Inova
Fairfax Hospital works to remove language
barrier between foreign patients, healthcare
providers.
When Elita Christiansen, vice president of
Community Health and Cultural Competence at
Inova Fairfax Hospital, received a call that
her father had suffered from a stroke, she
rushed to the hospital in Florida to be
with him.
Her father, an immigrant and a doctor of 30
years who became nearly fluent in English,
came out of the stroke with only the ability
to speak in his native language, Spanish. His
doctors could not communicate with him
because of the language barrier.
Subsequently, he was evaluated at a lower
level for his rehabilitation because no
interpreter was present during the
assessment.
This story is an all too familiar
situation for families who don't speak
English but need medical care.
On Friday, June 1, Inova and Language Line
Services offered a forum to address the
cultural needs of the rapidly changing
population in Northern Virginia.
"Hospitals cannot provide care if patients
and providers cannot communicate,"
Christiansen said.
In 2006, Inova treated approximately
48,000 Limited English Proficient (LEP)
patients system wide, said Martine Charles,
director of Cultural Competence and Community
Health Division at INOVA and director of the
forum.
Janet Erickson-Johnson, director of
Interpreter Certification at Language Line
University, defines Limited English
Proficiency as, "Those who have a limited
ability to read, write, speak, or understand
English."
"Life and death decisions are being
made
without the patient being confident on what
they have been told," Charles said.
Language barriers and the lack of medical
comprehension often leads Limited English
Proficient respondents to report problems in
understanding medical situations and
comprehending the use of medication,
according to a study by Elisabeth Wilson
published in the August 2005 Journal of
Internal Medicine.
Stories of misinterpretation of directions
and diagnoses litter hospital floors. Tina
Arcidiacono, South Jersey Healthcare Patient
Relations Manager, told of a LEP patient who
was diagnosed with a fatal disease. When he
died, his wife informed hospital officials
she had no idea he had ever been that sick.
"Facilities' efforts to improve
communication with LEP patients are hampered
by little or no resources," Erickson-Johnson
said.
"Bilingual friends and family members, even
children, continue to be used to interpret
for LEP patients because of lack of readily
available interpreters in a wide variety of
languages," she said.
Risks associated with family members
interpreting for their sick relatives include
limited knowledge of medical language,
emotional and psychological trauma resulting
if the patient is in a critical situation,
misinterpreting directions and translating a
statement incorrectly," Erickson-Johnson said.
Because of these risks, "hospitals, such as
Inova, have put in place several levels of
interpreter services, which vary in location
based on the need," Charles said.
"All locations have access to telephonic
interpreter services, contracted on-call
interpreters in 70 languages and trained
bilingual staff," she said.
"Language Line Services, which has been
partnered with Inova for the past two years,
provides language services throughout the
entire Inova system," said Jeanette Anders,
Healthcare and Business Manager of Language
Line Services.
Language Line Services supplied Inova with
approximately 400 dual handset phones.
These
phones allow the provider to pick up one
phone and the patient to pick up the other
with an interpreter on the other line. Direct
dial buttons on the phone allow for easy
connection to an interpreter on the other line.
Inova also employs interpreters to work at
the hospital.
Interpreters from the OB/GYN unit at Inova
attended the forum to support the use of
interpreters for LEP patients.
Maria Teresa Lemus, a medical interpreter
in the unit, was currently working with a
woman who is pregnant with quintuplets and is
in the high-risk unit.
"It is going to be difficult for her to
bring her pregnancy to term, and she doesn't
speak any English to talk with the doctors,"
Lemus said.
"The medical interpreters carry telephones
connected to their belts and whenever an
interpreter is needed in their unit they
receive a call," said Barbara Perez, medical
interpreter.
"We just began having 24-hour coverage for
women's services," Perez said.
The doctors, nurses and the interpreters
work as a team when helping LEP patients.
Perez said that the doctors were the ones who
lobbied hard for having interpreters in the
OB/GYN unit 24 hours.
The "Forum" also included other technologies
that are used at the hospital such as live
video interpreting which can be essential
when dealing with a deaf patient. The patient
and doctor can see and hear the video screen,
while the interpreter, who could be anywhere
in the country, can translate.
"Our population continues to grow and
become more diverse," said Karen Gilhooly of
Language Line Services.
"Today are the beginning steps of making a
change," she said.
"We still have a long way to go to assure
adequate language access to care," said
Cynthia Roat, consultant and trainer, "but at
least we're on the road."
This article is reprinted with permission
of
Talia Katz and copyright Connection
Newspapers 2007.
