“Because I couldn't understand and respond”: A mixed-method study examining the impact of language barriers on patient experiences of intensive care unit outreach team care

Abstract

Background

Almost 10% of hospitalised patients experience acute deterioration requiring emergency intervention. Language barriers can impede patient assessment and health outcomes.

Objective

The objective of this study was to explore the experiences of adult inpatients whose preferred language was not English, who received care from the intensive care unit (ICU) outreach team.

Methods

An explanatory sequential two-phase mixed-method design was used. A retrospective audit was undertaken to explore characteristics of and outcomes for recipients of ICU outreach team care, according to preferred language. In phase two, interpreter-mediated interviews were conducted with former patients whose preferred language was not English to explore their experience of critical illness and care by the ICU outreach team.

Results

From 4234 inpatients who received care from the ICU outreach team in 2022, there was a mean of 3.54 episodes of care (1–565) per patient. Those whose preferred language was not English had a higher proportion of admissions from the emergency department and were more likely to have a medical emergency team call as their first outreach episode of care but less likely to be admitted to the ICU. Vietnamese and Mandarin were the next most common languages spoken after English. Twenty-two former patients or delegated relatives were interviewed. Not all recalled receiving care from the ICU outreach team. There was strong support for involvement of professional interpreters for critical conversations and to aid autonomy. Family members acted as lay interpreters and fulfilled familial and cultural obligations, but visitor restrictions impeded this.

Conclusion

Patient deterioration requires an emergent response. This research demonstrates the importance of identifying and overcoming language barriers for patients in a way that protects and preserves patient autonomy and ensures information accuracy. Where time and the patient's condition allows, use of professional interpreters must become the norm.