ELIMINATING LANGUAGE BARRIERS FOR NON-ENGLISH-SPEAKING PATIENTS

OBJECTIVES. More than 31 million persons living in the United States d o not speak English, therefore language discordance between the clinic ian and patient may hinder delivery of cost-effective medical care. A new language service was developed in which interpreters are trained i n the skills of simultaneous interpretation commonly used at internati onal conferences. The interpreters are linked from a remote site to he adsets worn by the clinician and patient through standard communicatio n wires. The service is called ''remote-simultaneous interpretation,'' to contrast it with a traditional method of an interpreter being phys ically present at the interview and interpreting consecutively ''proxi mate-consecutive interpretation.'' The aim of this study is to assess in a randomized protocol the quality of communication, interpretation, and level of patient, interpreter, and physician satisfaction with th ese two language services.METHODS. The first postpartum visit with eac h of 49 mothers and their newborn babies was assigned randomly to prox imate-consecutive interpretation (control) or to remote-simultaneous i nterpretation (experimental). Main outcome measures included (1) the n umber of physician and mother utterances in the visit, (2) the quality of the interpretation, and (3) physician, interpreter, and mother pre ferences between the two services. RESULTS. The remote-simultaneous in terpreter service averaged 8.3 (10%) more physician utterances (95% co nfidence interval [CI] 4.3, 12.4) and 9.1 (28%) more mother utterances (95% CI 6.1, 12.1). On average, there were 2.8 (12%) fewer inaccuraci es of physician utterances in experimental visits compared with contro l visits (95% CT -5.9, 0.4) and 3.0 (13%) fewer inaccuracies of mother utterances in experimental visits compared with control visits (95% C I -5.4, -0.6). Mothers and physicians significantly preferred the remo te-simultaneous service to proximate-consecutive interpretation servic e. Interpreters stated that they thought mothers and physicians better understood each other using the remote-simultaneous service, although the interpreters preferred to work with the proximate-consecutive ser vice. CONCLUSIONS. Using remote-simultaneous interpretation to improve the quality of communication in discordant-language encounters promis es to enhance delivery of medical care for the millions of non-English -speaking patients in the United States.