Communication difficulties with limited English proficiency patients: clinician perceptions of clinical risk and patterns of use of interpreters

Aims To explore clinicians' perceptions of the communication difficulties experienced with Limited English Proficiency (LEP) patients and the clinical risks these difficulties pose in hospitals, as well as patterns of interpreter use among these clinicians. Methods Senior health professionals in the two District Health Boards (DHBs) in the Wellington Area (about 900) of New Zealand were sent an electronic survey. Twenty clinicians were interviewed about their experience in 22 consultations with LEP patients, and an equal number with English proficient patients. Descriptive statistics were calculated, and 95% confidence intervals and formal statistical tests. Results 141 responses were received to the survey. There was a high level of awareness of how to access interpreters (84%) and lesser awareness of DHB interpreter policy (65%). Most respondents felt that communication difficulties with LEP patients have a significant effect on care at least sometimes, but there is a wide variation in reported actual use of interpreters, with only 14% always using an interpreter. In the actual consultations studied, no professional interpreters were used despite clinician acknowledgement of increased clinical risk. Conclusion Even when clinicians are aware of policy, of how to obtain interpreters, and of the increased clinical risk in the situation, this does not necessarily lead to high levels of interpreter use with LEP patients.