USING PROFESSIONAL VIDEO INTERPRETATION TO ENHANCE PATIENT EDUCATION FOR RADIATION THERAPY PATIENTS WITH LIMITED ENGLISH PROFICIENCY

ABSTRACT

Purpose: The purpose of patient education is to maintain or improve health throughout the cancer care journey, from diagnosis to treatment and beyond. COVID-19 has undeniably created a shift in the delivery of cancer care education with the transition to virtual care and enforcement of visitor restrictions. This has hindered equity and inclusion for patients with limited English proficiency (LEP) as they rely heavily on family members to be ad hoc interpreters. Language barriers are linked to less health education, lower interpersonal care and lower patient satisfaction. At the time of the project, professional over-the phone interpreters were used infrequently. The purpose of this project was to investigate alternate methods to enhance patient education for patients with LEP. Materials and Methods: A needs assessment was completed by surveying staff about their perspectives on current LEP education and interpreter use in the department, and patients to determine their comfort in communicating with radiation therapists and their preferred interpretation methods. After assessing the results of the needs assessment and examining interpretation options, professional video interpretation was implemented in February 2020. Interpreter usage has been tracked and post-implementation evaluation conducted with staff and patients. Results: According to the staff survey (n=69), professional over-the-phone interpreters were used least at 8% compared to other methods due to inconvenience and time constraints. Although family members (59%) and bilingual staff (62%) are most commonly used for convenience, decreased accuracy and workflow disruption were significant concerns. In addition, of the 34 staff that are fluent in a second language, only 6% stated that they were ‘very comfortable' in interpreting medical conversations. Patient surveys (n=12) indicated that 67% of LEP patients were not aware that the hospital offered free interpretation services. When asked if they were comfortable asking questions or discussing side effects with their therapists, only 36% and 40% were very comfortable, respectively. When asked which interpretation method they would most prefer for daily interactions, patients and staff showed similar results with bilingual staff members as most preferred (35%), professional face-to-face interpreters (30%), family member or friend (22%) and professional over-the-phone interpreters (13%). With the implementation of professional video interpretation, professional interpreter usage increased two-fold after COVID-19 visitor restrictions were enforced. Positive feedback has been received by both patients and staff. Conclusions: The needs assessment analysis revealed that ad hoc interpretation was used most frequently and preferred by both patients and staff. However, challenges can arise if family members also have LEP or are unable to accompany the patient, and if staff do not speak the patient's language. During COVID-19, the implementation of an institutional live-video interpretation service showed a two-fold usage increase since visitor restrictions were introduced. LEP patients have been more comfortable asking questions and staff have complimented the convenience and accessibility of the video interpreters. Video interpretation is a convenient tool that allows radiation oncology staff to use professional interpreters to communicate with patients virtually face-to-face and accurately provide education in their preferred language.