Supporting Patients Who Use Languages Other Than English in Canadian Pediatric Hospitals

BACKGROUND: Patients and families who use a language other than English (LOE) for health care communication face heightened risks for poor outcomes due to structural language barriers. Although interpreter services are increasingly available, considerable variability remains in how language access is operationalized. This study aimed to examine interpreter service infrastructure, processes for identifying language needs, and barriers to equitable care for hospitalized pediatric patients who use LOEs in Canada. METHODS: We conducted a cross-sectional survey of clinical leaders from pediatric inpatient units across Canada. The survey explored interpreter service availability, language identification processes, staff training, and perceived barriers to effective communication. Quantitative data were analyzed descriptively, and open-ended responses were examined qualitatively using thematic analysis. RESULTS: Thirty-six tertiary academic and community hospitals participated. Only 40% of respondent hospitals reported a formal process for identifying language needs at admission, and most lacked standardized documentation in electronic medical records. Key identified barriers to optimal language support for patients and families, identified from both quantitative and open-ended responses, included time constraints, inconsistent service availability, and situations in which families declined interpreter support, potentially due to previous experiences of stigma or mistrust. Participants recommended improvements, including improved identification and documentation of patients needing interpreters, increased interpreter availability, and expanded staff training. CONCLUSIONS: There are persistent gaps in the equitable provision of interpreter services and supports for families who use LOEs in Canadian pediatric hospitals. To ensure that language access becomes a foundational component of safe family-centered care, interpreter services must be embedded into clinical workflows, supported by institutional infrastructure, and implemented in ways that foster trust and relational safety.