Almost all healthcare facilities in the US serve some patients with limited English proficiency (LEP).  How you approach communication– how you speak and how you listen, has an enormous impact on the success or failure of the communication. Here are 10 things you can do to  improve communication with LEP patients.

Listen Better

  1. Listen with patience. It takes time to communicate with LEP patients. Be quiet and allow pauses. Don’t interrupt, speak over, or finish their sentences. Listen to learn, not refute.
  2. Listen for key words, main ideas. Summarize or repeat this info back to the patient to confirm or clarify.
  3. Listen to body language. A blank stare or tense body may mean be a sign that they don’t understand. Body language is not the same across cultures. Asian patients may smile when they do not understand or when they feel uncomfortable.
  4. Listen for language level and then adjust your speaking (speed, vocabulary, grammar, etc)  accordingly. To assess language level, start with simple, yes/no questions and build in complexity using open ended questions that require explanation.
  5. Listen without prejudice. Do not equate an accent, poor grammar, or lack of fluency with lack of intelligence. Beware of the impact of culture. LEP clients may say they understand when they don’t, to save face.

Speak Better

  1. Speak Simply. Use short sentences with simple grammar and vocabulary. Avoid technical language, jargon, and idioms.
  2. Speak with structure. Use signposts (first, second, after that, etc) to lead the listener through a process.
  3. Speak in small doses. Don’t give too much information at one time. Be concise. Don’t digress. Check comprehension with each new piece of information.
  4. Speak slower with greater enunciation. Emphasize stress and intonation  to help the listener identify important or key information.
  5. Speak with your body. Use facial and hand gestures to emphasize and clarify. Demonstrate.