WIP 98 - Using Family-Directed Interpretation to Improve Language and Communication Equity Among Patients with Limited English Proficiency in Ambulatory Care Clinics: A Quality Improvement Study

Poster Number: WIP 98
Publication Number: WIP 98.893

Background: Children of non-English-speaking parents are at higher risk for adverse events, hospitalization, and delayed care and are more likely to receive appropriate treatment, have better disease management, and experience fewer adverse events if receiving interpreter services. While disparities in communication are documented in the pediatric hospital/emergency medicine literature, there is limited data assessing interpreter use in ambulatory pediatric clinics.

Objective: Using QI methodology, to increase appropriate interpreter use at each clinical and ancillary interaction for families listing Spanish as their primary language to 90% by 03/2024.

Design/Methods: A pre-intervention needs assessment was conducted to understand current interpreter use at 6 visit time points. The planned intervention will allow families to carry a tablet with interpretation services in each step of the visit rather than relying on staff to bring in a device. Reeducation of clinical staff in ambulatory care interpretation best practices will also occur. IRB expedited as QI. Timeline: Intervention: 11/23- 02/24; Data analysis: 02/24-03/24. Outcome measures include percent of interactions between clinic staff and families for which appropriate interpretation services are used and family satisfaction with access to interpretation services and care. The pre-intervention needs assessment evaluated 35 visits and found that interpreter use was lower during interactions with security (0% of visits), triage (22.9%), and registration (37.1%) compared to with the doctor (100%). Only 54.3% of families reported they were always able to communicate with any staff member in Spanish. 20% of families did not feel their concerns were understood by staff. In qualitative analysis examining self-reported barriers to care, multiple families voiced difficulty contacting the clinic and scheduling appointments. Formal QI and implementation science methodology, including S-charts, will be used to ensure feasibility, effectiveness, and scalability and survey data will be collected post-intervention to assess for improvement.