Multilingual Services Provide Healthcare Access to Diverse Communities in Queens

By Tasneem Alghamdi and Yiwei Xu

Liangji Huang was dumbfounded when he arrived at the emergency room of Elmhurst Hospital Center a year ago. His wife had been  hospitalized for brain surgery after a traffic accident. He was desperate to help, but he had no idea what the doctor was saying.

Huang has been in New York for 30 years. He is not as fluent in English as his daughter, who went to an American school. Although she knows English, the doctor’s language was still too advanced for her to understand. The shock and helplessness left both the father and daughter in tears.

It was a great relief for them to see a Chinese man who approached them and explained what the doctor said, Huang recalled. The man turned out to be a medical interpreter who had been hired by the hospital to help non-English speakers.

Huang is one of the many immigrants in Elmhurst with limited English skills. Almost two-thirds of the Queens neighborhood’s residents were born outside the U.S., and half of its population understands English “less than very well,” according to the American Community Survey released in 2015.

It’s challenging to make healthcare accessible and smooth the process for diverse communities, but Elmhurst Hospital Center, as the largest public hospital in the area, tries to pave the way for patients who are non-native speakers. The hospital manages an interpreting service that is free to patients. It cost the hospital $1.8 million in the last fiscal year, according to Glenn Zuraw, the hospital’s language access coordinator.

The language program isn’t the only service the hospital offers to patients who aren’t fluent in English. Like most of New York’s public hospitals, Elmhurst has a website that is available in over 100 languages. In addition, printed information comes in various languages, such as the general information booklet that patients receive at the entrance of the hospital. It’s written in the top five languages that patients speak, said Zuraw. Those languages are Spanish, Bengali, Mandarin, Korean and Arabic.

Interpreting plays a more important role when it comes to medical communication. In 2016, interpreting services were used in more than 200,000 visits to Elmhurst Hospital Center, according to the combined interpreting facility report from the hospital. Of those, 73 percent were Spanish, seven percent were Bengali, six percent were Mandarin and three percent were Korean.

“We don’t need to ask for interpreters,” said Hokhang Cheng, 51, in Mandarin. Cheng has been going to the hospital on a monthly basis for the past year after a surgery to fix a wound on his face. “They ask us what our native language is and put us on the phone,” he said.

A list of available interpretation services at the information desk of Elmhurst Hospital Center. (The Ink/Yiwei Xu)

What Cheng referred to is one of the three forms of interpreting services provided by Elmhurst Hospital Center—phone interpreting. The other two are face-to-face and remote video interpreting. Ninety-five percent of interpreting services  in 2016 were conducted on the phone, mostly because it is always available, said Zuraw. The total amount of phone interpreting was 2.5 million minutes last year, followed by face-to-face interpreting, totaling 200,000 minutes.

Although the hospital tries to integrate technology into its services, many patients still prefer face-to-face interpreting. Elmhurst Hospital Center has met that demand with both interpreters and “dual-role people”—hospital staff trained as interpreters who work with non-English speakers when they are not occupied by their other jobs. Volunteers, paid interpreters and staff members need to take a 40-hour course to become qualified interpreters and those interpreting in Spanish and Mandarin take tests annually to continue to qualify, said Zuraw.

“We discourage using family members,” said Zuraw. “We want to use official, qualified, interpreters, either on the phone or in person.”

For patients who speak languages that are less common, the hospital uses both face-to-face and phone interpreting  services from agencies such as Just Interpretation LLC and Geneva, Zuraw said. Both agencies have interpreting solutions for hospitals on their websites.

“A lot of times the language for face-to-face are more obtuse, so the more advance notice we have, the better, because those people that speak those languages, there’s a limited pool,” Zuraw said. “We are able to fill, I don’t have an exact percentage, but I want to say, 99.9 percent of [needs]; there’s always a .1 that’s hard to fill.”

When no interpreters are available, patients do the best they can to communicate. “We try speaking in English, and they sometimes have Bengali interpreters,” said Afia Nusrat, a Bengali woman in her 30s.

Patients say they like the quality of the service but often also rely on the judgment of families and friends who speak English. “Sometimes I go with my daughter,” Cheng said in Mandarin. “She knows English and she thinks the translation is good enough.”

Relatives who have been educated in this country also step in. “My relatives went to college, so they understood the doctors’ [language],” Huang said in Mandarin. “They talked with the doctors in English, and I felt their English was adequate for that.”

The quality of phone interpreting also seems to be a concern for some patients. “Face-to-face interpretation is clearer,” Cheng said in Mandarin. “Sometimes I can’t hear interpreters clearly over the phone. They use speakerphones, but the voice is still fuzzy.”

It’s hard to always provide the face-to-face interpreting that patients prefer. “They only have one or two Chinese interpreters there, and sometimes they are busy and can’t come to us,” said She Zheng, a 60-year-old restaurateur, in Mandarin.

Elmhurst Hospital Center is now working on translating an existing application to help patients schedule appointments, communicate with their doctors through the app, access test results and request prescription refills. The application will further contribute to the language services at the hospital, said Zuraw.