Jonathan S. Lee|Eliseo J. Pérez?Stable|Steven E. Gregorich|Michael H. Crawford|Adrienne Green|Jennifer Livaudais?Toman|Leah Karliner
Increased Access to Professional Interpreters in the Hospital Improves Informed Consent for Patients with Limited English Proficiency
University of California, San Francisco|National Institute on Minority Health and Health Disparities|Office of the Director|National Institutes of Health|University of California, San Francisco|University of California, San Francisco|University of California, San Francisco|University of California, San Francisco|University of California, San Francisco
language barriers disrupt communication impede informed consent patients limited english proficiency lep undergoing healthcare procedures effective interventions disparity remain unclearassess impact bedside interpreter phone system intervention informed consent patients lep compare outcomes english speakersprospective prepost intervention implementation study using propensity analysishospitalized patients undergoing invasive procedures cardiovascular general surgery orthopedic surgery floorsinstallation dualhandset interpreter phones every bedside enabling 24h immediate access professional interpretersprimary predictor pre vs postimplementation group secondary predictor postimplementation patients lep vs english speakers primary outcomes three central informed consent elements patientreported understanding 1 reasons 2 risks procedure 3 questions answered considered consent adequately informed three elements metwe enrolled 152 chinese spanishspeaking patients lep 84 pre 68 postimplementation 86 english speakers postimplementation vs preimplementation patients lep likely meet criteria adequately informed consent 54 vs 29 p 0001 propensity score adjustment significantly higher odds adequately informed consent aor 256 95 ci 115572 well consent element individually however compared postimplementation english speakers postimplementation patients lep significantly lower adjusted odds adequately informed consent aor 038 95 ci 016091a bedside interpreter phone system intervention increase rapid access professional interpreters associated improvements patientreported informed consent considered hospitals seeking improve care patients lep however improvements eliminate languagebased disparity additional clinician educational interventions languageconcordant care may necessary informed consent equal english speakers