Found in translation
Being a Spanish-speaking patient in an English-speaking hospital can be daunting — but it also can lead to a potentially lifesaving medical catch.
In particular, one of these catches happened in the case of a Spanish-speaking patient who is known to UF Health medical interpreters Raquel Bourget-Gras, Roxana Urrutia and Charisa Lakin. The interpreters, who assist patients with limited English proficiency, knew that the patient was regularly prescribed Lovenox, a blood thinner. So when Bourget- Gras was translating the patient’s discharge instructions, she found it strange that the discharge papers instructed her to stop taking Lovenox.
“She needs to take Lovenox on a daily basis unless physicians determine that her blood levels indicate otherwise,” Bourget-Gras said. “Because we are all familiar with the patient’s case, I questioned why they were discontinuing the medication.”
Bourget-Gras brought the issue to the attention of the nurse, who in turn contacted the patient’s physician. The physician verified that the patient should have been kept on the blood thinner. Because of this catch and others like it, the medical interpreters received a Great Catch award.
The medical interpreters will be the first to say that they give no medical advice: They simply interpret, word for word, the instructions that physicians give their patients. But translating those instructions gives the interpreters familiarity with each patient’s treatment and offers them the opportunity to notice errors. That can help when patients are discharged from the hospital and the interpreters translate their papers from English to Spanish.
“Had the discharge instructions not been translated, these errors would have gone by undetected,” Urrutia said. “The patients would have gone home and could have had an adverse reaction.”
Several such errors have been caught thanks to the interpreters’ translations, according to Urrutia and Lakin.
“Sometimes, the discharge instructions will be contrary to what we heard the doctor say,” Lakin said. “A physician might say, for instance,‘Make sure you don’t take a certain medication like Tylenol,’ but then the patient is prescribed something that has acetaminophen in it.”
The catches that the interpreters have made prompted the creation of an interdisciplinary performance improvement team. The team is creating a standardized template to help health care providers when writing the discharge instructions. The goal is to help patients more easily read and understand those instructions.
“Patients are just handed their information and they go out the door,” said Anne M. Meiring, patient experience improvement specialist for UF Health. “We know that many patients being discharged daily don’t have the advantage of the medical interpreters’ close review of their discharge documents.”
Bourget-Gras and other Great Catch Award winners were featured in a video for this year’s Patient Safety and Quality Week. See the latest Great Catch Award video featuring this story here.