Evaluating utilization and satisfaction of a pilot video-interpretation service in the emergency department

Language barriers in healthcare settings have been associated with medical errors, increased resource utilization, re-admissions, poor health outcomes, and decreased patient satisfaction. There is considerable variability in how interpretation services are delivered in emergency departments (ED) and healthcare institutions across Canada. This study is one of the first to examine healthcare providers' utilization and satisfaction of these services.

We administered cross-sectional surveys to ED physicians prior to, and to both physicians and nurses after the implementation of a pilot video-based interpretation service. Likert scales were used to examine utilization and satisfaction. Descriptive statistics were used to summarize characteristics. Mann-Whitney U tests and Wilcoxon-Signed Rank tests were used to compare utilization and satisfaction between phone and video interpretation services. Thematic analysis was performed on open-ended questions to examine barriers, improvements and suggestions described by healthcare providers.

46/112 physicians responded to the phone-based interpretation survey, and 32/113 physicians and 48/272 nurses responded to the video-based interpretation survey. Video-based interpretation was rated significantly higher than phone interpretation amongst healthcare providers across all domains including reliability, accuracy, ease of use, efficiency and satisfaction (p < 0.05). Nurses used video-based interpretation services significantly more often than phone-based interpretation services (p < 0.05). Thematic analysis revealed that healthcare providers described an improvement in accessibility of interpretation services and improved quality with the implementation of the video-based interpretation services; healthcare providers also felt that there should be better access to interpretation devices and more education surrounding the use of such devices.

This study suggests that healthcare providers were more satisfied with video-based interpretation services and utilized it more often when compared to the phone-based interpretation service available in the ED. This study will help guide effective ED interpretation programs and promote equitable outcomes for patients with limited English proficiency across Canada.