An Implementation Science Approach Improves Language Access in the Emergency Department

The underuse of interpreters for limited English proficiency (LEP) patient encounters is pervasive, particularly in the emergency department (ED).

To measure the outcome of strategies to improve the use of interpreters by ED providers.

Pre- and post- intervention evaluation of the unmet need for language assistance (LA) in a public ED. Informed by the Behavior Change Wheel (BCW), strategies included: education, training, technology-based facilitators, local champions and environmental cues.

Pre-intervention, of the 110 patient charts with interpreter requests, 17 (15.5%) had documentation of an interpreter-mediated encounter or were seen by a certified bilingual provider (unmet need = 84.5%). Post intervention, of the 159 patient charts with interpreter requests, 47 (29.6%) had documentation of an interpreter-mediated encounter or were seen by a certified bilingual provider (unmet need = 70.4%), difference + 0.14 (95% CI = 0.03-0.23).

In this pilot study, we found a statistically significant increase in the met need for language assistance.