TOW #5: Working with Limited English Proficiency (LEP) patients

As we work with our increasingly wonderfully diverse families in Seattle, we have an imperative to become experts in navigating visits with families who do not speak English as their primary language. One of our very talented gen peds faculty, Casey Lion, has developed this TOW to share her expertise and research in working with families with Limited English Proficiency (LEP). Here are the resources for this week:

Take-home points in working with families with LEP:

  1. Relevance: In the US 15% of children live with at least 1 parent who has LEP; that proportion is much higher in some areas, and it is growing everywhere.
  2. Importance: language barriers are associated with decreased adherence, comprehension, and satisfaction with care, as well as poorer outcomes and increased adverse events. Families with LEP are at risk for inequity. It is our responsibility to try to decrease that risk and prevent errors by using certified interpreters.
  3. The LAW: Under Title VI of the Civil Rights Act of 1964, federal law requires providers or institutions that receive any federal dollars (including Medicaid, Medicare) to provide medical care in a language patients understand. The rule applies to nearly every hospital and private group in the country. Under the Culturally and Linguistically Appropriate Care (CLAS) Standards, we are legally required to provide professional interpretation.
  4. How to know when an interpreter is needed: To determine if a patient or caregiver needs an interpreter, ask what language they prefer for discussing medical information. If they want to use a family member or friend to interpret say: “I am so sorry—hospital policy requires me to use a professional interpreter.” Teach-back is an excellent strategy to use to assess for parent or patient understanding.
  5. What type of interpreter form is best: patients and families tend to report equal degrees of satisfaction with in-person, telephone, and video interpretation, while providers tend to prefer in-person and video interpretation. All of the above work well, we just need to use them.

Enjoy getting to work with your families from all over the world!