Health Information Technologies and Processes

Language Barriers

  • 1.  Language Barriers

    Posted 07-06-2020 14:43
    I am curious if other facilities are having this issue and how you are handling it.  We have recently had a few patients present to our respiratory hut who did not speak much English.  When offered the language line the patient declined noting they could not speak English but could understand it.  However, it was clear that the patient did not understand as staff felt the patient needed to be seen in the ED instead and she drove off.  Clearly the language line would have been helpful.  How would you handle this?

    Thank you

    Ilene Estabrook
    Him Manager

  • 2.  RE: Language Barriers

    Posted 07-06-2020 15:38

    You can try some of the printed materials that are available from various resources (below), not just as handouts for walk-ins / in-person patients, but also for your website.  Staff can use these sheets, their monitors, or if necessary, even their phones, or an available tablet, so that either an in-person patient, one on the phone, or one asking via a patient portal can have access to this information when you don't have a translator immediately available or they are serving another patient.   You can choose which ones you need and share/post those, or potentially direct patients to the links (but tech may be another barrier issue in some cases).  Optimal utilization of these resources will likely vary greatly by patient population being served and type of setting.

    Free COVID-19 fact sheets in 35+ languages have been created by the COVID-19 Health Literacy Project in collaboration with Harvard Health Publishing. New languages are being added periodically.  The fact sheets can be found here: COVID-19 Fact Sheets
    Health Information Translations provides education resources in multiple languages for health care professionals and others to use in their communities. Resources are reportedly easy-to-read and culturally appropriate.

    The CDC also has a resource page for information in other languages

    Another 'Roundup' for Multilingual Resources on COVID19

    Also, courtesy of CyraCom, they used CDC Guidelines to create an educational video in American Sign Language to give an overview of Coronavirus (COVID-19), symptoms to look out for, and how people can help stop the spread (link also below) -->

    CDC ASL Video Series:
    How does it spread -->
    Symptoms of Coronavirus -->
    Third party educational link --> "What you need to know about Coronavirus"

    England's NHS also has resources in other languages -->

    Hope this helps!

    A. Andrews Dean, CPHIMS, CHDA, CPHI, CPPM, CPC
    AHIMA-Approved Data Analytics Trainer
    Health IT & Healthcare Compliance Consultant

  • 3.  RE: Language Barriers

    Posted 07-06-2020 18:47

    This can be challenging and I agree with Ashley's recommendations. I'm also wondering...

    Perhaps there are issues besides language to consider in the scenario you described? It has been my experience that immigrant and ESL patient populations access healthcare from a different position, and maybe the idea of going to the ED puts them at risk in other ways. Might there be someone on staff (or someone that can be hired) who can speak to these patient populations in their language? Many organizations struggle with this and there are no easy answers, but I think being willing to have the discussion and open to identifying interventions is a great start - kudos to you for putting this challenge out there.

    Here are a couple of links that may be helpful:
    Hope this helps. Keep asking those questions and being open to solutions!

    Maria Caban Alizondo
    Director, Hims
    UCLA Health System

  • 4.  RE: Language Barriers

    Posted 07-07-2020 09:22
    Ilene...what a valuable "real world" example you share.  Thanks!

    I believe that despite even the best of efforts, there may be people who for whatever reasons will refuse to make use of the available language services that you are providing.  I strongly suggest that (and this can really help if the patient or someone involved with the patient decides to file a complaint) when the services are refused, the patient's chart has clear documentation describing the steps taken to inform the patient of the language services and the patient's subsequent refusal to use these services.  You can just about guarantee that when a complaint is made and the investigation occurs, this documentation will be a real help and often shows that you did your part and that's all that can really be expected.

    Frank Ruelas
    Compliance Professional

  • 5.  RE: Language Barriers

    Posted 07-07-2020 10:57
    Thank you to everyone for providing such great ideas, thoughts and references,  Much appreciated.

    Ilene Estabrook
    Him Manager