The Growing LEP Patient Population

The U.S has incurred a massive influx of non-English speaking people from a variety of cultures over the last several years. Per the AHRQ, a colossal one fifth of the U.S. population speaks a language other than English within their home. For hospitals and health systems, this means a much greater limited English proficiency (LEP) patient population. In the wake of recent research suggesting that LEP patients are more negatively impacted by adverse events than fluent English speakers, healthcare professionals are in search of solutions to better address language barriers.

In the wake of recent research suggesting that limited English proficiency patients are more negatively impacted by adverse events than fluent English speakers, healthcare professionals are in search of solutions to better address… Click To Tweet

According to the Joint Commission, a U.S. based nonprofit that accredits more than 20,000 health care programs and organizations across the country, the leading causes of adverse events for LEP patients include:

  • A lack of meaningful communication &
  • A lack of qualified medical interpreters

Research conducted by the Agency for Healthcare Research and Quality (AHRQ) indicates that LEP patients who are not provided with meaningful access to care experience:

  • Greater risk for medical errors
  • Lengthier hospital stays
  • Greater difficulty following plans post discharge &
  • Higher risk of readmission

The Need for a Patient-First Standard

In response, the inclusion of a “patient-first” standard is being adopted by facilities nationwide, meaning that the welfare and safety of all patients, regardless of their culture or language, takes precedence over all other objectives. In addition, the Joint Commission, among other organizations, has exhibited a profound desire to emphasize the importance of competence in various languages and cultures. The key to fostering cultural competency in healthcare is providing LEP patients with the assistance of qualified medical interpreters. Qualified medical interpreters are trained to pick up on cultural nuances and act appropriately, navigating both the LEP patient and provider to mutual understanding.

The American Academy of Family Physicians defines cultural competency as “a set of congruent behaviors, attitudes and policies that come together as a system, that system, agency or those professionals to work effectively in cross-cultural situations. The word “culture” is used because it implies the integrated pattern of human thoughts, communications, actions, customs, beliefs, values and institutions of a racial, ethnic, religious or social group. The word competence is used because it implies having a capacity to function effectively.”

The National Center for Cultural Competence defines cultural competency as “the capacity of an organization and its personnel to communicate effectively, and convey information in a manner that is easily understood by diverse audiences including persons of limited English proficiency, those who have low literacy skills or are not literate, individuals with disabilities, and those who are deaf or hard of hearing”.

The Importance of Cultural Competency

Why is cultural competency so important? In order to provide meaningful access to healthcare information for LEP patients, cultural differences that impact communication must be taken into consideration.

Common language access barriers stemming from cultural differences include:

  • Linguistic Challenges
  • Understanding that medical decisions are made as a family
  • Making end of life decisions
  • Gender Roles
  • Religious choices when seeking treatment
  • Lack of eye contact
  • Not questioning
  • Late-stage diagnosis

The Role of Qualified Medical Interpreters

Interpreters who are medically qualified can quickly determine when a cultural difference is negatively impacting patient-provider communication and act accordingly. Healthcare programs and medical terminology from one country may function differently than in the United States and therefore require further explanation than a literal interpretation. Interpreters may need to interject additional information to explain a cultural nuance that may be impacting the patient-provider communication. For example, the word “hospice” holds a negative connotation for Latin American Spanish speakers, as it is an institution where elderly and disabled individuals are cared for, often with minimal resources. In the United States, however, hospice is a service where care is provided for a loved one within the comfort of their home. In order to ensure meaningful understanding of the term, the interpreter would need to explain the difference of its meaning in U.S. culture.

As the country continues to diversify at a rapid pace, the demand for culturally competent healthcare professionals is projected to rise. By having a comprehensive language access solution in place, hospitals and health care systems can ensure that LEP patients are provided meaningful access to their healthcare information with the assistance of a qualified, culturally competent language interpreter.


Photo by Andrew Stutesman on Unsplash

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