Hospital practices for determining patient language proficiency: a systematic review

Language barriers can constitute a formidable hurdle to receiving adequate healthcare. Linguistically accessible healthcare is a crucial part of optimising health outcomes for hospitalised patients, and linguistic minority patients often face worse health outcomes than their majority peers. Against this background, this study asks how hospital staff assess a linguistic minority patient’s language proficiency and how they identify the need for a multilingual communication strategy between the patient and their healthcare providers. This is done through a systematic literature review of 50 studies published between 2018 and 2023.

Findings show that language proficiency assessments are widely overlooked and treated as if they were self-evident. Language proficiency assessments thus become an invisible process that is not clearly anchored in any recognized workflow. Where responsibility for determining a patient’s proficiency in the institutional language and their need for a multilingual communication strategy is identified, it rests with hospital admission and triage staff. However, there is no widely accepted procedure or protocol that would guide admission staff members on how to perform this task in a way that will provide ongoing language support to patients for the entirety of their hospital stay. We conclude that the development of language assessment policies and procedures is an urgent task to improve healthcare provision for linguistic minority patients.