Interpreters in ER may limit medical errors: study
Key points
- Having professional translators in emergency rooms for non-English-speaking patients may help limit potential miscommunications, according to a U.S. study.
- The study, conducted at two pediatric ERs and published in the Annals of Emergency Medicine, found that mistakes which could have "clinical consequences," like giving the wrong medication dose, were about twice as likely if there were no interpreters or if the translator was an amateur.
- "The findings document that interpreter errors of potential clinical consequence are significantly more likely to occur when there is an 'ad hoc' or no interpreter, compared with a professional interpreter," said lead researcher Glenn Flores, of the University of Texas Southwestern Medical Center in Dallas.
- An estimated 25 million U.S. residents have limited English proficiency - that is, they say they speak the language less than "very well."
Having professional translators in emergency rooms for non-English-speaking patients may help limit potential miscommunications, according to a U.S. study.
The study, conducted at two pediatric ERs and published in the Annals of Emergency Medicine, found that mistakes which could have "clinical consequences," like giving the wrong medication dose, were about twice as likely if there were no interpreters or if the translator was an amateur.
"The findings document that interpreter errors of potential clinical consequence are significantly more likely to occur when there is an 'ad hoc' or no interpreter, compared with a professional interpreter," said lead researcher Glenn Flores, of the University of Texas Southwestern Medical Center in Dallas.
An estimated 25 million U.S. residents have limited English proficiency - that is, they say they speak the language less than "very well."
By law, U.S. hospitals that receive federal funds have to offer some type of translation help for those patients. That can mean a professional interpreter who works for the hospital or telephone or video-based translation services.
Studies have found that patients like to have a translator available, and that it may improve care and cut costs, by avoiding unnecessary tests, for instance. But it hadn't been clear how well professional interpreters performed against amateurs, or no interpreter at all.
The current study was based on 57 families seen in either of two Massachusetts pediatric emergency rooms. All were primarily Spanish-speaking and 20 families had help from a professional interpreter.
Errors of Medical Interpretation and Their Potential Clinical Consequences: A Comparison of Professional Versus Ad Hoc Versus No Interpreters Presented at the Pediatric Academic Societies annual meeting, May 2003, Seattle, WA; and the AcademyHealth annual meeting, June 2003, Nashville, TN. Results
The 57 encounters included 20 with professional interpreters, 27 with ad hoc interpreters, and 10 with no interpreters; 1,884 interpreter errors were noted, and 18% had potential clinical consequences. The proportion of errors of potential consequence was significantly lower for professional (12%) versus ad hoc (22%) versus no interpreters (20%). Among professional interpreters, previous hours of interpreter training, but not years of experience, were significantly associated with error numbers, types, and potential consequences. The median errors by professional interpreters with greater than or equal to 100 hours of training was significantly lower, at 12, versus 33 for those with fewer than 100 hours of training. Those with greater than or equal to 100 hours of training committed significantly lower proportions of errors of potential consequence overall (2% versus 12%) and in every error category.
Written and revised by
Gerald Hurowitz, M.D.
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