When In-Person Interpretation Matters: Perspectives From ICUs and Acute Inpatient Care Settings
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Matthew Tang1, Susan Curtis2, Ahmad Z Al-Khatib3
1Matthew Tang is a research intern, Biomedical Ethics Research Program, Mayo Clinic, Rochester, Minnesota, and a student, University of Pittsburgh, Pennsylvania.
Background:
Clinicians often care for multilingual patients and generally prefer in-person rather than remote interpretation. However, little is known about the reasons for selecting specific interpretation modalities in intensive care units (ICUs) and acute inpatient care settings.
Objective:
To examine the context and application of in-person interpretation in ICUs and acute care settings.
Methods:
Semistructured interviews of interprofessional stakeholders were conducted to understand the advantages and limitations of in-person and remote interpretation modalities in ICUs and acute care settings. Thematic analysis of the interviews was performed.
Results:
Forty-one interviews were completed. Certain contexts motivated preferences for selecting in-person rather than remote interpretation in ICUs and acute care settings. Three overarching themes were identified: (1) specific types of conversations (eg, goals-of-care, end-of-life, and difficult conversations), (2) additional patient-related communication barriers (eg, hearing problems, delirium), and (3) other considerations related to in-person interpreter expertise (cultural contexts and prebriefing) and barriers to use (eg, delays, difficulty contacting interpreters).
Conclusions:
Acute care clinicians often prefer in-person interpretation owing to factors that are either specific to in-person interpretation or cannot be fully replicated via remote modalities. Acute care clinicians consider conversation complexity, patient factors, and unique benefits versus logistical barriers when considering in-person interpretation. Overall, in-person interpretation provides advantages over alternative modalities for several scenarios to improve the quality of care for patients with non-English language preference in ICUs and acute care settings.
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