Lost in Translation: The Impact of Language Barriers in the Emergency Department

Rationale Language barriers pose a growing challenge in healthcare, potentially affecting the quality of care and patient safety. Aims This study quantified the prevalence and severity of language barriers in the emergency department (ED) and assess their impact on the ED consultation process and ED-related outcomes. Methods This was a prospective, observational single-centre cohort study. All patients between 18 April and 24 May 2024, presenting to the ED, were assessed for the presence of any language barrier. Demographic data and ED outcomes were collected for all patients. For patients with a language barrier, both the language barrier and its perceived impact on the consultation process (as assessed by the treating physician) were evaluated. Data were analysed using t-tests, chi-square tests. Regression analyses were performed to assess the impact of the severity of the language barrier on ED-related outcomes. Results During the study period, 116 (7.9%) out of 1474 patients had a language barrier. These patients were younger (mean age 48.4 vs. 61.5 years, p < 0.001) and more often male (62.9% vs. 51.8%, p = 0.022) compared to those without a language barrier. Patients with a language barrier had shorter total treatment time (2:06 vs. 2:42 h, p = 0.009) and fewer ED revisits during the past 30 days (5.2% vs. 13.6%, p = 0.004). Communication aids were used in 62% of consultations, with family or acquaintances assisting in 44%, and professional interpreters were used in 2.2% of cases. Language barriers mostly affected history taking (mean score 2.71/5), explaining treatment plans (2.41/5), and follow-up discussions (2.32/5). Conclusion Language barriers are frequently encountered in emergency care, mostly affecting history taking, explaining treatment plans, and discussing follow-up instructions. Communication aids are inconsistently applied, and interpreter use is rare, risking loss of information and adverse outcomes.