Moving From Knowledge to Action: Improving Safety and Quality of Care for Patients With Limited English Proficiency

Objective. This study assessed safety culture and staff communication with patients with limited English proficiency (LEP) to identify system-level approaches to increasing interpreter use and reducing health care disparities. Methods. An electronic survey and 7 focus groups were conducted with health care professionals in pediatrics and obstetrics/gynecology. Survey data were examined with univariate descriptive analysis. Focus group transcripts were coded through an iterative consensus process. Results. Survey participants (n = 68) reported less confidence in their ability to communicate effectively (74%) and form therapeutic relationships (56%) with LEP patients versus English-proficient patients. Focus groups identified knowledge as a facilitator of interpreter use. Workflow constraints, supply-demand mismatch, variable interpretation quality, and gaps in communication with interpretation services management were barriers. Conclusion. Knowledge gaps may not be a primary cause of interpreter underuse. Strategies to address workflow barriers and engage with interpretation services are critical to move from knowledge to action to improve LEP patient care.