Addressing Language Barriers in the Intensive Care Unit: A Case-Based Reflection and Brief Appraisal of the Literature

TL;DR

This paper discusses how language barriers affect ICU care for patients with limited English proficiency and offers solutions to improve communication and patient outcomes.

Contribution

The paper introduces a case-based reflection and literature appraisal to address language barriers in ICU settings through practical solutions.

Findings

Language barriers in ICU settings can lead to poor quality of care for patients with limited English proficiency.

In-person interpreters are the gold standard, but ICU workflows may require alternate interpretation methods.

Case-based learning highlights the impact of language interpretation on patient care and outcomes.

Abstract

At present, a substantial number of individuals in the US face limited English proficiency (LEP), posing difficulties for healthcare providers. Language barriers between healthcare providers and patients can lead to poor quality of care, especially in patients with hyperacute conditions such as stroke, myocardial infarction, acute trauma, and more. In the intensive care unit (ICU), diagnosis and rapid treatment decision-making rely on taking an accurate patient history and physical exam. While in-person interpreters are the gold standard for patients with LEP, the fast-paced nature of the ICU may require alternate modes of using interpreting services to fit ICU workflows. We present a case-based reflection of a patient with LEP who presented to our ICU after a motor vehicle accident. We present this case from the perspective of a third-year medical student caring for a patient while rotating in an ICU service. We illustrate how language interpretation impacted the patient’s care. We conclude by appraising the ICU literature and providing solutions to addressing language barriers for ICU patients with LEP to deliver patient-centered, high-quality care.