Study: Having Interpreters in the ER Improves Safety, Efficiency, Overall Mood

Patients who are not proficient in English and provided with professionally trained, in-person interpreters in the emergency department report higher satisfaction with their communication in the ER, as do the physicians treating them, according to the results of a randomized controlled trial released online in Annals of Emergency Medicine.

According to the article, titled “Examining Effectiveness of Medical Interpreters in Emergency Departments for Spanish-Speaking Patients with Limited English Proficiency: Results of a Randomized Controlled Trial,” the increase in limited-English-speaking patients has led to hospitals using a variety of interpretation methods for these patients. They include using a family member as an interpreter, using a member of the hospital staff as an ad hoc interpreter or using simultaneous interpretation via headphones (also known as the UN model). This study used interpreters who had received training in medical interpreting and were dedicated to the emergency department for purposes of the study.

“The magnitude of the difference was striking: Patients who had professional in-person interpreters were four times more likely to be satisfied than patients who didn’t,” said lead study author Ann Bagchi, Ph.D. of Mathematica Policy Research in Princeton, N.J. “The results were the same for physicians and nurses, which could be important for reducing staff burnout and errors. The improved quality of care can also reduce the likelihood that a patient will return to the ER for the same health problem.”

Researchers enrolled 242 patients in the in-person, professional interpreter group and 205 patients in the control group. Departing from the traditional method of randomized trials, researchers used a cluster-randomizing design, in which time blocks instead of individuals were assigned to interpreter or control conditions. Of the patients assigned to the interpreter group, 96 percent were “very satisfied” with their ability to communicate during the ER visit. Of the patients in the control group, only 24 percent were “very satisfied.”

“Professional interpreters can improve efficiency and throughput in the ER and can shorten overall length of stay, an important consideration in view of Press Ganey’s recent report showing a new high in the average amount of time people are spending in the ER,” said study co-author Robert Eisenstein, M.D., FACEP, vice chair of the department of emergency medicine at Robert Wood Johnson University Hospital in New Brunswick, N.J. “Using the same interpreter from triage to discharge creates continuity of care and also ensures that we are not missing anything important when talking to the patient. It has the potential to help us get a more accurate patient assessment on arrival in the emergency department as well as better patient compliance with discharge instructions because the patient actually understands what we’re telling them to do!”

Annals of Emergency Medicine is the peer-reviewed scientific journal for the American College of Emergency Physicians, a national medical society. ACEP is committed to advancing emergency care through continuing education, research, and public education. Headquartered in Dallas, Texas, ACEP has 53 chapters representing each state, as well as Puerto Rico and the District of Columbia. For more information visit www.acep.org.

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