Translation app helping nurses and midwives ‘bridge care gaps’
A new app aimed at overcoming language barriers between patients and nursing or midwifery staff has been successfully rolled out at a London NHS trust.
Amanda Fitzsimons, chief nursing information officer (CNIO) of Lewisham and Greenwich NHS Trust, has overseen the rollout of the app, CardMedic, across the hospitals she covers and said it had become a useful companion for staff at times where an interpreter was not available.
“The gap in care comes when there are quick conversations you have with a patient”
Amanda Fitzsimons
The trust trialled the app in a maternity unit, before widening its use to 7,500 staff across its hospitals earlier this year.
The smartphone and laptop app contains translations of thousands of ready-made clinical phrases, questions and answers which clinical staff can use during interactions with patients.
It is designed to facilitate two-way translated interactions, allowing patients to respond, without the need for non-clinical translation websites or hand signals, something Ms Fitzsimons – a community midwife by background – said had the potential to otherwise cause things to get lost in translation.
“Particularly for patients on a ward, and when a member of staff wouldn’t call an interpreter, it helps say to someone, ‘I need to do your blood pressure’, or, ‘I need to take some blood tests’; a quick interaction, asking if someone needs anything,” added Ms Fitzsimons.
“We use interpreting services such as telephone and in-person translators on ward rounds and for scheduled appointments.
“The gap in care comes when there are quick conversations you have with a patient…. CardMedic helps us bridge that gap.”
The app was also helpful when an interpreter was unable to be reached, explained Ms Fitzsimons.
Amanda Fitzsimons
She emphasised, however, that the app was not replacing interpreter services, which remained the “gold-standard” at her trust and would not see a decline in use.
Ms Fitzsimons explained: “For a full appointment [a community midwife] would try to have an interpreter, but I know from experience there would be plenty of occasions where I’d sit on hold for half an hour to an interpreting service, only to tell me they can’t get an interpreter.
“I rely on a bit of sign language and a bit of [free online translation software] to try and get me through the appointment because you need to make sure this person’s had some level of care.
“I would then book them in, as soon as possible, back with another interpreter. But CardMedic allows you to provide a level of support if you can’t get access to an interpreter.”
She said that the app had been useful for its breadth, with access to more than 50 languages, having experienced that interpreters for some languages are difficult to access and more likely to be booked up.
As of April 2024, the app had been rolled out at trusts in all five of London’s integrated care systems (ICSs).
The Lewisham, Greenwich and Bexley boroughs of London, which Ms Fitzsimons’ trust covers, is a diverse area, with an above average number of people for whom English is not their first language.
The CNIO said CardMedic, as a result, filled a definite need: “When I used to run antenatal clinics in Bexley, which is probably one of the lesser diverse areas we cover, I’d have at least two to three interpreters in my clinic every week.
“The patient may be feeling like they’ve not been able to properly communicate, or they’ve not fully understood what you’ve said.
“The app helps patients feel they’re getting appropriate care and like they’re properly cared for, as opposed to having someone rush and try to do the best they can.”
Ms Fitzsimons added that online translation software, which are not designed for use in the medical field or checked by clinical professionals, did not always translate words and phrases appropriately, in contrast to CardMedic.
As CNIO, Ms Fitzsimons has been responsible with ensuring new assistive technology is integrated into nursing workflows smoothly.
She said the rollout of the app, despite some stumbling blocks, had been a success.
“Staff are really busy, and they’re not always aware of new things,” said Ms Fitzsimons. “The lessons learned from maternity was that we needed the buy-in from senior management to promote it.”
She further said that she would welcome other similar apps and technologies to assist nurses and midwives with their day-to-day.
“It is encouraging to hear how positive feedback from midwives has led to the wider adoption of CardMedic at the trust”
Rachael Grimaldi
“My role is to embrace any kind of digital transformation into healthcare that’s going to be beneficial to patients and clinicians,” she told Nursing Times.
“I think moving forward, there’s going to be more apps that help, but it’s all to do with finding the right ones for your organisation.
“For example, we were very clear with our staff that CardMedic was not a replacement for interpretation, it was something to use as an add-on, and to fill a gap, to make sure that we’re providing the best care that we can.”
Ms Fitzsimons said her next step would be to analyse usage data of the app to decide how best to further roll it out.
Dr Rachael Grimaldi, co-founder and chief executive of CardMedic, added: “Maternity teams recognise the importance of consistently good communication around the clock, so it is encouraging to hear how positive feedback from midwives has led to the wider adoption of CardMedic at the trust.
“CardMedic is available 24/7 and helps ensure that communication barriers do not get in the way of great care.
“Lewisham and Greenwich NHS Trust joins several other healthcare providers across London using CardMedic to provide instant communication support to a diverse and dynamic population.”
