Language should not be a barrier to quality care

By | 2022-09-22T14:14:34-04:00 October 25th, 2016|Tags: , |4 Comments

As our nation becomes increasingly more diverse, so does our patient population and healthcare workforce. Diversity in healthcare manifests itself in many different and beautiful ways, but one of the most important is the number of languages patients and providers can, and perhaps more importantly, cannot speak.

According to a 2015 U.S. Census Bureau report, data from an American Community Survey showed at least 350 languages were spoken in U.S. homes. With data like these, healthcare providers face many challenges in caring for the patients they serve and in getting the bilingual and multilingual staff they need to deliver that care. Inability to meet these challenges can lead to misinterpretations, miscommunications, mishaps and even malpractice.

Nurses spend more time with patients than any other healthcare group, so the ability to speak more than one language is a major asset for nurse applicants and a skill recruiters value. Whether teaching medication doses, giving instructions on diagnostic testing, explaining procedures or making sure a consent is truly an informed one, the quality of the communication between the nurse and the patient is crucial.

Along with their recruitment work, healthcare facilities also provide services like telephone language lines and other mobile computer technologies for patients and families because staff translators are not always available and families may not be present or able to help with translation. Some also use contracted language interpreters who work in person or off-site by phone or video, but if the interpreter has good language skills and is not highly knowledgeable about medical standards, terminology, etc., there’s a risk of information being lost in translation.

Regardless of the problems that may arise with these services, healthcare facilities are required by regulatory agencies to provide language services that will help ensure access to quality care no matter which language the patient speaks. The intent of the regulations is that the interpretation and translation methods used support effective communication between patients and care providers and are effective in a variety of care situations. Simply put, the services must meet the patient’s needs.

But the need is not a new one. As long ago as 2004, when The Institute of Medicine report, “Health Literacy: A Prescription to End Confusion,” was published, health literacy was defined as “the degree to which individuals have the capacity to obtain, process, and understand basic health information and services needed to make appropriate health decisions,” and language is most certainly a vital part of health literacy. It can mean the difference between life and death if what the patient or provider is trying to communicate is not clear and understandable.

Read the article, “Speaking their language” for a look at some special roles bilingual nurses  in meeting the needs of the diverse patient populations they serve. Patients’ safety and recovery depend on good communication all along the care continuum, and bilingual staff, as well as interpretation and translation services play a vital role in making that happen. •

About the Author:

Eileen Williamson, MSN, RN
Eileen Williamson, MSN, RN, continues to write and act as a consultant for Before joining the company in 1998, Eileen was employed by North Shore-Long Island Jewish Health System in New York (now Northwell Health System) where she held a number of leadership positions in nursing and hospital administration, including chief nurse at two of their System hospitals. She holds a BSN and an MSN in nursing administration and is a graduate fellow of the Johnson & Johnson University of Pennsylvania Wharton School Nurse Executives program. A former board member and past president of the New Jersey League for Nursing, a constituent league of the National League for Nursing, Eileen currently is a member of the Adelphi University, College of Nursing and Public Health Advisory Board.


  1. Avatar
    K Lucier October 26, 2016 at 4:41 pm - Reply

    Thought this ACA Section 1557 may be of interest as well. Not many organizations are aware of the recent 2016 updates on this pertaining to Language Access and use of staff as Professional Interpreters in a healthcare setting.

    Section 1557: Ensuring Meaningful Access for Individuals with Limited English Proficiency.
    The Section 1557 final rule applies to any health program or activity, any part of which receives funding from the Department of Health and Human Services (HHS), such as hospitals that accept Medicare or doctors who receive Medicaid payments; the Health Insurance Marketplaces and issuers that participate in those Marketplaces; and any health program that HHS itself administers.
    Protections for Individuals with Limited English Proficiency
    • Consistent with longstanding principles under civil rights laws, the final rule makes clear that the prohibition on national origin discrimination requires covered entities to take reasonable steps to provide meaningful access to each individual with limited English proficiency who is eligible to be served or likely to be encountered within the entities’ health programs and activities.
    o An individual with limited English proficiency is a person whose primary language for communication is not English and who has a limited ability to read, write, speak, or understand English.
    o Reasonable steps may include the provision of language assistance services, such as oral language assistance or written translation.
    o The standards in the final rule are flexible and context-specific, taking into account factors such as the nature and importance of the health program and the communication at issue, as well as other considerations, including whether an entity has developed and implemented an effective language access plan.
    • Covered entities are required to post a notice of individuals’ rights providing information about communication assistance for individuals with limited English proficiency, among other information.
    • In each state, covered entities are required to post taglines in the top 15 languages spoken by individuals with limited English proficiency in that state that indicate the availability of language assistance.
    • Covered entities are prohibited from using low-quality video remote interpreting services or relying on unqualified staff, translators when providing language assistance services.
    • Covered entities are encouraged to develop and implement a language access plan to ensure they are prepared to take reasonable steps to provide meaningful access to each individual that may require assistance.
    OCR has translated a sample notice of nondiscrimination and the taglines for use by covered entities into 64 languages. For translated materials, visit
    For more information about Section 1557, visit

  2. Avatar
    オーラルデント November 5, 2016 at 3:32 am - Reply

    Hi friends, its fantastic article regarding teachingand fully explained, keep it up
    all the time.

  3. Avatar
    Translationpage November 9, 2016 at 11:12 am - Reply

    It’s a Fantastic article on language translation. Translation should be accurate to remove the language barrier. Thanks for the article.

  4. Avatar
    Selina November 29, 2016 at 7:55 am - Reply

    Thanks for sharing this Awesome article with us, who Take care of Language Barriers.

Leave A Comment