351 - In-person Spanish interpretation increases access to family centered rounds for Spanish-speaking families in the pediatric intensive care unit.

Poster Number: 351
Publication Number: 351.2064

Background: Many patients and families served by the Children’s Hospital Colorado pediatric intensive care unit (PICU) are non-native English speakers, the majority of whom speak Spanish as their primary language. Currently, PICU staff primarily use audio or video interpreters to communicate with Primarily Spanish-speaking Families (PSSF) for daily clinical updates. As a result, it is difficult for these families to participate in Family-Centered Rounds (FCR) and express timely concerns compared to English-speaking families.

Objective: To increase the rate of involvement of PSSF on rounds from 0% to 50% in a 3-month period by implementing in-person (IP) Spanish interpretation during PICU FCR and understand the impact of this change on families and medical teams through qualitative methods.

Design/Methods: Through PDSA cycles, patients and their families identified as PSSF on admission in the electronic health record received a door sign noting language preference. The Interpreter then proactively checked in with families and medical teams and coordinated a rounding time schedule. At FCR, the interpreters provided simultaneous interpretation and updates between the families and medical team. Family and staff surveys were collected to assess interpreter style preference and satisfaction with process; analysis included mean and standard deviation.

Results: 325 interpreter encounters occurred during the 3-month period, 111 for family-centered round for 51 individual families. Baseline Spanish speaking family involvement was zero and successfully increased to greater than 50%. Rounds lasted an average of 10 minutes (range 6-60 min) with no significant increase compared to baseline rounding. 100% of Spanish speaking families (n=32) found having an IP interpreter on rounds helpful; 93% of Spanish speaking families and 97% of PICU staff (n=79) preferred IP interpreters versus phone or video. On a scale of 1 (strongly disagree) to 10 (strongly agree), staff felt an IP interpreter improved their ability to communicate with families as an average of 9.5 (SD 1.4) and ranked their perception of the families improved understanding with an IP interpreter as 9.36 (SD 1.76) [Figure 1].

Conclusion(s): Language remains a major barrier to health equity. Incorporating an IP Spanish interpreter on PICU rounds is a feasible way to include families and better involve these families in shared decision making without increasing the duration of rounds. Families exceedingly prefer IP interpretation during rounds in the PICU over video or phone interpretation methods. The medical teams also preferred IP Spanish interpretation.