Language Access and the Prevention of Medical Errors

Language Access and the Prevention of Medical Errors
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The case of Francisco Torres, a Spanish-speaking patient in Riverside, Cali., who had the wrong kidney removed during surgery, once again gives the medical community reason to pause and consider the absolute necessity clear communication plays in avoiding catastrophic medical errors. While wrong-site surgery can happen without a language barrier, the fact that Mr. Torres was not provided a medical interpreter prior to major surgery is deeply concerning.

Statistics show that language is a major factor in cases of misdiagnosis and instances of poor treatment at hospitals, and delays in service or access to preventive care. Medical error in general is a troubling issue, but patients with limited English proficiency are almost twice as likely to suffer adverse events in U.S. hospitals, resulting in temporary harm or death, according to a pilot study by The Joint Commission - an independent, not-for-profit organization that evaluates and accredits more than 15,000 health care organizations and programs in the United States.

The fact is, the medical system is failing those who have limited English skills - and there are many people who fall into this category. According to census data, over 47 million people in the U.S. speak a language other than English at home, and nearly 23 million are considered limited English proficient (LEP). Overall, more than 176 different languages and dialects are spoken across the country.

Given the growing number of LEP patients across the country, we need a federal call to action that includes a nationally recognized process for certifying medical interpreters, a requirement that only certified medical interpreters may be employed by health care organizations, as well as funding to help hospitals pay for these vital patient safety measures.

While we are still waiting for this sweeping federal mandate that requires trained and tested medical interpreters, the good news is that there is now a nationally available procedure in place that can help determine whether medical interpreters are adequately prepared. After years of research and development by different organizations, the independent National Board of Certification for Medical Interpreters launched the Certified Medical Interpreter (CMI) program in October 2009. With this independent certification process, developed by leading industry professionals from a range of organizations and specialties, hospitals, physicians and even individual patients can now begin to ascertain whether or not the interpreters they rely on are in fact experienced and qualified.

Despite this progress, the lack of reimbursement is seen as a huge roadblock for many hospitals and providers in their ability to offer patients a comprehensive language access program, contributing to health care disparities and a waste of health care dollars. Many in the medical interpreter profession have been advocating for patient safety and the need for both reimbursement for medical interpretation services and a federal requirement that only certified interpreters may be employed. Our effort included a recent Medical Interpreter Advocacy Day on April 30, where more than 200 meetings were held on Capitol Hill on this very issue.

Until steps are taken at a national level to protect LEP patients from painful, disabling and even deadly medical errors, we will continue to see the consequences of language barriers in medical settings, including the tragic case of Mr. Torres, whose quality of life has been irrevocably harmed.

A qualified medical interpreter is quite literally the bridge to potential life-saving care for LEP patients. As a nation, we must work together to build a strong foundation for that communication bridge - a nationally recognized procedure to ensure that every interpreter on the job is really and truly up to the task. And that reimbursement for language access services for hospitals becomes a reality.

It is a matter of life and health.

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