Interpretation and Limited English Proficient Families: Provider Attitudes and Behaviors in the Pediatric Emergency Department

Abstract Background Professional interpretation improves healthcare quality and outcomes for limited English proficient (LEP) patients, yet interpreter use remains low even when interpretation is available remotely. We analyzed the effect of remote interpretation (telephone or video) on pediatric emergency provider attitudes and behaviors around professional interpretation. Methods A cross-sectional questionnaire of pediatric emergency providers was conducted as part of a randomized trial of telephone versus video interpretation with Spanish speaking LEP families. Providers recalled lapses of professional interpretation for medical communication (use of an ad hoc or no interpreter), if they had delayed or deferred communication due to the need for professional interpretation, and were asked about their satisfaction with the interpretation modality. Bivariate and multivariate analysis of professional interpreter use and communication behaviors were analyzed by self-report of study group assignment. Results One-third of providers reported lapses of professional interpretation and many reported less frequent (46%) and deferred communication (35%) due to the need for interpretation. There was no significant difference in these outcomes between telephone and video assignment. Interpreter skill and technical difficulties were similar between groups. Providers assigned to telephone, compared to video, were more likely to be dissatisfied (p Conclusion Despite access to interpretation, providers caring for patients enrolled in a study of professional interpreter modalities reported frequent lapses in professional interpretation and deferring or delaying communication because an interpreter was needed. Addressing barriers to remote interpreter use will improve quality of care and health equity for LEP patients.