An assessment of interpretation services for communicating with patients, parents & careers: Increasing interpretation accessibility and efficiency using the consolidated framework for implementation research (CFIR) and organisational learning

Abstract

Background: Paediatric patients and their parents who do not speak English experience significant healthcare inequality in the UK. The language barrier prevents them from accessing healthcare services, understanding information, and following doctors’ recommendations. At the same time, interpretation services are under-utilised in many care settings, including Great Osmond Street Hospital for Children (GOSH), London. Objectives and research questions: This study aims to examine the perceived barriers and facilitators to staff members’ utilisation of interpretation services for communicating with patients, parents, carers, and families in the UK who do not have English as a first language. The goal is to develop evidence-based recommendations for GOSH administrators and staff members to make interpretation services more cost-effective, accessible, and patient-oriented. Methodology: A narrative review of 21 studies was conducted. Studies included in the sample used different methodologies (qualitative, quantitative, and mixed) and focused on the experiences of both patients and care providers, which allowed for a balanced view of the nuances of the use of interpretation. Theoretical framework: The research analysed the findings through the prism of two theoretical frameworks: the Consolidated Framework for Implementation Research (CFIR) and organisational learning. The former helps better understand the barriers to using interpreters in clinical settings, whereas the latter informs the development of recommendations for GOSH. Findings: The narrative review revealed that the utilisation of a team-based approach, consideration of a cultural context, being empathetic, and using family-centred communication facilitated interpreter engagement in communication with patients with limited English proficiency (LEP). The use of technology and the involvement of family members can also facilitate communication, but it has its limitations. Barriers to interpretation use include costs, 2 time pressure, lack of interpreter training, staff’s lack of awareness, and absence of organisational guidelines.