Breaking Down Language Barriers: A Quality Improvement Project for Patients With Limited English Proficiency

According to the Affordable Care Act of 2010, any health program that receives federal funding must take reasonable steps to provide oral or written language assistance to individuals with limited English proficiency (LEP).

After conducting a needs assessment, a disconnect between nursing knowledge and hospital policy was discovered.

The purpose of this quality improvement initiative was to improve communication for individuals with LEP.

This initiative occurred in 2 medical intensive care units in a tertiary academic medical center. An audit was performed to identify the number of LEP patients, assess if nurses were documenting medical interpreter use, and identify areas for improvement. A needs assessment and an educational intervention were developed. A post-education questionnaire was used to evaluate the effectiveness of the interventions.

All nurses (45/61%) responded that they were aware of their legal and ethical responsibilities to use a medical interpreter when communicating with LEP patients and 35% responded that they hardly ever document medical interpreter use. Barriers faced when accessing interpreters included: not knowing how and not enough time to call.

Education and audits continue to improve interpreter use and research should continue in this area to improve outcomes for this patient population.