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JGIM: studies show importance of language services on disparities, quality of care
Date:11/1/2007

This study showed that, despite the availability of on-site professional interpreter services, hospitalized patients who do not speak English are less likely to have signed consent forms in their medical records. Researchers from the Department of Medicine at the University of California, San Francisco, compared records of LEP and English-speaking patients for full documentation of informed consent a legal and ethical requirement prior to invasive, non-emergency medical procedures. Full documentation includes a note documenting a consent discussion and a signed consent form. For LEP patients, it also requires some evidence of interpretation.

Although the health care system has a long way to go in improving performance on informed consent for all patients, the results of this study showed that charts of English-speaking patients were nearly twice as likely as those of LEP patients to contain all elements of informed consent (53% vs. 28%). When examining the components of informed consent, charts of English-speaking and LEP patients were similar in the proportion documenting that a consent discussion took place, but charts of English-speaking patients were more likely to contain a signed consent form in any language (85% vs. 70%). The researchers conclude these findings suggest differences in practice, not documentation alone.

Informed consent is a fundamental tenet of the U.S. health care system, said lead researcher Yael Schenker, M.D. While language barriers make obtaining informed consent more complex, it is still a legal and ethical requirement and is increasingly recognized as a key component of quality care and patient safety. Hospitals must work harder to break down the language barriers faced by LEP patients.

Senior author Alicia Fernandez M.D., reported that the hospital leadership has responded very appropriately to the study findings, and the hospital has substantially revised its informed consent process to ensure that a
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Contact: Nick Ferreyros
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