The Clinical Consequences of Inadequate Medical Interpreting/Interpretation Services

Having professional standby interpreters in emergency rooms for non-English-speaking patients may help limit potential miscommunications, according to a recent U.S. study. The study, based on 57 families, all primarily Spanish-speaking and seen in either of two Massachusetts pediatric emergency rooms, was recently published in the Annals of Emergency Medicine.
Researchers concluded that having professional interpreters available in US hospitals can significantly reduce interpreter errors of potential clinical consequence, when compared to using an ‘ad-hoc’ interpreter or no interpreter at all.

Provisions in place for successful interpreting

There is a sizeable non-English speaking population of about 45 million in the US, of whom an estimated 25 million have limited English proficiency – that is, they say they speak the language less than “very well.”
By law, U.S. hospitals that receive federal funds have to offer some type of translation help for those patients. That can mean a professional interpreter who works for the hospital or telephone or video-based translation services.
Although it was known that patients liked to have some type of translation available, until now, it had not been clear how well professional interpreters performed against amateurs, or no interpreter at all.
Regarding the issue of training, the study demonstrates that where interpreters had had at least 100 hours of training in medical interpreting, significantly fewer errors were made. After 100 hours of training or more, only two percent of interpreters’ slips had the potential to cause any harm to the patient.
Only a small number of training programs for medical interpreters provide at least 100 hours of training and even when hospitals run their own programs, the hours involved vary widely. Other studies have also revealed that less than 25% of U.S. hospitals provide interpreters who have had any professional training at all.

The fatal consequences of interpreter failings

This US study also highlights the clinical consequences of errors in interpreting ranging from the seriously harmful, such as giving a patient the wrong medication dose (twice as likely if there is no interpreter or if an amateur interpreter is used) to the wasteful, with unnecessary tests being carried out on patients, squandering financial resources.
However it has been published at the same time as it is revealed that a series of significant failings on the part of police and translation services in Preston, UK, led to the death of suspect Bogdan Wilk in police custody.
Mr Wilk, was arrested on suspicion of assaulting his partner last year and taken to Preston Police Station. He was found lifeless in his cell the next morning.
A jury at Preston Coroner’s Court heard that a spray Mr Wilk used to control chest pains had not been booked in at the custody suite along with other medication brought from his home. The court was told that an interpreter had not taken notes of a conversation at the station in which Mr Wilk explained, in Polish, that he was suffering serious chest pain, akin to a heart attack.
The jury ruled Mr Wilk had died from a coronary atheroma, a heart complaint. They returned a narrative verdict which said: “We think it more probable than not that the joint failings of police, [health care professionals] Medacs, and translation procedures are all contributing factors to the death of Mr Wilk.”


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