Sharing Best Practices for Effective Multilingual Communication in Healthcare
Did you know that, according to the US Census Bureau, at least 380 different languages are spoken in the United States? While this is a mind-blowing fact in and of itself, even more amazing is the fact that about 25 million people in the US who speak languages other than English go about their daily lives using very few English words, or none at all. They live in close-knit communities that cater to their every need. They can find food from their own culture in the local store, newspapers in their own language and almost anything else they might need. There may be very few instances when they need to interact with English-speakers, but there is one looming exception, which is when they enter the healthcare system
So many things can go wrong when a patient and a medical professional are unable to communicate. Communication is the foundation of patient safety and quality care. Patients with Low English Proficiency (LEP) are more prone to experience adverse outcomes. They have difficulty understanding basic instructions regarding their condition, including taking medications and recognizing symptoms that require returning to see their healthcare provider. Well-translated versions of vital documents such as admission forms, informed consents, compliant forms and discharge instructions can be of great help to medical professionals and can literally be life-savers for LEP patients. Here are some tips for translating medical documents that can improve patient outcomes:
Make sure the document is well-written and straightforward, and the content is up to date and accurate. Avoid using colloquial expressions or figurative language that might not have an equivalent in other languages.
Sight translation is when an interpreter reads the document in English and speaks the translation aloud. Speed should not trump accuracy. For more information see my blog entry on sight translation in healthcare settings.
Medical translators understand language nuances, have training in medical terminology and can write correctly in their native language. Machine translation can help with the general understanding of a topic but it is not accurate enough and can lead to adverse events.
Healthcare documents are typically written at the 6th to 8th grade level. The translation should reflect the same reading level as the English document. When selecting medical translators, it is necessary to find skillful linguists who understand complex medical terminology and are capable of delivering natural renditions at the appropriate literacy level.
It is important to take into account cultural beliefs about health in order to properly address people from different genders and age groups.
Creating custom glossaries before the translation starts ensures the consistency of word usage in the translation. It also helps to establish the meaning of certain terms in different contexts. Glossaries are particularly helpful when the content is updated over time and are required to maintain the same language register.
Translation platforms that include tools that capture translation equivalents in a multilingual database (i.e. translation memory) allow you to reuse previous translations and keep subsequent documents consistent. They also assist in finding translation matches within the same document. This reduces the need to pay for the translation of repeated content within a document or when updating the document over time.
Healthcare translation is challenging and requires a multistep quality assurance process. It should start with the selection of specialized medical translators accompanied by a bulletproof translation process. Three different linguists should perform translation, editing, and proofreading to ensure the document is accurate and has the same meaning and intent as the original.
Bilingual medical professionals are well-intentioned but in many cases don’t have the language background to produce well-written documents. They may have learned to speak another language from their parents but never received formal education in the patient’s language. For more on this, see my post about native speakers. It is common for bilingual staff to make corrections that work against the quality assurance process implemented by the translation service. If in doubt, ask your translation vendor for clarification.
Well-translated medical documents can reduce clinical errors and improve patient outcomes only if they are actually used. There are documented cases in several healthcare institutions where patients were asked to sign informed consents in English while the institution had a large repository of consents in other languages. It is important to educate medical staff about the availability of this resource and remind them of the impact it can have.