Factors Associated with EMS Clinician Preparedness to Provide Care for Patients with Limited English Proficiency

Abstract

Objectives: Emergency medical services (EMS) clinicians report challenges in providing care to patients with limited English proficiency (LEP); however, associated factors are not well defined. The objective of this study was to examine EMS clinicians' self-reported preparedness to provide emergency care to patients with LEP in the prehospital setting.

Methods: We conducted a cross-sectional survey between October 10 and December 3, 2024, to assess the education and training received by nationally certified EMS clinicians on providing care to patients with LEP. We analyzed the data using univariate and bivariate analyses, including Pearson's chi-square and analysis of variance tests. We used least absolute shrinkage and selection operator to identify key predictors and logistic regression models (Odds Ratio (OR), 95% Confidence Interval (CI)) to determine associations with preparedness.

Results: Of the 986 EMS clinicians who responded to the survey, 58.3% reported providing care to one or more patients with LEP over the past month. Although provision of EMS care to patients with LEP was common, only 28.8% of clinicians reported receiving initial education on delivering care to patients with LEP and 29.5% reported additional education. Among respondents, 44.3% reported access to professional interpreter services. Of these, 64.9% reported that it was easy or very easy to access services, 88.0% reported that the services were effective or very effective, but 64.9% reported using interpreter services less than 25% of the time or never. Respondents with initial (OR 1.96, 95% CI (1.46-2.63)) or additional (OR 1.54, 95% CI (1.15-2.06)) education on the provision of care for patients with LEP reported feeling more prepared when delivering care to this population, compared to clinicians who did not receive education on this topic.

Conclusions: Prehospital clinicians commonly provide care to patients with LEP; however, EMS education or training on delivering care to this population is uncommon and interpreter use is rare. Clinicians felt more prepared in delivering care when provided any LEP education. Future efforts in EMS should consider incorporating LEP-related content in initial and additional education efforts and create strategies to overcome the low use of professional interpreter services.