PV QA 4 - Poster Viewing Q&A 4
Purpose/Objective(s): Approximately 8% of the total population in the US has limited English proficiency (LEP), defined as speaking English less than “very well” per the US Census Bureau. Due to language barriers, these patients are at higher risk for treatment complications, lower quality care, and serious adverse events. As our institution serves a diverse patient population, our health care personnel (HCP) rely primarily on a telephone-based interpreter (TBI) service to aid translation. Varying user experiences however have led to the hypothesis that this is an inefficient means of communication. Thus, in order to improve patient care and clinic workflow, we formally assessed the experiences of our HCP who incorporate TBIs into their daily clinical radiation oncology practice.
Materials/Methods: To characterize the LEP patient population in the department of radiation oncology, the total number of LEP patient encounters and the languages requiring translation, were recorded over a 4 week period. HCP experiences were assessed via a survey consisting of five questions targeting various aspects of the TBI service including, ease of incorporating the translation service into routine clinic workflow, quality of the call, perceived time to complete an encounter, and ability to effectively communicate with the patient. Answers were set to a 5-point scale ranging from poor to excellent. All responses were collected anonymously.
Results: Within the study period, 4.0% (n=38) of all encounters (n=945), including new-patient-visits, on-treatment-visits, and follow-up visits, involved a patient with LEP. The most common languages requiring translation were Mandarin (50%), Cantonese (13%), Vietnamese (10%), and Spanish (10%). The survey response rate was 89% (8/9 nurses and 8/9 residents). All respondents felt that TBI encounters took at least twice as long to complete as compared to non-TBI encounters. Furthermore, 75% of respondents (63% of nurses and 87.5% of residents) found it either inconvenient or frustrating to incorporate the TBI into clinical practice. Call quality was rated as either below average or poor by 56% of respondents (50% of nurses and 62.5% of residents). Interestingly, despite these responses, 81% (88% of nurses and 75% of residents) felt that they were able to effectively communicate with their patient.
Conclusion: LEP patients comprise a significant portion of the total patient population. Based on the responses of HCP in our department, the TBI service currently in use at our institution is felt to be time consuming and often frustrating to use. However, despite these shortcomings, the majority of people still found TBIs to be an effective means of communication. We plan on using these results to improve patient communication by offering longer appointments for LEP patients determined at the time of patient scheduling, providing live human translators whenever possible, and integrating newer technologies, such as real time translation software, into our clinic workflow.
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