SHM Converge Scientific Abstract ePoster Gallery-Humility Is One Case Away: Patient With Difficulty Accessing Care in His Native Language

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This case report describes a 67-year-old blind Navajo-speaking man with liver cirrhosis and choledocholithiasis who experienced major barriers to care because his preferred language was not identified early and interpreter services were used inconsistently. Over a 44-day course of care across nine encounters (five inpatient, three emergency department, one outpatient), professional interpreters were used only twice.<br /><br />The case illustrates several common problems in caring for patients with limited English proficiency (LEP): difficulty recognizing the patient’s language needs, underuse of interpreters, and reliance on communication in English despite poor understanding. Early notes show that clinicians could not understand the patient and he was difficult to engage. It was not until hospital day 6 that a hospitalist asked about language preference, learned he spoke Navajo, and documented this in the electronic medical record. The patient then reported through an interpreter that he did not understand what people were saying because they spoke too fast. However, by day 9, he was again spoken to in English without interpreter support for more than 48 hours.<br /><br />The authors emphasize that professional interpreters improve outcomes for patients with LEP and that hospitals are legally required to provide access. Common reasons for underuse include convenience, time pressure, and normalization of poor interpreter use. Recommended interventions include better systems to identify preferred languages, adequate availability of trained interpreters, staff education, and leadership support.<br /><br />The key conclusion is that clinicians should work with hospital leadership and interpreter services to build robust systems so that patients’ language preferences are identified early and interpreters are used consistently in all clinical interactions.

Asset Subtitle

Tenzin Desel

Meta Tag

Author List Eileen Barrett, Tenzin Desel

Category Clinical Vignettes

Concept Limited English Proficiency

Concept Professional Interpreter Services

Concept Language Access

Concept Preferred Language

Concept Interpreter Use

Distinguished Non-Finalist

Presenter Organization University of New Mexico School of Medicine

Presenting Author Tenzin Desel

Track Adult

Keywords

limited English proficiency

professional interpreters

Navajo language

language barriers

healthcare communication

interpreter services

patient safety

cirrhosis

choledocholithiasis

hospital care

Limited English Proficiency

Professional Interpreter Services

Language Access

Preferred Language

Interpreter Use