Evaluating the use of the ICI Linguistic Aid in GP Practice Nurse-Patient consultations

Problem

In the 2011 UK census, 864,000 people reported that they could not speak English well or at all, this often being associated with poorer physical and mental health outcomes. Current systems, including the use of professional interpreters, are already in place to assist non-English speaker’s communication during health consultations. The use of professional interpreters however is often time-consuming, expensive and requires planning in advance, which in reality therefore limits their widespread use in busy healthcare settings. Translated healthcare advice leaflets are also already available for non-English speaking patients pre- and post-consultation, but little is currently available as a ready access aid for healthcare professionals to use during the consultation itself.

The aim was to create an in-consultation interpreter “ICI” linguistic aid to help consultations between healthcare staff and non-English speaking patients, so reducing the likelihood of potential errors from language misunderstandings and hence potentially improving patient outcomes.

Approach

A London based GP surgery was selected for implementing the ICI linguistic aid. A needs analysis was initially conducted for the practice population area and staff were interviewed to identify the most common non-English speaking communities. Of the languages identified, Polish, Arabic and Romanian were selected for translation.

Common reasons for consultations were identified by observing different types of appointments patients had with the Practice nurse. These included: ‘Asthma and COPD reviews’, ‘Diabetic checks’, ‘Antenatal appointments’, ‘Postnatal appointments’ and ‘Wound care appointments’. Nurse consultations were targeted, as the purpose of the appointment is often pre-determined so certain areas and concerns will always need to be addressed.

Medical students and Doctors fluent in these languages were then used to translate salient questions relating to each of the five topic areas above. These can be answered yes or no, numerically or pictorially. A general section was also included addressing common symptoms patients may be experiencing to help identify more acute problems.

ICI booklets covering all five areas were then created for each language. Consultations were observed with the nurse pointing to the appropriate question in English with the relevant translation underneath.

Findings

Nurse reflections via surveys, will be used initially to evaluate the effectiveness of this novel approach to interpretation focussing on: ease of use, usefulness during consultations and perceived level of patient satisfaction. It is envisaged that later our research will involve exploring the impact on patients themselves and patient outcomes.

Consequences

Using the reflections obtained from both the practice staff and patients will help further shape this novel, yet simple linguistic tool, which has the potential to give health professionals a quick and easy alternative to interpretation in the consultation. The ICI tool therefore has the opportunity to improve health outcomes and bridge the health inequality gap often seen with non-English speaking patient groups.