Communication problems are known to be the cause of potentially harmful medical errors. A failure in communication is particularly likely when there is a language barrier between health care providers and patients or their families. A multicenter prospective cohort study was undertaken to evaluate the association between parents' limited comfort with English and adverse events in a cohort of hospitalized children.

The study was conducted in the pediatric inpatient units of seven teaching hospitals and included Arabic-, Chinese-, English-, and Spanish-speaking parents of children age 17 or younger. The researchers ascertained adverse events or suspected errors by reviewing patient records, clinician and hospital reports, and family safety interviews. Of 1,666 parents, 147 expressed limited comfort with English. Spanish was the most commonly spoken language among these parents.

The researchers identified a total of 217 adverse events, of which 142 were classified as preventable. In multivariate analysis, children whose parents expressed limited comfort with English had twice the odds of experiencing one or more adverse events and one or more preventable adverse events compared with children whose parents said they were comfortable with English.

The authors note that the study was conducted at academic teaching hospitals. The availability of interpreters and the proportion of parents who have limited comfort with English at these hospitals may differ from other facilities. Another limitation was that the languages spoken by the study cohort were not representative of the national population of people who have limited English proficiency, according to the authors. Health literacy wasn't routinely assessed, they add, and the study relied on parents' self-reported comfort with English.