ArticleBMJ open2024
Language Access Systems Improvement initiative: impact on professional interpreter utilisation, a natural experiment.
Article in BMJ open, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 7 papers, 1 of them a synthesis that pooled it.
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The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
7 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Strategies to Increase Professional Interpreting in Clinical Settings: A Systematic Review.JAMA network open · 2025Pooled it
- Reliability and Validity of Patient Ratings and Clinician Self-Report in the Assessment of Clinician Non-English Language Skills.Journal of general internal medicine · 2026Observational
- Translation and interpreting services must be considered across the lifecycle of clinical trials.Trials · 2026Article
- Comparing remote and in-person interpretation experiences for clinicians and Spanish-speaking patients with limited English proficiency: a mixed methods study.BMJ open quality · 2025Article
- Physicians' Perspectives on Using Direct Observation to Assess Non-English Language Proficiency for Clinical Practice: A Qualitative Study.Joint Commission journal on quality and patient safety · 2025Article
- Qualified Multilingual Assessment Policy for US Medical Students: A National Delphi Consensus Study.Teaching and learning in medicineReview
- Patient Time Spent With Professional Medical Interpreters and the Care Experiences of Patients With Limited English Proficiency.Journal of primary care & community healthArticle
Corrections and comments
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Authors and funding
8 authors.
Funding
Abstract
objectivesThis study aims to evaluate the Language Access Systems Improvement (LASI) initiative's impact on professional interpreter utilisation in primary care and to explore patient and clinician perspectives on professional interpreter use.
designMulti methods: Quantitative natural experiment pre-LASI and post-LASI, qualitative semistructured interviews with clinicians and focus groups with patients post-LASI.
settingLarge, academic primary care practice.
participantsCantonese, Mandarin, Spanish, English-speaking adult patients and their clinicians.
interventionLASI initiative: Implementation of a clinician language proficiency test and simultaneous provision of on-demand access to professional interpreters via video medical interpretation.
main outcome measuresQuantitative: Proportion of language discordant primary care visits which were professionally interpreted. Qualitative: Salient themes related to professional interpreter use and non-use.
resultsThe researchers categorised language concordance for 1475 visits with 152 unique clinicians; 698 were not fully language concordant (202 pre-LASI and 496 post-LASI). Professional interpreter utilisation increased (pre-LASI 57% vs post-LASI 66%; p=0.01); the visits with the lowest percentage of profssional interpreter use post-LASI were those in which clinicians and patients had partial language concordance. In inverse probability weighted analysis, restricting to 499 visits with strict estimated propensity score overlap (100% common support), post-LASI visits had higher odds of using a professional interpreter compared with pre-LASI visits (OR 2.39; 95% CI 1.04 to 5.48). Qualitative results demonstrate video interpretation was convenient and well liked by both clinicians and patients. Some partially bilingual clinicians reported frustration with patient refusal of interpreter services; others reported using the video interpreters as a backup during visits. Views of the care-partner role differed for clinicians and patients. Clinicians reported sometimes having family interpret out of convenience or habit, whereas patients reported wanting family members present for support and advocacy, not interpretation.
conclusionsLASI increased utilisation of professional interpreters; however, this was least prominent for partially language concordant visits. Health systems wishing to implement LASI or similar interventions will need to support clinicians and patients with partial bilingual skills in their efforts to use professional interpreters. TRIAL REGISTRATION NUMBER: HSRP20153367.
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