Language barriers lead to medical error

COMMUNICATION problems involving patients with limited proficiency in English is a leading cause of medical errors, yet there has been little effort to address and prevent them, says a study in the Journal for Healthcare Quality (JHQ). Situations in which adverse events and medical errors were most likely to occur are medication reconciliation, patient discharge, the informed consent process, emergency department visits and surgical care

Three of the most common causes for medical errors attributed to insufficient patient language proficiency were identified:

? Use of family members, friends or non-qualified staff as interpreters
? Clinicians with basic foreign language skill who try to communicate without using qualified interpreters 
? Cultural beliefs and traditions that effect health care delivery.

Lead author Melanie Wasserman of Abt Associates and colleagues reviewed and evaluated two evidence-based tools from recommendations published by the Agency for Healthcare Research and Quality (AHRQ) titled “Improving Patient Safety Systems for Limited English Proficient Patients.”

AHRQ recommended that strategies and systems to prevent medical errors should include strengthening interpreter services, improving coordination of clinical services, providing translated patient education materials, and improving training for healthcare staff for communication, interpreter use, cultural awareness and advocacy.

“We found the tools contained in the AHRQ’s recommendations for improving communication with limited English proficiency patients are implementable and conducive to learning, but further research on the impact of the guide is needed to shed light on its value as a multifaceted intervention,” said Dr. Wasserman.

JHQ is the peer-reviewed publication of the National Association for Healthcare Quality (NAHQ).