The guy reaches the triage area and shouts: “Tengo una golpeando la migrana. Estoy viendo destellos de lux plateada. Puedo oir la electricidad en la pared. Y creo que voy a vomitar ahora!”Assume a patient races into a hospital emergency room in the dead of night, moaning, sweating with his hands shielding his eyes.
Or maybe he wails: “Ich habe einen stampfenen migrane. Ich sehe blinkt der silbermen lichts. Ich kann horen die elektrizitat in der wand. Ich gehe jezt zu erbrechen!” Obviously, the nurses can tell he wants medical attention. But if they don’t speak his language — in this case Spanish or German — well, it might as well be Greek. Otherwise, they’ll never know this poor guy is trying to tell them: “I have a pounding migraine. I’m seeing flashes of silvery light. I can hear the electricity in the wall. And I think I’m going to barf now.”
A growing number of Connecticut hospitals are relying on certified medical interpreters, staff proficient in a foreign language, to act as intermediaries, conveying critical patient information to doctors and vice versa. In fact, the state Department of Social Services is trying to assess the need for interpreters. Hospital administrators around Connecticut began receiving notices from the state agency Monday that it wants to know to what extent their facilities rely on interpreters in their emergency rooms and other departments.
In Bridgeport, where 71 languages and an untold number of dialects are spoken, Bridgeport Hospital is taking a unique approach in situations where it would otherwise be hard pressed to find translators proficient in languages from Bengali to Mandingo to Zange.”We contracted with a firm that provides us with two-way live video conferencing language translation services,” said Lynn Charbonneau, director of patient relations for Bridgeport Hospital. “Our patients can see the interpreter and the interpreters can see them, too. And I think that visual element is important because they can assess them in a way you can’t when you’re just on the phone.”From February to early May, the hospital used Language Access Network to converse with emergency room patients who spoke Arabic, Turkish, Cantonese, Mandarin Chinese, Creole French, Farsi, French, Gujarati, Portuguese, Hindi, Somali, Bengali, Vietnamese and sign language.
About 56,000 Bridgeport area residents speak a language other than English at home, according to the U.S. Census Bureau, and 53,655 of them have only a limited proficiency in English.Bridgeport Hospital has signed a five-year contract with Language Access Network for the Ohio-based firm to provide translators in any foreign language, as well as sign language, on demand at any time.
“Bridgeport Hospital is our first client in Connecticut, but we expect to have additional ones soon,” says Michael Guirlinger, chief executive officer at Language Access Network. “It usually takes us less than 60 to 120 seconds to connect an interpreter” with a hospital.Among the firm’s other clients are Boston Medical Center, Memorial Sloan-Kettering in New York City and Texas Children’s Hospital.
Beyond its contract with Language Access Network, Bridgeport Hospital offers a Spanish proficiency exam in-house for staff who want to be certified as medical interpreters. So far, 30 staffers from a variety of departments have passed the test. For further training, the hospital has many of them enrolled in a University of Massachusetts program. The most common languages after English and Spanish heard in the emergency department in Bridgeport are Portuguese and Polish.”We are starting to think about asking a question on our employment applications if an individual speaks another language and if they are interested in becoming certified as an interpreter,” Charbonneau said. “There are times when a patient will want to rely on a family member, but unless that person is specifically trained in communicating medical information, we would discourage that because we need to make sure that we get complete information from a patient and that what our staff has to convey is being communicated in its entirety.”
For that reason, even in cases where a non-English speaking patient wants to enlist a relative to talk to nurses and doctors, Charbonneau encourages hospital staff to call for an interpreter anyway. In an emergency room, quick and accurate communication can make the difference in how a patient recovers — or not — from a medical trauma or illness. According to the Connecticut Health Foundation, language barriers are a major contributor to systemic disparities in health care, which contribute to higher health care costs and poorer treatment outcomes.
“The result is an inferior health system for patients who do not speak English well and who lack access to doctors or other health care providers who can communicate with them in their primary language,” Ann Bagchi, a health researcher with Mathematica Policy Research, informed state lawmakers during a 2007 public hearing. Bachi testified before the General Assembly’s Human Services Committee in support of a bill last year that made interpreter services available under Medicaid.
What the 2007 law left unanswered is what hospitals can or should do about the costs they incur providing translation services. Bridgeport Hospital eats the cost of such service, which Charbonneau estimates “are in excess of $100,000.” That’s the quandary many hospitals are in, said Patricia Baker, executive director of the Connecticut Health Foundation, adding that federal Medicaid law allows participating hospitals to bill their state Medicaid programs for medical interpreter services. Connecticut has not adopted that policy — yet.
Interpreter services cost about $50 an hour on average, but data about how much time translators spend with patients is scarce, Baker said, because most providers don’t directly track it. Based on government reports and academic studies, the Connecticut Health Foundation estimates that Connecticut hospitals spend $4.7 million annually for interpreters. If the state billed Medicaid, it could cut those costs in half.