Dr Jennifer White has over 25 years experience as an occupational therapist and researcher across a range of settings including acute, post-acute, and community health care. Dr White is passionate about the of delivery of evidence based and holistic person-centered care. She has expertise in longitudinal, mixed methods research to formulate, implement and evaluate health programs.
The experience of interpreter access and language discordant clinical encounters in Australian health care: A mixed methods exploration.
Current evidence highlights that language discordant clinical encounters seriously compromise patient quality of care and health outcomes.
To characterise patterns of interpreter service use in medical inpatient wards use and explore clinician experience of language discordance.
Participants included medical students, residents, attending physicians, nursing and allied health professionals working in General Internal Medicine wards across two tertiary referral hospitals servicing a large Australian health care area. This study involved a retrospective electronic medical record audit of interpreter use. Six focus groups were conducted with 32 participants. Data were analysed using an inductive thematic approach with constant comparison.
Allied health professionals were identified as the largest users of interpreter services, followed by medical doctors. Distinct themes emerged regarding clinician experiences of language discordant encounters including: (1) Negotiating care when unable to get an accurate assessment; (2) Over servicing to fill in the gaps; (3) Using family members instead of professional interpreters: a vexed solution; (4) Disparities in care provision; and (5) Communication drought: broken by a flood.
Patients with low English proficiency are at risk of being less informed of care processes, and having a very large volume of information given in a shorter period of time when an interpreter is present. There is a need for systematic and transformative change that addresses utilisation of professional interpreters as well as embedded healthcare culture and practices leading to less interaction with patients with limited English proficiency and reliance on family members as informal interpreters.