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The Root of Things

Access Without Excess

As we begin the new year and take measure of the one passed, I find myself reflecting on the countless providers, physicians and administrators across the healthcare space I’ve talked with about language access solutions and all of the challenges we face in addressing health inequity.

As you likely know, The Joint Commission (JACHO) estimates that “80% of serious medical errors involve miscommunication between caregivers and patients” and yet we still adopt the same methodologies that allow this to happen. I applaud any effort to genuinely deliver the same patient experience to everyone, but it seems like all of the feature-laden resources and the fractured standards by which they are measured, fall short of the ideal. Something is clearly better than nothing, but features without strategy won't solve the problem.

The patience of patients... and providers

You've arrived as a patient at the hospital and what limited signage there is in your language, instructs you to see the front desk and request translation. Exactly how are you supposed to ask an English speaking employee for translation? The clock is running and at best you’re 5 minutes from starting the process, assuming the first hurdle is overcome. Be it the hospital medical translator or the chosen service, device or “wheelie cart”… it’s coming and you’re waiting. Once the solution arrives, documentation and check-in can begin, but already the process is lagging behind that of an English speaking patient. What's worse is that in an emergency, there won’t be time for you to understand or consent, it will be confusing and it will happen in the blink of an eye. You will wake up amid confusion and uncertainty with every interaction to follow being a game of pantomime until your preferred language is established. You will wait longer than everyone else to simply have a shot at being understood. I cannot begin how to process that, and no one should have to.

As an English-speaking Doctor, I don’t experience the pain that the LEP (Limited English Proficiency) patients endure, however I struggle with the other side of these encounters. You're a physician or provider and are called to help an LEP woman. Upon arriving in the room, you see that she is scared, in pain, and trying to communicate something that has brought her to tears. You walk to the nurses desk to grab the translation iPad so you can understand her and all of them are in use. After fived minutes of misunderstandings, you resort to google translate because half right is better than hand signals and tears. Of course, that lessened translation experience is only possible if the Wi-Fi will cooperate, or you find that one corner of the floor where cell service is available. Relief! You finally find an available iPad, pull up language line and the battery runs out. Now what? What options do you have at this point? How many providers are staring at battery icons, waiting to help patients? The sense of helplessness and amount of time this consumes, all in order to provide equitable care, can be overwhelming.

We Should Talk

For over a year, we’ve been developing an access over excess approach, by simply listening to the wealth of feedback from Limited English Proficiency patients, doctors, pharmacists, nurses, and administrators. I’d like to make this resolution on behalf of my co-founders and myself. In 2022 we are committed to delivering language access that Just. Plain. Works. It will be simple, it will be fast, it will be universally available, and it will be peer reviewed - all so that when a patient needs to speak nothing stands in the way of their voice.

If you'd like to learn more about how we want to reimagine access, or you'd like to share your translation story, contact us today.

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