http://intqhc.oxfordjournals.org/cgi/content/abstract/mzl069v1


Language proficiency and adverse events in US hospitals: a pilot study


Chandrika Divi, Richard G. Koss, Stephen P. Schmaltz and Jerod M. Loeb

The Joint Commission, One Renaissance Boulevard, Oakbrook Terrace, IL
60181, USA

OBJECTIVE: To examine differences in the characteristics of adverse
events between English speaking patients and patients with limited
English proficiency in US hospitals.

SETTING: Six Joint Commission accredited hospitals in the USA.

METHOD: Adverse event data on English speaking patients and patients
with limited English proficiency were collected from six hospitals over
7 months in 2005 and classified using the National Quality Forum
endorsed Patient Safety Event Taxonomy.

RESULTS: About 49.1% of limited English proficient patient adverse
events involved some physical harm whereas only 29.5% of adverse events
for patients who speak English resulted in physical harm. Of those
adverse events resulting in physical harm, 46.8% of the limited English
proficient patient adverse events had a level of harm ranging from
moderate temporary harm to death, compared with 24.4% of English
speaking patient adverse events. The adverse events that occurred to
limited English proficient patients were also more likely to be the
result of communication errors (52.4%) than adverse events for English
speaking patients (35.9%).

CONCLUSIONS: Language barriers appear to increase the risks to patient
safety. It is important for patients with language barriers to have
ready access to competent language services. Providers need to collect
reliable language data at the patient point of entry and document the
language services provided during the patient-provider encounter.

Keywords: patient safety, adverse events, language barriers, language
proficiency, patient safety event taxonomy



International Journal for Quality in Health Care Advance Access
published online on February 2, 2007







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