When In-Person Interpretation Matters: Perspectives From ICUs and Acute Inpatient Care Settings

Background Clinicians often care for multilingual patients and generally prefer in-person rather than remote interpretation. However, little is known about the reasons for selecting specific interpretation modalities in intensive care units (ICUs) and acute inpatient care settings. Objective To examine the context and application of in-person interpretation in ICUs and acute care settings. Methods Semistructured interviews of interprofessional stakeholders were conducted to understand the advantages and limitations of in-person and remote interpretation modalities in ICUs and acute care settings. Thematic analysis of the interviews was performed. Results Forty-one interviews were completed. Certain contexts motivated preferences for selecting in-person rather than remote interpretation in ICUs and acute care settings. Three overarching themes were identified: (1) specific types of conversations (eg, goals-of-care, end-of-life, and difficult conversations), (2) additional patient-related communication barriers (eg, hearing problems, delirium), and (3) other considerations related to in-person interpreter expertise (cultural contexts and prebriefing) and barriers to use (eg, delays, difficulty contacting interpreters). Conclusions Acute care clinicians often prefer in-person interpretation owing to factors that are either specific to in-person interpretation or cannot be fully replicated via remote modalities. Acute care clinicians consider conversation complexity, patient factors, and unique benefits versus logistical barriers when considering in-person interpretation. Overall, in-person interpretation provides advantages over alternative modalities for several scenarios to improve the quality of care for patients with non-English language preference in ICUs and acute care settings.