Obtaining History with a Language Barrier in the Emergency Department: Perhaps not a Barrier After All

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dc.contributor.authorLitzau, Megan
dc.contributor.authorTurner, Joseph
dc.contributor.authorPettit, Katie
dc.contributor.authorMorgan, Zachary
dc.contributor.authorCooper, Dylan
dc.contributor.departmentEmergency Medicine, School of Medicineen_US
dc.date.accessioned2019-06-28T17:54:28Z
dc.date.available2019-06-28T17:54:28Z
dc.date.issued2018-11
dc.description.sponsorshipIntroduction: Patients with limited English proficiency may be at risk for incomplete history collection, potentially a patient safety issue. While federal law requires qualified medical interpreters be provided for these patients, little is known about the quality of information obtained in these encounters. Our study compared the medical histories obtained by physicians in the emergency department (ED) based on whether the patients primarily spoke English or Spanish. Methods: This was a prospective, observational study conducted at a single, urban, academic ED during a six-month time period. Resident and faculty physicians caring for adult patients with a chief complaint of chest or abdominal pain were eligible for participation. Patient encounters were directly observed by medical students who had been trained using simulated encounters. Observers documented which key historical data points were obtained by providers, including descriptions of pain (location, quality, severity, radiation, alleviating/aggravating factors), past medical/family/surgical history, and social history, in addition to the patient's language in providing history. Providers, interpreters, and observers were blinded to the nature of the study. We used chi-square analyses to examine differences in whether specific elements were collected based on the primary language of the patient. Results: Encounters with 753 patients were observed: 105 Spanish speaking and 648 English speaking. Chi-square analyses found no statistically significant differences in any history questions between Spanish-speaking and English-speaking patients, with the exception that questions regarding alleviating factors were asked more often with Spanish-speaking patients (45%) than English-speaking patients (30%, p=.003). The average percentages of targeted history elements obtained in Spanish and English encounters were 60% and 57%, respectively. Conclusion: In this study at a large, urban, academic ED, the medical histories obtained by physicians were similar between English-speaking and Spanish-speaking patients. This suggests that the physicians sought to obtain medical histories at the same level of detail despite the language barrier. One limitation to consider is the Hawthorne effect; however, providers and observers were blinded to the nature of the study in an attempt to minimize the effect.en_US
dc.eprint.versionFinal published versionen_US
dc.identifier.citationLitzau, M., Turner, J., Pettit, K., Morgan, Z., & Cooper, D. (2018). Obtaining History with a Language Barrier in the Emergency Department: Perhaps not a Barrier After All. The western journal of emergency medicine, 19(6), 934–937. doi:10.5811/westjem.2018.8.39146en_US
dc.identifier.urihttps://hdl.handle.net/1805/19761
dc.language.isoen_USen_US
dc.publishereScholarship Publishingen_US
dc.relation.isversionof10.5811/westjem.2018.8.39146en_US
dc.relation.journalWestern Journal of Emergency Medicineen_US
dc.rightsAttribution 3.0 United States*
dc.rights.urihttp://creativecommons.org/licenses/by/3.0/us/*
dc.sourcePMCen_US
dc.subjectCommunication Barriersen_US
dc.subjectEmergency Service, Hospitalen_US
dc.subjectHispanic Americansen_US
dc.subjectHospitals, Teachingen_US
dc.subjectMedical History Takingen_US
dc.subjectPatient Safetyen_US
dc.subjectPhysician-Patient Relationsen_US
dc.subjectProspective Studiesen_US
dc.titleObtaining History with a Language Barrier in the Emergency Department: Perhaps not a Barrier After Allen_US
dc.typeArticleen_US
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