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language barriers in the healthcare realm

Importance of the Issue. Appropriate medical care is a necessity in today's society. Many American's do not experience proper medical care due to ineffective communication practices and language barriers in our healthcare community. Hospitals, doctors offices, and medical staff should employ superior medical care by ensuring that supplementary interpreter services are utilized to grant a higher standard of care for non-English speaking patients and their families. .

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language barriers in the healthcare realm

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    1. Language Barriers in the Healthcare Realm Presentation by: Lori King, RN, BSN Multicultural Education Dr. Christian October 17, 2006

    2. Importance of the Issue Appropriate medical care is a necessity in today’s society. Many American’s do not experience proper medical care due to ineffective communication practices and language barriers in our healthcare community. Hospitals, doctors offices, and medical staff should employ superior medical care by ensuring that supplementary interpreter services are utilized to grant a higher standard of care for non-English speaking patients and their families.

    3. Abstract This presentation evaluates the language barriers experienced in the healthcare realm. Federal and state statues are provided to enable readers to comprehend the laws positioned to aid non-English speaking citizens. Authentic accounts of miscommunication and life changing events are mentioned to engage others to grasp the veracity of this issue. This publication also looks at ways to combat the dilemma at hand and construct concrete transformations to permit non-English citizens with the equal opportunities they deserve.

    4. Primary languages America is home to an abundance of immigrants from around the globe. Many immigrants living in the United States do not verbalize English as their primary language. Virtually 47 million people speak a language other than English at home. Somewhere from 11 to 21 million people have a restricted capability to speak English. ACORN, 2004

    5. Percentage of Americans Who Speak Non-English Languages or With Limited English Proficiency Flores, 2006 (Data obtained by the U.S. Census Bureau)

    6. Census Information According to the 2000 Census, over 18 percent of the United States population speaks a language other than English at home. The population of America recently sky rocketed to 300 million. Based on the percentages stated by the Census Bureau, almost 54 million people in our population speak a non-English language. Kaiser, 2003

    7. Major Risks Hospital patients who speak little or no English are at greater risk of: Medical errors Misdiagnosis Possible death Kaiser, 2002 Many immigrants are unable to maneuver through the complicated landscape of hospitals because of language complexity. Often they do not receive the care they warrant. Many studies have revealed that this lack of suitable communication is an obstruction to receiving satisfactory healthcare. ACORN, 2004

    8. Deleterious Effects of Language Barriers Patients who experience language barriers are less likely than others to have a usual source of medical care, receive preventative services at reduced rates, and have an increased risk of non adherence to medication. Flores, 2006

    9. Satisfaction Survey According to a study conducted by Newsday, patients who did not obtain interpreter services reported Twenty-seven percent of patients said they left the hospital incapable of understanding how to administer their medications. One-third of the patients devoid of an interpreter stated that they would not come back to the facility. More than fifty percent of those lacking an interpreter said the hospital staff on no account asked them if they required help to pay for medical care. Kaiser, 2002

    10. Tragic Consequences Case no. 1 A Spanish-speaking 18 year old staggered into a friends room and collapsed, after saying he was “intoxicado.” The non-Spanish speaking paramedics thought this word meant “intoxicated”; the tangible meaning of the word is “nauseated.” After almost 36 hours in the hospital the patient was worked up for a drug overdose, the comatose patient was reevaluated and identified to have intracerebellar hematoma with brain-stem compression and a subdural hematoma secondary to a ruptured artery. This case led to deferred patient care and unnecessary quadriplegia. Flores, 2006

    11. Tragic Consequences Continued Case no. 2 A Spanish speaking mother told a resident that her two year old “hit herself” when she fell off her tricycle; the resident misunderstood the two words. He believed that the fracture was a product of abuse, so he contacted The Department of Social Services (DSS). DSS sent a worker devoid of an interpreter. The mother then signed over guardianship of her children. This circumstance occurred because of an initial miscommunication between the doctor and the mother. This could have been prevented with the use of interpreter. Flores, 2006

    12. Federal Statutes There are many federal and state statues that prohibit the behavior mentioned in the previous examples. Title VI of the 1964 Civil Rights Act states: Refusal or delay of medical care because of language barriers is considered discrimination (Kaiser, 2006).

    13. Federal Statutes In 1998, the Office for Civil Rights of the Department of Health and Human Services issued a communication regarding the exclusion, under Title VI of the 1964 Civil Rights Act. This provision affects persons with inadequate English aptitude. The memorandum states that the refutation or hindrance of medical services due to language barriers represents discrimination and entails that recipient of Medicare or Medicaid funds afford language aid to persons with limited English aptitude. Flores, 2006

    14. State Statues Many states have laws on the books to remedy this tragic situation regarding the language barriers. Rhode Island law as of 2002 requires hospitals to offer interpreter services as a stipulation for continued licensure. Massachusetts Emergency Services Interpreter Law of 2001 commands that all acute care facilities that provide emergency room services, must provide interpreter services for every patient. ACORN, 2004

    15. Remedy the Situation As evidenced by the previous examples, it is obvious that these laws are not being followed adequately. In order to better serve the non-English speaking population, the following steps should be taken: The federal government must take stronger action to enforce Title VI of the Civil Rights Act. State officials must develop laws requiring better language services and extend a plan to reimburse providers for language services. ACORN, 2004

    16. Remedy the Situation Hospitals must develop programs to teach staff cultural competence and also aid them in developing their language skills. Health departments could also develop campaigns to educate non-English speaking people about health issues. Medical and nursing schools could also offer special courses so that these healthcare professionals will better understand and interpret the cultures of their clients. ACORN, 2004 & Healthcare Coverage, 2004

    17. For More Information Visit These Websites: Kaiser Family Foundation http://www.kff.org The Henry J. Kaiser Family Foundation focuses on health care issues, mainly policy, public education, and health and development in South Africa. This information can be useful for the general public, by aiding them in making decisions based on the health care policies noted. This is also a great source of information for medical professionals as well. The New England Journal of Medicine http://content.nejm.org/cgi/content/full/355/3/229 This article published in the NEJM discusses language barriers to health care in the United States. This information can be useful to healthcare professionals, teachers, and American citizens as a whole. It provides an eye opening account to the reality that these immigrant groups experience. ACORN www.acorn.org The Association of Community Organizations for Reform Now enables people to voice their views and organize positive change in the community. ACORN is a useful site for anyone that longs to make a change or a difference in their neighborhood.

    18. For More Information Visit These Websites: Hablamos Juntos http://www.hablamosjuntos.org/mediacenter/default.todays_stories.asp Hablamos Juntos strives to improve communication skills between healthcare professionals and their patients with limited English proficiency. This website is especially useful for healthcare professionals. But, Hablamos also offers education classes teaching Spanish for many other professions, such as: business experts, teachers, and public figures. The National Center for Cultural Competence http://www11.georgetown.edu/research/gucchd/nccc/ The National Center for Cultural Competence serves to increase the ability of health and mental health programs to devise, execute, and assess culturally and linguistically competent service delivery systems. This site includes conceptual frameworks and models, tools and processes for self-assessment, and policies currently being enforced. I believe that teachers, medical professionals, and our general community can utilize the information and tools provided to better understand the non-English speaking realm.

    19. Useful Journal Articles Healthcare Coverage; Language is top barrier for Hispanics to receiving medical care in the South. Author: Unknown This article describes the language barriers that are keeping the south’s Hispanic community from receiving much needed medical care and interpreters. It lists some possible remedies for the situation as well. This is useful for teachers, medical professionals, and the southern citizens. It can aid people in understanding the barriers that are posed and help them work to correct the barricades. Healthcare Access; The Language barrier negatively impacts health care for 50 million U.S. residents. Author: Glenn Flores This article was published in the New England Journal of Medicine. It highlights healthcare communication in the United States and gives examples to aid in the fixation of the problem. This journal writing is particularly useful for medical and auxiliary staff, but can be utilized by other professions as well.

    20. Conclusion It is apparent in today’s society that language barriers are a major blockade to better understanding and healthcare for non-English speaking individuals. As a society, we must work together to better understand, develop relationships, and utilize a sense of cultural competency to convey our nation as one with freedom and opportunity for all.

    21. References ACORN (2004). Speaking the language of care: Language barriers to hospital access in America’s cities. Retrieved from: http://acorn.org/fileadmin/Additional_Accomplishments/National_report.pdf Flores, G. (2006). Healthcare Access; The language barrier negatively impacts health care for 50 million U.S. residents. Obesity, Fitness & Wellness Week, 1350. Flores, G (2006).Language barriers to health care in the United States. The New England Journal of Medicine. 355, 229-231. Kaiser Family Foundation (2002). Language barriers greatly increase medical error for hospitals, study says. Retrieved from: http://www.kaisernetwork.org/daily_reports/print_report.cfm?DR_ID=10842&dr_cat=3 Kaiser Family Foundation (2003). Immigrants health care coverage and access. Retrieved from: www.kff.org Kaiser Family Foundation (2006). Daily health policy report. Retrieved from: http://www.kaisernetwork.org/daily_reports/rep_index.cfm?hint=3&DR_ID=38611 Unknown, (2004). Healthcare Coverage; Language is top barrier for Hispanics to receiving medical care in the South. Obesity, Fitness & Wellness Week, 666.

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