Health care interpreter use in an inpatient rehabilitation setting: examining patterns of use and associated clinical outcomes

Abstract

Purpose

Professional interpreters can improve healthcare quality and outcomes when there is language discordance between patients and health care providers. Multidisciplinary rehabilitation relies on nuanced communication; however, the use of interpreters in rehabilitation is underexplored. This study aimed to examine patterns of health care interpreter use in an inpatient rehabilitation setting.

Methods

A retrospective cohort study was conducted including patients admitted for subacute rehabilitation during 2019–2020 identified as having limited English proficiency. Patterns of interpreter use (professional and “ad hoc”) and rehabilitation outcomes were evaluated via medical record review.

Results

Eighty-five participants were included. During inpatient rehabilitation (median 17 [12–28] days), most clinical interactions (95%) occurred without an interpreter present. Patterns of interpreter use were variable; with greater use of ad hoc versus professional interpreters (received by 60% versus 49% of the cohort, respectively). Those who interacted with a professional interpreter had a longer length-of-stay, larger Functional Independence Measure (FIM) gain, and lower rate of hospital readmission six months post-discharge. The number of professional interpreter sessions correlated positively with FIM gain.

Conclusions

Access to professional interpreters in inpatient rehabilitation was variable, with some patients having no or minimal access. These findings provide preliminary evidence that professional interpreter use may be associated with clinical rehabilitation outcomes.

Implications for rehabilitation

• Professional health care interpreters can be used to overcome language barriers in rehabilitation.

• In an inpatient rehabilitation setting, professional interpreters appeared to be underutilized, with many patients having no or minimal access to interpreters.

• Use of ad hoc, untrained interpreters and informal communication strategies was common during rehabilitation.

• Use of professional interpreters appeared to be associated with favorable rehabilitation outcomes.

Keywords:

• Rehabilitation
• language
• communication
• health care interpreter
• quality of health care
• limited English proficiency
• culturally and linguistically diverse (CALD)
• Non-English Speaking Background (NESB)

Acknowledgements

The authors gratefully acknowledge Tami Ebner (Diversity and Health Literacy Coordinator, St Vincent’s Hospital Sydney) for providing comment on the study rationale and manuscript.

Disclosure statement

The authors have no conflicts of interest to declare.

Additional information

Funding

This study was funded by a Translational Research Grant from the St Vincent’s Centre for Applied Medical Research Inclusive Health Innovation Fund; and a Research Development Scholarship (Dr Yuriko Watanabe) from the Royal Australasian College of Physicians, Australasian Faculty of Rehabilitation Medicine (RACP, AFRM).