Doctor takes on language barrier to help stroke patients

Communication is key when the clock is ticking. Non-English speaking patients need to be understood.

By TJ Banes, IU Health Senior Journalist, tfender1@iuhealth.org

Dr. Shaney Peña was working at a local hospital when a non-English speaking came in for urgent care. The care team at first thought the patient was intoxicated. They couldn’t readily understand the needs. There was a language barrier.

It turned out the patient spoke primarily Spanish and was unable to communicate with the care team. As an Indiana University School of Medicine resident who sees patients at IU Health, Peña had her own brainstorm - her capstone project is focused on the outcomes in terms of disabilities in non-English speaking patients. In the coming year, she will be the first IU School of Medicine stroke fellow in several decades and is working at Methodist Hospital with mentor Dr. Ann Marie Jones.

The sooner a stroke is diagnosed, the more quickly treatment can begin. Time is critical in recognizing the signs and symptoms and understanding the patient’s needs.

“I think this project is really unique for our stroke division. We strive to provide patients with fast, efficacious, and appropriate stroke follow-up care. Through her project we started looking at different stroke metrics - how fast were patients triaged,” said Jones. Other factors reviewed include how fast the non-English speaking patients received their care and it they received necessary follow-up.

“From what we gathered, we found there is a fair amount of miss documentation regarding some demographic findings including language preference. We also found non-English proficient patients seem to have less follow-up and many do not go to acute stroke rehab. Knowing these deficits will allow us to target care toward a patient's unique and challenging needs,” said Jones.

One of the most important factors of Dr. Peña’s research will be gathering accurate documentation. About 1-1.5 percent of stroke patients are primarily Spanish speaking, said Angel Duzan director of the Comprehensive Stroke Center at IU Health Methodist Hospital.

Peña was born in Salem, Mass. and grew up in a household where Spanish was her first language. She lived much of her childhood between Massachusetts and the Dominican Republic.

At a young age, Peña said she played “doctor” and was always interested in science. During her rotations at IU Health, she often called her mother about her experiences.

“My mom could tell how excited I was about neurology. She said she recognized a light and how happy I was. Even when things weren’t going right, I always wanted to try again and get better as I pursued a career in neurology,” said Peña. “I also always had an interest in projects that involved diversity and how language impacts our outcomes. When I had that patient experience with a language barrier it hit me that we could do better.”

Her overall goal is to record and compare statistical differences in the care received by patients who don’t speak English.

“We will work with IU Health to learn how to best document language preference, set systems in place to get these patients back to clinic and learn how to counsel them on the needs of stroke recovery,” said Jones. Peña’s research will help team members assess if changes are needed in practices to promote the most successful outcomes for patients surviving a stroke.