Connecticut: Hospital breaks down language barriers

Harold Schiffman hfsclpp at
Wed May 7 14:48:26 UTC 2008

Hospital breaks down language barriers

Assume a patient races into a hospital emergency room in the dead of
night, moaning, sweating with his hands shielding his eyes.
The guy reaches the triage area and shouts: "Tengo una golpeando la
migrana. Estoy viendo destellos de lux plateada. Puedo oir la
electricidad en la pared. Y creo que voy a vomitar ahora!" Or maybe he
wails: "Ich habe einen stampfenen migrane. Ich sehe blinkt der
silbermen lichts. Ich kann horen die elektrizitat in der wand. Ich
gehe jezt zu erbrechen!"

Obviously, the nurses can tell he wants medical attention. But if they
don't speak his language — in this case Spanish or German — well, it
might as well be Greek. Otherwise, they'll never know this poor guy is
trying to tell them: "I have a pounding migraine. I'm seeing flashes
of silvery light. I can hear the electricity in the wall. And I think
I'm going to barf now." A growing number of Connecticut hospitals are
relying on certified medical interpreters, staff proficient in a
foreign language, to act as intermediaries, conveying critical patient
information to doctors and vice versa. In fact, the state Department
of Social Services is trying to assess the need for interpreters.
Hospital administrators around Connecticut began receiving notices
from the state agency Monday that it wants to know to what extent
their facilities rely on interpreters in their emergency rooms and
other departments.

In Bridgeport, where 71 languages and an untold number of dialects are
spoken, Bridgeport Hospital is taking a unique approach in situations
where it would otherwise be hard pressed to find translators
proficient in languages from Bengali to Mandingo to Zange.
"We contracted with a firm that provides us with two-way live video
conferencing language translation services," said Lynn Charbonneau,
director of patient relations for Bridgeport Hospital. "Our patients
can see the interpreter and the interpreters can see them, too. And I
think that visual element is important because they can assess them in
a way you can't when you're just on the phone." From February to early
May, the hospital used Language Access Network to converse with
emergency room patients who spoke Arabic, Turkish, Cantonese, Mandarin
Chinese, Creole French, Farsi, French, Gujarati, Portuguese, Hindi,
Somali, Bengali, Vietnamese and sign language.

About 56,000 Bridgeport area residents speak a language other than
English at home, according to the U.S. Census Bureau, and 53,655 of
them have only a limited proficiency in English. Bridgeport Hospital
has signed a five-year contract with Language Access Network for the
Ohio-based firm to provide translators in any foreign language, as
well as sign language, on demand at any time.
"Bridgeport Hospital is our first client in Connecticut, but we expect
to have additional ones soon," says Michael Guirlinger, chief
executive officer at Language Access Network. "It usually takes us
less than 60 to 120 seconds to connect an interpreter" with a

Among the firm's other clients are Boston Medical Center, Memorial
Sloan-Kettering in New York City and Texas Children's Hospital.
Beyond its contract with Language Access Network, Bridgeport Hospital
offers a Spanish proficiency exam in-house for staff who want to be
certified as medical interpreters. So far, 30 staffers from a variety
of departments have passed the test. For further training, the
hospital has many of them enrolled in a University of Massachusetts

The most common languages after English and Spanish heard in the
emergency department in Bridgeport are Portuguese and Polish.
"We are starting to think about asking a question on our employment
applications if an individual speaks another language and if they are
interested in becoming certified as an interpreter," Charbonneau said.
"There are times when a patient will want to rely on a family member,
but unless that person is specifically trained in communicating
medical information, we would discourage that because we need to make
sure that we get complete information from a patient and that what our
staff has to convey is being communicated in its entirety."

For that reason, even in cases where a non-English speaking patient
wants to enlist a relative to talk to nurses and doctors, Charbonneau
encourages hospital staff to call for an interpreter anyway. In an
emergency room, quick and accurate communication can make the
difference in how a patient recovers — or not — from a medical trauma
or illness. According to the Connecticut Health Foundation, language
barriers are a major contributor to systemic disparities in health
care, which contribute to higher health care costs and poorer
treatment outcomes.

"The result is an inferior health system for patients who do not speak
English well and who lack access to doctors or other health care
providers who can communicate with them in their primary language,"
Ann Bagchi, a health researcher with Mathematica Policy Research,
informed state lawmakers during a 2007 public hearing. Bachi testified
before the General Assembly's Human Services Committee in support of a
bill last year that made interpreter services available under

What the 2007 law left unanswered is what hospitals can or should do
about the costs they incur providing translation services. Bridgeport
Hospital eats the cost of such service, which Charbonneau estimates
"are in excess of $100,000." That's the quandary many hospitals are
in, said Patricia Baker, executive director of the Connecticut Health
Foundation, adding that federal Medicaid law allows participating
hospitals to bill their state Medicaid programs for medical
interpreter services. Connecticut has not adopted that policy — yet.

Interpreter services cost about $50 an hour on average, but data about
how much time translators spend with patients is scarce, Baker said,
because most providers don't directly track it. Based on government
reports and academic studies, the Connecticut Health Foundation
estimates that Connecticut hospitals spend $4.7 million annually for
interpreters. If the state billed Medicaid, it could cut those costs
in half. MariAn Gail Brown, who covers regional issues, can be reached
at 330-6288.

[Moderator's note: anyone want to comment on the "German" quotation?
Transliterated word-for-word from Spanish? (hs)]
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