sum.
A 59-year-old Egyptian woman who speaks no English undergoes a
urologic procedure. The surgeon removes her kidney, but blood loss
leads to hemorrhagic shock, heart failure and death. An investigation
determines that hospital employees had been unable to identify the
patient's language, so they presented the Conditions of Admission in
English without translation or a translator. The informed consent they
presented, also in English, failed to mention the possibility of
nephrectomy. The case settles for just under $100,000.
1
Every day, miscommunications occur between healthcare providers
and patients who don't speak English well or at all. Many patients suffer
and some even die as a result. Miscommunication is also expensive to
facilities and providers. Patients with limited English proficiency (LEP)
have longer lengths of stay than English-speaking patients, no matter
their socioeconomic status.
(2-4)
They also have a significantly higher
risk of 30-day readmission. When they encounter facilities that are not
accommodating, they are likely to rate their satisfaction as low. And
they may even sue. According to one study, 1 in 40 malpractice cases is
directly related to poor or non-existent interpretation services.
1
The challenge of language barriers is of increasing concern. One in
five U.S. residents speaks a language other than English at home and
40% of that group does not speak English well enough to effectively
communicate with a healthcare provider.
As a percentage of American residents, non-English speakers have
been on the rise for more than 30 years. One reason is that Congress
loosened immigration laws in the 1960s. Globalization is another fac-
tor; people outside of the U.S. are more willing than ever to travel
here for education and careers. Wars and civil conflict as well as the
climate change that is occurring is Central America are also driving
people out of their native countries and making them refugees.
2 0 • O U T PA T I E N T S U R G E R Y M A G A Z I N E • N O V E M B E R 2 0 1 9
