Errors of Medical Interpretation and Their Potential Clinical Consequences: A Comparison of Professional Versus Ad Hoc Versus No Interpreters

Division of General Pediatrics, Department of Pediatrics, UT Southwestern Medical Center, Dallas, TX
Annals of emergency medicine (Impact Factor: 4.33). 03/2012; 60(5):545-53. DOI: 10.1016/j.annemergmed.2012.01.025
Source: PubMed

ABSTRACT To compare interpreter errors and their potential consequences in encounters with professional versus ad hoc versus no interpreters.
This was a cross-sectional error analysis of audiotaped emergency department (ED) visits during 30 months in the 2 largest pediatric EDs in Massachusetts. Participants were Spanish-speaking limited-English-proficient patients, caregivers, and their interpreters. Outcome measures included interpreter error numbers, types, and potential consequences.
The 57 encounters included 20 with professional interpreters, 27 with ad hoc interpreters, and 10 with no interpreters; 1,884 interpreter errors were noted, and 18% had potential clinical consequences. The proportion of errors of potential consequence was significantly lower for professional (12%) versus ad hoc (22%) versus no interpreters (20%). Among professional interpreters, previous hours of interpreter training, but not years of experience, were significantly associated with error numbers, types, and potential consequences. The median errors by professional interpreters with greater than or equal to 100 hours of training was significantly lower, at 12, versus 33 for those with fewer than 100 hours of training. Those with greater than or equal to 100 hours of training committed significantly lower proportions of errors of potential consequence overall (2% versus 12%) and in every error category.
Professional interpreters result in a significantly lower likelihood of errors of potential consequence than ad hoc and no interpreters. Among professional interpreters, hours of previous training, but not years of experience, are associated with error numbers, types, and consequences. These findings suggest that requiring at least 100 hours of training for interpreters might have a major impact on reducing interpreter errors and their consequences in health care while improving quality and patient safety.

  • Source
    Annual Review of Public Health 03/2014; 36(1):150112150436006. DOI:10.1146/annurev-publhealth-031914-122421 · 6.63 Impact Factor
  • Source
    [Show abstract] [Hide abstract]
    ABSTRACT: The aim of this study was to explore and suggest strategies for communicating via in-person interpreters, based on experiences of professional home care providers (i.e. nurses and nurse assistants) and social workers. Home care services with its multifaceted emphasis on physical, psychological, social aspects of care and focus on quality of life for the patients presents a challenge for successful interpreted communication as the communication have to cover a wide variety of topics. Previous studies have shown that non-medical issues tend to be less communicated about when using interpreters. The study has an interpretative design, and data were collected in seven focus groups interviews with registered nurses, assistant nurses and social workers in home care services. Data were analysed by means of inductive content analysis. The results reveal suggestions for strategies: making preparations for structure and transparency, creating a flowing conversation on multifaceted topics, forming an understanding of the patient's voice and limiting the information content. This study concludes that the home care providers and social workers need to be prepared for communication via an interpreter about complex phenomena, that communicating information via an interpreter requires preparation prior to the meeting, as well as being an active part in the conversation. Infrequent use of professional interpreters could threaten the possibilities for care providers and social workers to communicate with linguistic diverse patients in an optimal way.
  • Source
    [Show abstract] [Hide abstract]
    ABSTRACT: This paper describes the methods used and the challenges encountered during data collection for an ethnographic study on language barriers and ad-hoc interpreting in a linguistically diverse inner-city hospital emergency department (ED). Data collection relied on ethnographic participant observation and transcripts of audio-recorded clinician-patient interactions to describe and analyse how staff, patients, and ad-hoc interpreters interact in an ED setting. This paper reviews the different practical steps that needed to be undertaken before embarking on data collection, with a view to stirring the discussion on these issues and facilitating future research. Keywords: audio recording, language barriers, ad hoc interpreting, emergency department, ethnographic data collection, access to the field


Available from
Jun 2, 2014