How are language barriers bridged in hospitals? a systematic review

This thesis investigates how language barriers experienced by linguistic minority patients are bridged in hospital settings. Linguistically accessible healthcare is a crucial part of optimising health outcomes for hospitalised patients (Malevanchik et al., 2021; Portillo et al., 2021) and linguistic minority patients often face worse health outcomes than their majority peers (Jacobs et al., 2020; Ortega, 2020). Against this background, this study examines, first, the types of language barriers that exist in hospitals. Second, it asks how hospital staff assess a linguistic minority patient’s language proficiency and how they identify the need for a multilingual communication strategy. Third, it examines what current tools and language support strategies hospitals use to bridge language barriers, and what their strengths and limitations are. This is done through a systematic literature review of 50 studies published between 2018 and 2023. Findings show that much of the current literature examines spoken language barriers between patients and hospital staff. These are overwhelmingly bridged through the provision of interpreting services, whether by professional or ad hoc interpreters, in person or remotely. The key problem identified with consistent interpreting service provision relates to time constraints. Another reason for haphazard service provision lies in inconsistencies in the assessment procedures to identify a patient’s linguistic proficiency and need for language support. The study also highlights the use of some novel assistive communication technologies. Overall, this systematic literature review provides a detailed picture of the current state of hospitals’ multilingual communication strategies. The study is a pilot for a PhD project that aims to contribute to more inclusive linguistic practices in diverse hospital settings.