Communication methods between outpatients with limited-English proficiency and ancillary staff: LASI study results

Objective: Describe communication methods between primary care ancillary staff, including front desk administrative staff and medical assistants (MAs), and patients with limited-English proficiency (LEP).

Methods: Patients with LEP completed a telephone survey after a primary care visit including questions about communication with ancillary staff (n = 1029). To inform practice improvements and lend qualitative perspective to these quantitative data, we subsequently conducted semi-structured interviews with ancillary staff and physicians.

Results: Professional interpreter use was minimal with ancillary staff (<4%). Among patients who did not use their preferred language with bilingual staff, about one-third reported using English to communicate, despite most (≥ 80%) speaking English 'not well' or 'not at all.' In semi-structured interviews, ancillary staff felt basic English sufficient for most patient communication. However, physicians reported taking on extra visit tasks to compensate for the communication barriers between ancillary staff and patients with LEP.

Conclusions: Use of professional interpretation by front desk staff and MAs was minimal. This led many patients with LEP to 'get by' with limited English when communicating with ancillary staff, in turn increasing burden on the physician visit.

Practice implications: Future interventions should focus on increasing use of professional interpretation by outpatient ancillary staff when communicating with LEP patients.