Quality Translations: A Matter of Patient Safety, Service Quality, and Cost-Effectiveness

“The directions on the bottle of blood-pressure pills read simply enough: ‘Take once a day until finished.’ But a Mexican immigrant still wobbly in her English, misreads just one word. In her native Spanish, ‘once,’ means 11. The pills, if taken too many at a time, make her dizzy—or worse. They could kill her.”1 The lack of comprehensible and usable written and spoken language is a major barrier to health communication targeting primary and secondary disease prevention and is a major contributor to the misuse of health care, patient noncompliance, and rising health care costs.2 Without appropriate and quality language services, limited-English proficient (LEP) and non-English proficient (NEP) patients experience compromised health care—often relying upon “safety-net” public and nonprofit providers, and using alternative or underground sources of care.3 At Kaiser Permanente (KP), we have an opportunity and an obligation to improve the health and quality of life of our members. KP's membership is a microcosm of the diversity of our nation and our world, representing over 100 different languages. For members whose primary or preferred language is other than English, our ability to provide patient-centered care is often challenged when we cannot communicate effectively in their languages. For example, how do we manage informed consent? How do we ensure that LEP/NEP patients have correct and complete information to follow pre-operative instructions as well as access to medical benefits and coverage information? The availability of qualified interpreters and comprehensible written in-language material is thus paramount to ensuring equal access to health information and crucial for treatment adherence, patient safety, and quality care.