141 - Increasing the Documented Utilization of Interpreter Services in a Pediatric Inpatient Unit of a Municipal Hospital in New York City: A Quality Improvement Project

Poster Number: 141
Publication Number: 141.1603

Background: Availability of and access to interpreter services is essential to ensuring quality patient care, especially when serving a diverse patient population. Within the pediatric inpatient unit, interpreter services allow for effective communication with Limited English Proficiency (LEP) patients and their caregivers.

Objective: Our quality improvement (QI) study aims to improve patient-provider communication in the pediatric inpatient unit by increasing the documented utilization of interpreter services when interacting with LEP patients and their caregivers from an estimated baseline of 40% to 60% in 4 months.

Design/Methods: The Model for Improvement methodology was used. A pre-intervention resident physician survey was conducted in March 2023 to measure knowledge of available interpreter services and to identify barriers in use and documentation. A Pareto chart was constructed from the survey results to identify possible areas of intervention, with the most common barriers being lack of interpreter service devices and time constraints (figure 1). A Key Driver Diagram (figure 2) was used to guide change ideas. Plan-Do-Study-Act (PDSA) cycles were conducted from July to October 2023. A combination of resident education, technology utilization and engagement interventions were used for each cycle (figure 3 footnote). The outcome measure was the documented use of interpreter services on admission notes per cycle. The process measure was the percentage of inpatient unit residents with interpreter service mobile application installed pre- and post-education session. Our balancing measure is a post-intervention survey to identify if workflow was affected by the QI study.

Results: In cycle 1, documented use of interpreter services on admission notes improved to 55%. Cycles 2, 3, and 4 noted an increase in documented use of interpreter services surpassing the stretch goal (67%, 63%, and 91%, respectively; Figure 3). After the monthly education sessions, median percentage of inpatient unit residents with interpreter service mobile application installed and available to use increased from 42% to 100%.

Conclusion(s): Our findings suggest that a QI approach focusing on resident education, technology utilization and engagement effectively improves physician documented use of interpreter services in the pediatric inpatient unit. Increasing the documented use of interpreter services enhances the quality of patient care and patient-provider communication.