Research Report: Addressing Language Barriers at Royal Perth Hospital

This research report addresses the critical issue of communication barriers at Royal Perth Hospital, primarily focusing on the challenges arising from patients speaking diverse languages. The study identifies the hospital's struggles with a high volume of non-English speaking patients, leading to potential misunderstandings and inadequate medical care. The report explores solutions such as increasing the number of permanent translators, particularly in the emergency unit, and implementing mobile translating software. It also delves into the ethical implications of recruiting focus groups comprising doctors and patients, highlighting potential issues like patient coercion, breaches of confidentiality, and cultural sensitivity. The research emphasizes the need for ethical considerations in research design and the importance of cost-effective communication strategies. The report concludes by advocating for the efficient use of professional interpreters and the integration of technology to enhance communication while acknowledging the need for thorough ethical considerations in future research projects. The report also provides insight into the ethical implications of the research project and the relationship between the ethical implications and the ethical form.

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Part 1
Introduction
This paper aims to identify and expound on some of the challenges faced by the health
department and the available solutions that will ensure the patients get the services they deserve
and the doctors, on the other hand, do not break the oath they were sworn into when they started
to practice medicine. Also, it will show the benefits of a proper research done to Royal Perth
Hospital in the Western part of Australia on the methods by which effective communication can
be achieved among people who speak different languages. The main problem faced in this
hospital, is the fact that the patients come from diverse backgrounds hence speak in different
languages thereby patient-doctor communication becoming a challenge. The paper also
highlights the ethical difficulties, such as patients feeling uncomfortable communicating to the
researcher due to certain reasons, associated with the recruitment of focus groups comprised of
doctors and patients in a research project.
The Main Challenge Facing Royal Perth Hospital
The Royal Perth Hospital serves very many people from Australia most of them being
immigrants who are not very fluent English speakers (Heath, Orrell, Lee, Pearman, McCullough,
& Christiansen 2003, pp.4652). It is known to have the most occupied emergency reception area
and also handles very many cases of trauma (Heath et al 2003, pp. 4651). A nurse in the

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emergency care unit shed light on the issue of communication saying that each day they deal
with many people most of who speak in unfamiliar languages (Roter, & Hall 2006, pp.45).
Following the research, some of the patients ended up not receiving the medical help they needed
since the doctor tried as much as he/she could in understanding the patient's problem but due to
the barrier created by the language the proper assistance was not given (Ha&Longnecker 2010,
pp.39). Also, for the patients in the ward who were not conversant with English, communicating
to the rest of the stuff such as those in the kitchen department was a problem, therefore, they
were unable to ask for the food options they preferred. To ensure no patient was misunderstood
or served in an unsatisfactory manner, communication needed to be enhanced (Bender&Sartipi
2013, pp.333). The hospital had hired fifty translators, however, only two of them translating
Chinese and Vietnamese were permanent workers. An effective solution would be to increase the
number of permanent translating workers within the emergency unit since it is the busiest unit.
Enablers and Barriers of Best-practice
Research showed that implementing the solution stated above would be challenging since
it would cost the hospital more money to have a full-time translator as compared to hiring them
when their need arose (Hudelson 2005, pp.331). The government of Australia allocated $54.3
million in the budget year 2013-2014 for translation and interpretation services in the Refugee
and Humanitarian Program. On the bright side, however, the issue of a language barrier and
unsatisfied patients would be completely erased as the doctors would have a clear understanding
of the patient's condition or injury before they start treatment (Hudelson 2005, pp.332). Another
solution would be to use mobile translating software to enhance communication between the
patients and the medical practitioners.

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Research showed that the convenience brought by the software surpassed that of a
professional translator and it was also cost effective (Prgomet, Georgiou, &Westbrook 2009,
pp.792). Also, the software was available to everybody with a smart phone hence; the nurses did
not have to wait for the translator in order to attend to the patients (Lee 2007, pp.245). The
technology enabled the nurses to describe the prescriptions to the patients and also for the
kitchen employees to discuss the diet choices that were favorable to the patient according to
his/her religion. Patients were also able to ask questions and get clarity about their conditions
(Lee 2007, pp.246). Team work among the staff was increased since they could communicate
easily. On the down side of this software technology, questions of how accurate the translations
were coming up and more time were needed for a more precise version of the software to be
created.
Part 2
Ethical Implications Associated with the Proposed Research Project
Following the example of Royal Perth Hospital above, focus groups comprising of
nurses, doctors, and patients could be recruited to find out ways to enhance communication
within the hospital setting. In the previous years, the use of focus groups has been on the rise to
collect information on various issues concerning health (Barbour 2005, pp.742). There are
ethical problems associated with the use of such a diverse focus group (Barbour 2005, pp.744).
First, the patients may feel like they are being forced to participate hence end up being part of a
research they want nothing to do with. Secondly, the patients not being able to discuss their
engagement in the research project with others (Gallagher, Waterman, Ebers, Fraser, &

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Levinson2003, pp.1001). Also, the patients are not given time to decide if they want to take part
or not.
When the research process takes place during the patient's consultation hours the doctor's
focus may be diverted to the interviewer other than attending to the patient. For the doctors, they
may feel like they are compelled to participate if the research project has been authorized from
above. In a case where people with disabilities are involved, the researcher might tend to be
biased and give them special treatment because of their condition. The participant might end up
feeling isolated when he/she wants to feel normal and accepted by the society (Lennox, Taylor,
Rey‐Conde, Bain, Purdie, & Boyle 2005, pp.297). In culturally sensitive areas, the researcher
might fail to observe basic things termed as important to the society such as the way he/she
speaks to the members of the opposite gender.
Relationship between Ethical Implications and the Ethical Form
From the ethical difficulties above, there might be a conflict of interest if the doctors
participate in the research process during working hours (Part C, Item 7) therefore neglecting the
patients (Gallagher et al 2003, pp.1002). The doctors may also feel undermined having to take
part in a process that also includes their patients (Part C, Item 12). Due to the diversity of the
participants, issues of language barrier may arise (Part C, Item 14) especially if the issue of
translation is not properly addressed (Roter, & Hall 2006, pp.47). There might be problems when
the consent process is not thoroughly done and the participants feel like they were forced into
taking part (Part C, Item 10) especially if there are incentives being offered (Part C, Item 11). In
addition, where most of the participants are given incentives as a motivation to participate, the

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budget might go higher than estimated and the available resources, in the end, fail to sustain the
entire project (Part C, Item 6). There might be risks involved (Part C, Item 4) when people of a
particular society feel like the researcher fails to acknowledge their cultural beliefs may be in the
way he/she conducts himself or herself, they might display antisocial behavior towards the
researcher.
Conclusion
The problem of language barrier has been a challenge for the Royal Perth Hospital but
with the advancement in technology, it will soon be forgotten. Also, with the use of software
technology in translation, more clinics will be opened in the future thereby easing the workload
at this Perth Hospital. For the patients who are not very good in speaking and hearing the English
language, the professional interpreters have been of great aid to them. The professional
interpreter’s services, however, need to be utilized efficiently to cut down on the cost of
healthcare provided. In discovering ways to improve communication, researchers need to put the
ethical implications into consideration at the same time using methods that are pocket-friendly.
The involvement of diverse groups of people in a research project means more ethnic
consideration and the higher the chances of a language barrier. The results achieved, however,
are more accurate unlike when small focus groups are used.

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