Focusing on cultural diversity helps ensure patient safety
Thursday December 13, 2007 -- Deron Hamel
Catering to the language needs of patients who cannot speak English is a vital part of ensuring patient safety within the University Health Network (UHN), says Dr. Michael Baker.

Baker, physician-in-chief at UHN, which consists of Toronto General, Toronto Western and Princess Margaret hospitals, notes that these facilities cater to an “exceedingly diverse” myriad of cultures.

One of the most visible ways interpreters help foster patient safety is when it comes to prescribing and dispensing medication. Baker underscores the importance of healthcare professionals clearly understanding exactly which medications a patient is on, how long they’ve been taking medication and how well the medication has been working.

Healthcare professionals also need to know if patients have allergies, or if medications have been causing undesired side effects.

“Those are important, subtle patient safety issues that we have learned to focus on,” says Baker.

To ensure the patient and doctor have a clear understanding of each other, it’s essential for an interpreter to be present to assist the doctor and the patient.

Patients who cannot speak English frequently come to the network’s emergency wards. Often, these patients will be accompanied by a relative who speaks some English and who will act as a translator.

However, the network also sees patients admitted on a regular basis who are unable to communicate with hospital staff members, and require an interpreter. UHN has interpreters on staff who are fluent in several languages and who can be called immediately to help these patients communicate.

Portuguese, Italian, Cantonese and Mandarin are some of the most common languages spoken by patients within the network who cannot speak English, says Baker.

UHN has a pre-determined list of hospital staff members — including doctors, nurses, physiotherapists and pharmacists — fluent in languages other than English who can be reached when a patient needs an interpreter. These individuals are all educated in all areas of privacy and sensitivity.

At nights and on weekends, when many of the regular staff members are off, staff members will put patients needing a translator in touch with a telephone interpretation service if no translator can be found.

Having a family member act as an interpreter can create challenges, Baker adds. Because most family members will not fully understand medical terminology, it can create a roadblock when it comes to explaining things. For this reason, UHN turns to in-house interpreters.

Other challenges can arise from privacy issues associated with patient visits, notes Baker, adding some people might find it awkward to detail their medical history in front of a close relative.

“Any interpreter gets in the way of a doctor-patient relationship, which often has to be quite personal,” says Baker.