Patient Safety and Healthcare Quality: The Case for Language Access

Document Type : Perspective

Author

Hopkins Center for Health Disparities Solutions, Department of Health Policy and Management, Johns Hopkins Bloomberg School of Public Health, The Johns Hopkins University, USA

Abstract

This paper aims to provide a description of the need for Culturally and Linguistically Appropriate Services (CLAS) for Limited English Proficient (LEP) patients, an identification of how the lack of CLAS for LEP patients can compromise patient safety and healthcare quality, and discuss barriers to the provision of CLAS.

Keywords

Main Subjects


  1. Breaking down the Language Barrier: Translating Limited English Proficiency into Practice (Videos available from the U.S. Department of Justice Civil Rights Division at http://www.justice.gov/crt/pressroom/videos.php?group=2
  2. Texas Association of Healthcare Interpreters and Translators (TAHIT). Public Service Announcement [internet]. Available from: http://www.youtube.com/watch?v=UBLuaoGXOBg
  3. U.S. Census Bureau, 2010 Census. doi: 10.1007/s11113-013-9292-7
  4. U.S. Census Bureau, 2011 American Community Survey. doi: 10.1002/9781118662762.app6
  5. Pandya C, Batalova J, McHugh M. Limited English Proficient Individuals in the United States: Number, Share, Growth, and Linguistic Diversity. Washington, DC: Migration Policy Institute; 2001.
  6. U.S. Department of Health and Human Services, Office for Civil Rights. Guidance to Federal Financial Assistance Recipients Regarding Title VI Prohibition against National Origin Discrimination Affecting Limited English Proficient Persons [internet]. Available from: http://www.hhs.gov/ocr/civilrights/resources/laws/revisedlep.html
  7. U.S. Department of Health and Human Services, Office of Minority Health. Final Report: National Standards for Culturally and Linguistically Appropriate Services in Health Care, 2001. doi: 10.1177/1084822303253595
  8. U.S. Department of Health and Human Services, Office of Minority Health. National Standards for Culturally and Linguistically Appropriate Services (CLAS) in Health and Health Care [internet]. 2013. Available from: https://www.thinkculturalhealth.hhs.gov/content/clas.asp
  9. Institute of Medicine. Unequal Treatment: Confronting Racial and Ethnic Disparities in Health Care. Washington, DC: National Academies Press; 2002. doi: 10.1056/NEJM200309253491321
  10. The Joint Commission Sentinel Event Database [internet]. Available from: http://www.jointcommission.org/sentinel_event.aspx
  11. Flores G. The Impact of Medical Interpretation Services on the Quality of Health Care: A Systematic Review. Medical Care Res Rev 2005; 62: 255–99. doi: 10.1177/1077558705275416
  12. Flores G, Laws MB, Mayo SJ, Zuckerman B, Abreu M, Medina L, et al. Errors in Medical Interpretation and Their Potential Clinical Consequences in Pediatric Encounters. Pediatrics 2003; 111: 6–14. doi: 10.1542/peds.111.1.6
  13. Divi C, Koss RG, Schmaltz SP, Loeb JM. Language Proficiency and Adverse Events in U.S. Hospitals: A Pilot Study. Int J Qual Health Care 2007; 19: 60–7. doi: 10.1093/intqhc/mzl069
  14. Weise E. Demand Surges for Medical Translators at Medical Facilities. USA Today [serial on the internet]. 2006 July 20. [cited 2013 Nov 2]; Available from: http://www.usatoday.com/news/health/2006-07-19-medical-interpreters_x.htm
  15. Diamond LC, Schenker Y, Curry L, Bradley EH, Fernandez A. Getting By: Underuse of Interpreters by Resident Physicians. J Gen Intern Med 2008; 24: 256–62. doi: 10.1007/s11606-008-0875-7
  16. Ebden P, Carey OJ, Bhatt A, Harrison B. The Bilingual Consultation. Lancet 1988; 1: 347. doi: 10.1016/s0140-6736(88)91133-6
  17. Flores G, Abreu M, Schwartz I, Hill M. The Importance of Language and Culture in Pediatric Care: Case Studies from the Latino Community. J Pediatr 2000; 137: 842–8. doi: 10.1067/mpd.2000.109150
  18. Harsham P. A Misinterpreted Word Worth $71 Million. Med Econ 1984; 61: 289–92.
  19. Health Research & Educational Trust. Hospital Language Services for Patients with Limited English Proficiency: Results from a National Survey [internet]. 2006. Available from: http://www.hret.org/resources/1550998119
  20. Martinez EL. White Paper: For the Health Care CEO: Thinking about Language Access in Health Care [internet]. 2008. Available from: http://www.pgsi.com/Products/Resources/WhitePapers/WhitePaper1.aspx#form