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Interpreters in the ED: A Look at Errors & Consequences

According to recent United States Census estimates, more than 25 million Americans have limited English proficiency (LEP), and many of these individuals are school-age children. Language barriers affect multiple aspects of healthcare for LEP patients, including access to care, health status, use of health services, and patient safety. LEP patients often defer needed medical care, have higher risks of leaving hospitals against medical advice, and are less likely to have a regular healthcare provider. They’re also more likely to miss follow-up appointments and to be non-adherent with medications. “Medical interpreters are an essential component of effective communication between LEP patients and healthcare providers.” Federal policy requires that hospitals provide adequate language assistance to LEP patients. Medical interpreters are an essential component of effective communication between LEP patients and healthcare providers. Professional interpreters are hired specifically to provide language services to LEP patients, but all too often, language services are provided by ad hoc interpreters. These individuals—who range from family members and friends to hospital/clinic employees and strangers from waiting rooms—are untrained in medical interpretation. A New Comparison of Interpretation Methods Previous studies have shown that family members and untrained bilingual people who provide ad hoc interpretation can commit many errors of interpretation. No investigation, however, has been conducted comparing these errors and their potential consequences in encounters with a focus on professional interpreters versus ad hoc interpreters or no interpreters. In the March 2012 Annals of Emergency Medicine, my colleagues and I had a study published in which we performed a cross-sectional error analysis of audiotaped ED visits during a 30-month period in the two largest pediatric EDs in...
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