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Imagine going to the hospital in a country where your first language is not the common tongue. You may be feeling sick, or you’re injured in some way, and you have no way to explain to the nurses and physicians what exactly is wrong with you. This can cause problems, sometimes actually making matters worse than they already are. This is where the “language lines” come in, a term typically used for telephone interpretation services. Unfortunately, asking for a language line in the emergency room isn’t always a simple process. Depending on the hospital you go to, requesting a language line may be met with a long wait before being handed a phone where you’ll then have to likely wait longer in order to get connected to an operator. With how diverse countries such as The United States and Canada are, it shouldn’t be as difficult as it tends to be to get an appropriate translator.

Dedication to interpretation services varies depending on what country you’re in. Victoria in Australia, for example, has guidelines that help identify when language services should be offered to clients. These guidelines are based on legislative requirement as well as best practice service delivery. With Victoria being one of the most culturally diverse and fastest-growing areas in Australia, these guidelines can help bridge language gaps that tend to appear. Of course, not every area of the world is like that. Parts of Canada, such as Alberta and British Columbia, use a single, centrally coordinated telephone interpretation system but the remaining areas in Canada have no coordinated services and must rely on individual organizations and health authorities to provide proper translation services. 

Many instances of success exist when it comes to addressing language needs in hospitals. A report by the Wellesley Institute was able to identify several hospitals in the Greater Toronto Area of Canada that all had a few things in common. The hospitals all had a centralized language service program, primary languages were asked when appointments were booked as well as if they needed an interpretation service, and staff are trained on how to access and use interpretation services efficiently. Unfortunately, establishing programs as in-depth as these can prove difficult due to having to generate buy-in among front-line staff members. When guidance from federal or provincial establishments is lacking, it’s up to hospital officials to create these programs. This isn’t always easy though, as staff often need to demonstrate how these services are useful as well as figure out appropriate training opportunities for staff on how to properly make use of the service.

One of the biggest challenges in using interpretation services, specifically in the emergency department, is that staff commonly fear that using one will reduce efficiency as well as increase the length of the encounter. Unfortunately, not much evidence currently exists stating that language lines in the ED extend the total time of an encounter, or if using them would affect how tests were ordered as well as emergency department flow. While efficiency in the emergency department is an issue, using interpretation services can greatly increase diagnostic accuracy, decrease clinically significant medical errors, provide higher rates of pain control, and decrease re-admission/admission rates, all being important metrics in the ED. One study did find that when telephone interpretation was used, appointment times increased by 28%, but is that 28% worth the potential reduction in readmission rates, or the ability to provide an accurate diagnosis?

Ultimately, language barriers in healthcare and emergency medicine, in particular, need to improve. Many other facets of life, such as not speaking the native language when you’re arrested, warrant receiving a translator, so why doesn’t healthcare?