What is the most appropriate action to ensure a patient with a language barrier understands her medical care before undergoing a laparoscopic cholecystectomy?

Professional Healthcare Interpreter Services for Non-English Speaking Patients

For patients who do not share a common language with healthcare providers, a professional healthcare interpreter service should be contacted to ensure the patient's full understanding of their medical care. 1

Importance of Professional Interpreters in Healthcare

• Professional interpreters are superior to using ad hoc interpreters (family members, friends, or untrained staff) for patients with limited English proficiency 2
• Using family members as interpreters (like the patient's son in this case) can lead to errors in communication, violations of confidentiality, and increased risk of poor health outcomes 2
• Children should never be used as interpreters except in emergencies, as this can compromise the quality of communication and place inappropriate burden on family members 2

Guidelines for Communication with Non-English Speaking Patients

Evidence-Based Recommendations

• For families who do not share a common language with clinicians, medical interpreters should be used rather than family interpreters 1
• Professional interpreters improve both patient and provider satisfaction with communication 1
• In-person professional interpreters result in the highest satisfaction and best communication outcomes for patients 3

Communication Techniques When Using Interpreters

• Use simple, clear sentences and pause frequently to allow for interpretation 1
• Ask the patient to state their understanding after explanations to verify comprehension 1
• Be aware of cultural differences, not just language differences 1
• Address the patient directly rather than speaking to the interpreter 2

Risks of Inadequate Interpretation

• Patients with limited English proficiency experience challenges accessing healthcare and are at higher risk of receiving suboptimal care than native English speakers 4
• Studies show significant differences in recall of diagnosis, medication name, and medication function between non-English and English-speaking patients 1
• When both the patient's English and the provider's second language skills are poor, interpreters are often not called when needed, leading to poor understanding of diagnosis and treatment 5

Legal and Ethical Considerations

• Title VI of the Civil Rights Act mandates that interpreter services be provided for patients with limited English proficiency who need this service 2
• Standardized collection and exchange of patient interpretation needs can improve access to appropriate language assistance services 6
• Collecting and documenting patients' self-reported interpreter preferences can improve quality of services, patient care experiences, and equitable healthcare delivery 6

Common Pitfalls to Avoid

• Using bilingual staff who lack formal training in medical interpretation can lead to errors 5
• Web-based translation applications may not accurately convey medical terminology and nuances 1
• Assuming that a family member who speaks both languages can adequately interpret complex medical information 1, 2
• Failing to document a patient's need for interpreter services in their medical record 6

In this specific case of a 67-year-old Nepali-speaking woman preparing for laparoscopic cholecystectomy, contacting a professional healthcare interpreter service is essential to ensure she fully understands her preoperative assessment, required laboratory studies, and surgical preparation. This approach will help minimize the risk of adverse outcomes and ensure the patient's right to informed consent is properly respected.