Human Services News

Commonwealth Fund:

Effective communication between patients and providers is critical to high-quality health care.

When patients are children, parents or guardians must step in to ensure a full and open exchange of information.

When parents do not speak English, however, children may not receive high-quality---or even safe---care.

As part of a larger project supported by The Commonwealth Fund and directed by Lisa Simpson, a research team led by Christina Bethell conducted focus groups to examine communication-related hospital quality and safety issues for children from Spanish-speaking families with limited English proficiency (LEP).

According to, "Quality and Safety of Hospital Care for Children from Spanish-Speaking Families with Limited English Proficiency" (Journal for Healthcare Quality, May/June 2006), parents, providers, hospital staff, and quality improvement (QI) professionals agree that language and cultural differences lead to communication issues that can have a pervasive, negative impact on the quality and safety of care children receive, but disagree about what exactly needs to change.

To identify priorities and strategies, the researchers conducted 12 focus groups with 72 individuals at children's hospitals in South Florida and Southern California.

The groups consisted of: Spanish-speaking parents with limited English proficiency (LEP) whose children had recently been hospitalized; physicians, nurses, or other hospital staff who came into direct contact with families; and QI professionals.

Problems and Priorities During the focus group discussions, 12 overarching themes emerged about how language and cultural differences contribute to communication problems and, consequently, how these differences affect quality and safety of care.

Hospitals should provide more medically trained interpreters through each phase of the hospital stay and ensure continuity of interpreters for families and providers.