Still lost in translation.

¿Habla español? Ba. n có nói tiếng viҲt? If you don't, then make sure you bring the interpreter into that patient's room. Not only is it likely your hospital's policy and a Joint Commission requirement, 1 but it's also good medical care. The pediatric literature over the past few decades has highlighted the importance of quality interpretation for Limited English Profi cient (LEP) patients to provide quality care. For a decade, Glen Flores has pointed out the health risks associated with not speaking English. 2 Poor outcomes such as disparities in care, adverse events, readmissions and medical errors all can complicate a hospitalization of a patient with LEP. In this month's Hospital Pediatrics, researchers from Seattle Children's add to the growing literature of challenges faced by LEP patients in the hospital. Ebel et al in the fi rst article highlight a new methodology for capturing LEP patients. Using " capture-recapture " methodology, the researchers were able to identify hospitalized patients who were not screened positive for requiring language services. 3 While your average pediatric hospitalist won't be implementing this methodology on a daily basis, this strategy could be employed as a performance improvement (PI) initiative to assure that your hospital is meeting it's obligatory requirements to provide culturally competent care to LEP patients. In a companion article from the same group, the consequences of LEP patients and inadequate translation become apparent. Only one third of the LEP post-operative patients at Seattle Children's received interpretive services at least twice a day and LEP patients were had signifi cantly higher levels of pain prior to receiving an opiod. 4 The authors conclude " it is likely that consistent use of interpreters enhanced the overall communication of patients, families and healthcare providers and improved the evaluation and treatment of each child's pain. " This study adds to the already robust literature of adverse outcomes of post-operative pain control in LEP adults and the previously noted literature in pediatrics. Taken together, these articles highlight that even in a well-resourced, top-10 Children's Hospital with doctors with the best intentions, we are still missing opportunities to provide interpretive services to LEP patients. Since recent immigrants may deny the need for interpreters due to embarrassment, shame or misunderstanding , or feel that their children are able to speak English well enough, this work highlights the responsibility of the pediatric hospitalist to assure quality care and err on …