Do You Have Micro Encounters with Limited English Proficiency Patients?

In our journey to develop No Barrier, we've engaged with numerous healthcare providers to gain insights into language barriers in healthcare. When we explored various settings, the usual encounter categories emerged - outpatient consultation visits, emergency room visits, urgent care visits, inpatient consults, and more. These can be referred to as "long encounters" - lasting at least a few minutes, with a significant amount of information exchanged between the provider and the LEP patient, ideally with a human interpreter present.

However, providers also described many "in-between" situations. For simplicity, we'll call these "Micro Encounters". These are typically very short conversations, statements, or requests, sometimes consisting of just three sentences.

Let's review some examples providers reported:

Routine Hospitalized Patient Care: A nurse may need to enter the room and ask something brief, like "Can we take the tray?", "Are you hungry?", or "Do you have any pain now?". Alternatively, the patient may have a question or two about their condition.

During Clinical Procedures: Imagine a clinical procedure where silence is mostly maintained, but occasionally the provider instructs the patient to do something: "Now breathe more heavily", "Can you please roll over to the left side", or “You’ll feel a small pinch with the needle”.

Post-Op, Follow-Up: For example, a patient who has undergone a colonoscopy and the provider wants to inform them that nothing was found, and all is well: "Your surgery went well, any questions?"

There are more anecdotal occurrences where there is a clear need for effective communication between provider and patient, even if it's a very brief exchange. The burden of securing an interpreter for these 3-4 sentence exchanges is even more apparent than in regular "long consult" cases. It seems that providers (and patients!) need more independence in their micro encounter communications, to streamline their communication in every LEP encounter, be it short or long.

This is where an instantly accessible, ad hoc application like No Barrier comes into play.

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