The challenge, however, is when the provider must convey patient specific instructions such as “Come to the ophthalmology clinic at 8 am on Thursday and bring your records from the outside hospital.” Frequently, there is no mechanism for requesting written translations in the acute setting. 4 Many electronic health records (EHRs) have pre-written patient education sheets for specific diagnoses such as “Upper Respiratory Infection” in a variety of languages and providers can easily use these to provide written materials in the patient’s preferred language. Whereas most hospitals in the USA have access to spoken language assistance via phone interpreters, a gap exists in the capacity for written translation. Written discharge instructions contain critical information about the patient’s diagnosis, treatment plan, and follow-up. 3 The discharge process is a particularly important point in terms of patient–provider communication. Patients with limited English proficiency (LEP) have low rates of understanding of appointment type and medications 1, higher rates of medication errors 2, and unplanned return visits to an emergency department. GT for discharge instructions in the ED is inconsistent between languages and should not be relied on for patient instructions. Mean Likert scores (on a 5-point scale) were high for fluency (4.2), adequacy (4.4), meaning (4.3), and severity (4.3) but also varied. Spanish had the highest accuracy rate (94%), followed by Tagalog (90%), Korean (82.5%), Chinese (81.7%), Farsi (67.5%), and Armenian (55%). The overall meaning was retained for 82.5% (330/400) of the translations. Volunteers were 50% female and spoke Spanish (5), Armenian (2), Chinese (3), Tagalog (4), Korean (2), and Farsi (2). Twenty volunteers evaluated 400 google translated discharge statements. Translations were evaluated using a previously validated matrix for scoring machine translation, containing 5-point Likert scales for fluency, adequacy, meaning, and severity, in addition to a dichotomous assessment of retention of the overall meaning.
MethodsĪ prospective assessment of the accuracy of GT for 20 commonly used ED discharge instruction phrases, as evaluated by a convenience sample of native speakers of seven commonly spoken languages (Spanish, Chinese, Vietnamese, Tagalog, Korean, Armenian, and Farsi). To perform a pragmatic assessment of GT for the written translation of commonly used ED discharge instructions in seven commonly spoken languages. A recent study of discharge instructions in Spanish and Chinese suggested that accuracy rates of Google Translate (GT) were high. Because many hospitals have no mechanism for written translation, ED providers resort to the use of automated translation software, such as Google Translate (GT) for patient instructions.
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