Communication Tips for Clinicians Working with Non-English-Speaking Patients

Part of providing quality care to patients with limited English proficiency is communicating with them in their own language, an AdventHealth CMO says.

CMOs need to ensure that health systems and hospitals have translation services for patients with limited English proficiency, the CMO of AdventHealth Apopka says.

In 2019, 67.8 million people in the United States spoke a language other than English in the home, according to the U.S. Census Bureau. Spanish was found to be the most common non-English language spoken in U.S. homes.

"Having translation services is critical to serve all patients consistently throughout the country," says Omayra Mansfield, MD, CMO of AdventHealth Apopka, an 158-bed hospital in Apopka, Fla., operated by AdventHealth.

"It should be a CMO's top priority to make sure we have the ability to communicate with our patients," Mansfield says. "Otherwise, you would never be able to deliver the type of care that we aspire to deliver."

A CMO should want patients to get high quality care like family members, and the ability to communicate is essential to attain quality, according to Mansfield.

"As a CMO, I care that my patients are treated like family," Mansfield says. "I can't imagine in a country like ours, which is so beautifully diverse, that we would have the ability to speak every language and every dialect just with the workforce that we have onsite."

AdventHealth Apopka's approach

Technology plays a role in how AdventHealth Apopka communicates with patients who have limited English proficiency. The hospital has contracted with a company that provides medical translation services virtually through video-enabled iPads capable of conducting three-way communication between clinicians, patients, and translators.

"We are able to navigate and identify what language the patient speaks—in particular what dialect," Mansfield says. "Then we connect with an interpreter so we can have communication with the patient in real time and in person."

By working with a translation service that specializes in medical communication, AdventHealth Apopka is ensuring that non-English speaking patients can understand medical terminology and care plans, according to Mansfield.

"We know the interpreter is capturing accurately what we are sharing and communicating to the patient," Mansfield says. "Similarly, we are getting the patient's responses, their questions, and their general understanding of the care plan as well."

For communicating with patients in general, and non-English speaking patients in particular, Mansfield uses the analogy of eating a pineapple, which is done in chunks rather than all at once.

"We need to provide small pieces of information—allowing the patient to digest those small pieces of information and ensuring understanding of information before we move on to the next chunk," Mansfield says.

Patience is also important when fostering clear communication with non-English speaking patients, according to Mansfield.

"We may have to take an additional step simply because of a language difference to be able to share information," Mansfield says. "Having patience is the only way we are going to give the care delivery we would want as if the patient was a loved one."

Another best practice for communicating with patients who have limited English proficiency is a process called teach back, Mansfield explains. After medical information has been shared with the patient, the translator is asked to prompt the patient to repeat back their understanding of what has been shared.

"That is one of the ways that we can adequately have confidence that our patients are understanding what we are sharing with them," Mansfield says. "If patients do not show an understanding of what we are sharing with them, we have to take the time to communicate in a different way to make sure they have understanding."