Written by Julia López PhD, MPH, LCSW and Shan Wang, BA
In a city known for its vibrant culture and dynamic health care landscape, ensuring that every patient receives accessible and compassionate healthcare is paramount. Barnes Jewish Hospital (BJH) and St. Louis Children’s Hospital (SLCH) are two of the four level-one trauma centers in St. Louis that provide essential resources for emergency care. Language barriers in these emergency departments (EDs) would endanger patient safety and risk closing an essential gateway to the healthcare system.
The Challenge: Language Barriers in Emergency Departments
For many patients and their families, visiting an ED is already a stressful experience. When language barriers add to the urgency of medical care, the risk of misunderstandings and poor health outcomes rises. Limited access to language services can delay care, cause dangerous miscommunications, and ultimately widen health disparities for those who prefer languages other than English.
A Seed of Change
Recognizing this critical need, the Center for Human Rights, Gender, and Migration awarded a seed grant to Shan Wang and me. Our goal? To gather participant perspectives on language access in BJC emergency departments and pave the way for meaningful improvements in language services.
Diving into Patient Experiences
To truly understand the problem, we conducted 15 in-depth, semi-structured interviews in Spanish with recent ED patients and parents who accompanied their children to the emergency department. Participants were over 18 years old, spoke Spanish as their first language, reported having limited English proficiency (LEP), and had visited the BJH or SLCH ED within the past two years. These personal stories provided an invaluable window into patient experiences with ED language services.
From Insights to Action
By analyzing the interview transcripts, our team identified common themes that emerged from participant narratives. These findings established the groundwork for four policy recommendations to improve language access in hospital EDs:
- Hiring more bilingual providers and staff: Ensuring patients receive care in their preferred language at every stage of the ED course.
- Closing access gaps in Video Remote Interpreting services: Technology must function smoothly to bridge the communication divide.
- Providing written materials in the patient’s preferred language: Clear communication is essential, from consent forms to discharge instructions.
- Investigating language access in other healthcare institutions and migrant communities: Similar studies in different languages and hospitals may reveal additional setting-specific interventions.
Collaborating for a Healthier Future
We shared the brief with the BJH and SLCH emergency departments and are currently collaborating with ED physicians to design and implement essential improvements in language services. It’s also been distributed to community organizations serving the Latine migrant population of St. Louis. We hope that our findings will empower these communities to advocate for greater language access in the ED.