Improving the quality of translation for patients with language barriers

BACKGROUND: Patients with language barriers have worse health outcomes. To promote equitable care, efforts must be made to ensure effective communication with patients, specifically by using professional impartial translation services. AIMS: To build upon previous cycles to promote the use of professional impartial translation. METHODS: A multi-centre quality improvement project in the Acute Medicine Departments of Bart's Health Trust Hospitals in East London. Patients with language barriers were identified; methods of translation were analysed; and interventions to improve access to professional translation were introduced. Professional impartial translation was defined as use of either a member of staff or interpreter. RESULTS: The first three cycles were completed at the Royal London Hospital. Interventions included the dissemination of information to staff members and also the provision of Bengali interpreters on the ward. This improved the number of patients receiving professional impartial translation from 5% to 20%. Further cycles at Newham Hospitals were then undertaken. The initial intervention included the provision of a portable language line device providing 24hour access to professional translation via telephone or video. Despite this, <20% of patient received professional impartial translation, with >50% still receiving translation via a family member instead. Following departmental teaching sessions on the project, this improved significantly with 35.7% having in person and 33.3% having telephone professional translation. LESSONS: Translation is commonly provided by family members who are often seen as natural advocates for patients; however they may lack impartiality and may be selective in their translation. Impartial professional translation is essential in delivering equitable care. Improved access to translation services alone was not enough, with significant increases in impartial professional translation only being seen after education on its benefits. KEY MESSAGES: • Education of staff and easy access to translation services improve their use. • However, further research is needed to identify why family members are still chosen over professional services.