The experience of interpreter access and language discordant clinical encounters in Australian health care: a mixed methods exploration.

Abstract:

BACKGROUND:Current evidence highlights that language discordant clinical encounters seriously compromise patient quality of care and health outcomes. We aimed to characterise patterns of interpreter service use in medical inpatient wards use and explore clinician experience of language discordance. METHODS:Participants included medical students, residents, attending physicians, nursing and allied health professionals working in General Internal Medicine wards across two tertiary referral hospitals servicing a large Australian health care area. This study involved a retrospective electronic medical record audit of interpreter use. Six focus groups were conducted with 32 participants. Data were analysed using an inductive thematic approach with constant comparison. RESULTS:Allied health professionals were identified as the largest users of interpreter services, followed by medical doctors. Distinct themes emerged regarding clinician experiences of language discordant encounters including: (1) Negotiating care when unable to get an accurate assessment; (2) Over servicing to fill in the gaps; (3) Using family members instead of professional interpreters: a vexed solution; (4) Disparities in care provision; and (5) Communication drought: broken by a flood. CONCLUSIONS:Patients with low English proficiency are at risk of being less informed of care processes, and having a very large volume of information given in a shorter period of time when an interpreter is present. There is a need for systematic and transformative change that addresses utilisation of professional interpreters as well as embedded healthcare culture and practices leading to less interaction with patients with limited English proficiency and reliance on family members as informal interpreters.

journal_name

Int J Equity Health

authors

White J,Plompen T,Osadnik C,Tao L,Micallef E,Haines T

doi

10.1186/s12939-018-0865-2

subject

Has Abstract

pub_date

2018-09-24 00:00:00

pages

151

issue

1

issn

1475-9276

pii

10.1186/s12939-018-0865-2

journal_volume

17

pub_type

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