Department of Emergency Medicine, Olive View-UCLA Medical Center, 14445 Olive View Drive, North Annex, Sylmar, CA, 91342, USA.
Department of Emergency Medicine, UCSF, San Francisco, CA, USA.
J Immigr Minor Health. 2020 Jun;22(3):439-447. doi: 10.1007/s10903-019-00964-9.
Many ED patients have limited English proficiency (LEP). Under Title VI of the 1964 Civil Rights Act, LEP patients are entitled to language assistance, however, multiple studies demonstrate that language assistance is underutilized. We aimed to characterize the knowledge, practice patterns, and preferences of ED providers and staff regarding language assistance for LEP patients. We performed a self-administered, anonymous questionnaire in an urban, public ED where most patients have LEP. Subjects included all ED providers and staff with substantial patient contact. We recorded ED role, knowledge of language assistance policy, prior training on working with interpreters, non-English language skills and bilingual certification. Outcomes included frequency of and comfort level with respondent's own non-English language (NEL) use in the ED, and the preferred and most frequently used modalities of language assistance. Of the 354 total ED employees, 261 were approached and 259 agreed to participate, which represents a 73% response rate (259/354). Respondents were 37% MD/NPs, 34% RNs and 29% other ED staff. Only 50/259 (19%) had prior training on working with interpreters. 171/257 (67%) were "unsure" if the hospital had a policy on language assistance. The most frequent modalities accessed for spoken language assistance were "Other ED staff" 106/259 (41%) or "ad hoc interpreter" 62/259 (24%). Although 227/274 (83%) use a non-English language with patients regularly, comfort levels in using their NEL for clinical care were variable. Most ED providers and staff had little training in the use of language assistance and were unaware of hospital policy. Use of NEL skills by providers for clinical care is common. Dissemination of best practices for the provision of language assistance and the clinical use of NEL skills has the potential to improve communication with LEP patients.
许多急诊科患者的英语水平有限（LEP）。根据 1964 年《民权法案》第六篇的规定，LEP 患者有权获得语言援助，但多项研究表明，语言援助并未得到充分利用。我们旨在描述急诊科医生和工作人员对 LEP 患者的语言援助的知识、实践模式和偏好。我们在一家城市公立急诊科进行了一项自我管理的匿名问卷调查，该急诊科的大多数患者都有 LEP。研究对象包括所有有大量患者接触的急诊科医生和工作人员。我们记录了急诊科的角色、语言援助政策的了解程度、与口译员合作的培训经历、非英语语言技能和双语认证。结果包括受访者在急诊科使用自己的非英语语言（NEL）的频率和舒适度，以及受访者对语言援助首选和最常使用的模式。在 354 名急诊科员工中，有 261 人被联系，其中 259 人同意参与，这代表了 73%的回应率（259/354）。受访者中有 37%是 MD/NP，34%是 RN，29%是其他急诊科工作人员。只有 50/259（19%）接受过与口译员合作的培训。257 名受访者中有 171 人（67%）不确定医院是否有语言援助政策。最常使用的口语语言援助模式是“其他急诊科工作人员”106/259（41%）或“临时口译员”62/259（24%）。尽管 227/274（83%）的人经常与患者使用非英语语言，但他们在使用自己的 NEL 进行临床护理时的舒适度存在差异。大多数急诊科医生和工作人员在语言援助的使用方面接受的培训很少，并且不知道医院的政策。提供者在临床护理中使用 NEL 技能是很常见的。传播提供语言援助和临床使用 NEL 技能的最佳实践方法有可能改善与 LEP 患者的沟通。
