“Language access” is what allows service providers to communicate with patients or clients who speak limited English.
You assure language access when you provide:
Interpreters, such as
- Staff interpreters
- Dual-role interpreters (bilingual staff, hired for another purpose, who have been trained to interpret when necessary)
- Freelance interpreters
- Telephonic interpreters
- Video interpreters
Bilingual service providers
- Whose language skills have been screened
Translated documents, such as
- Consent forms
- Discharge instructions
- Patient instructions
- Patient rights forms
- Financial statements
Multilingual or pictorial signage
- Where’s the Emergency Department?
- How do we find Pediatrics?
- Is the cafeteria down this way?
Multilingual phone options
- For English, press one
- Para español, oprima el número 2
- Pour le français, aprete le numero 3
Anything you do that helps bridge a language barrier creates language access.
And why should you care?
Our patient populations are changing.
Between 1990 and 2000, the number of people in the U.S. with limited English proficiency (LEP) rose from 14 million to 21.3 million – from 6.1% to 8.1% of the population. By 2008, it had increased to 8.6%. 47 million people speak a language other than English at home. And more than 11 million households are linguistically isolated, meaning that nobody in the family speaks English (US Census data). And in addition to increasing in the states we usually associate with linguistic diversity (such as California, Texas and Florida), LEP populations grew the most in states that had been traditionally linguistically homogeneous: North Carolina, Georgia, Nevada. The need for language access in health care has never been greater, nor more widespread.
Language access promotes access to care.
Immigrant and refugee communities repeatedly identify language as one of the principle barriers to accessing quality health care. Patients with limited English proficiency (LEP) who cannot access routine care are more likely to have poor health outcomes, to have children with unmanaged chronic health problems, and to end up in the Emergency Department with serious and costly complications.
Language access is the law—and required for Joint Commission accreditation.
- The Americans with Disabilities Act (ADA) requires interpreters for patients who are deaf or hard of hearing.
- Title VI of the 1964 Civil Rights Act prohibits discrimination on the basis of race, color or country of national origin. The Supreme Court, in Lau vs. Nichols (1974), ruled that language is an aspect of country of national origin. So if your facility receives any kind of federal funding and so is bound by the 1964 Civil Rights Act, you must provide language access to your services.
- Many civil liability suits have been won based on poor outcomes caused by language barriers.
- New Joint Commission accreditation standards in 2011 are even clearer about the requirement to provider language access to care.
Providing clear communication across language barriers from the first encounter saves money and promotes efficiency.
Access to interpreters and the resulting clear communication supports correct diagnosis, appropriate use of diagnostic exams, and increased use of primary care over the ED. It also supports appropriate rates of clinic throughput, leading to greater systems efficiency.
Providers can’t do their jobs if they can’t communicate clearly.
Communication is the heart of health care. The single most important—and the cheapest—diagnostic test that healthcare providers perform is the medical interview. But how can providers get a good history if they can’t communicate easily with their patients? How can the share a diagnosis, explain a treatment regimen, or follow up on results?
The bottom line is, when language barriers are not addressed, providers can’t do their jobs, patients can’t get the care they need and deserve, health care systems get backed up and care is more expensive.
So whether you are an LEP patient, a healthcare administrator, a healthcare provider, a community advocate, an interpreter or just someone waiting to be seen in a busy clinic or emergency room, language access is important to you.