli, MD, on behalf of the SAEM Academy for Diversity and Inclusion in Emergency Medicine (ADIEM) and the ADIEM Accommodations Committee
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Rochester has one of the largest per capita Deaf populations in the United States, and our hospital has 24/7 ASL interpreting available for Deaf patients and staff. In this article, we want to share some best practices for those who work in healthcare, particularly in emergency medicine, where time is of the essence and resources are limited.
Introduction
Research has extensively shown that patients face severe challenges when language barriers exist in health care settings. These challenges include worse clinical outcomes, difficulty navigating health care processes, and increased medical errors. In contrast, patients report better outcomes when medical interpreters are utilized, or
when their health care provider speaks their primary language. The importance of providing accessible health care to patients with limited English proficiency has been further emphasized by the joint commission’s establishment of Standard RI.01.01.03 in 2010, which asserts that patients have the right to receive medical information in a way they can understand. This requires hospital systems and providers to provide interpretation services to nonEnglish speaking patients, which can include portable virtual tablets, in-person interpreters, and language preference verification. Establishing the patient’s language preference is the first step towards providing accessible health information, and offering interpretation in their primary language through a
qualified interpreter is considered the gold standard. However, pitfalls while working with interpreters are common and include: unadjusted (fast) rate of speech, directing conversation to the interpreter instead of the patient, poor patient engagement, poor positioning, assumptions regarding the role of the interpreter, not giving enough time for the patient encounter, and inadequate cultural awareness. To improve communication with our patients, it is crucial to establish effective working relationships with interpreters. So, how does one work with an interpreter? And is working with one for a spoken language the same as working with an ASL interpreter? Here, we provide a summary of best practices