339 - Family-Initiated Interpretation: A Quasi-Experimental Study in the Pediatric Intensive Care Unit

Poster Number: 339
Publication Number: 339.1714

Background: Use of a language other than English (LOE) is associated with worse health outcomes for hospitalized children. These outcomes are likely to be exacerbated in the pediatric intensive care unit (PICU), where parents face challenging and sensitive medical decisions. Professional interpretation improves outcomes for patients who use an LOE, but interpreters are still underused. No studies have examined whether patient-driven access to interpretation technology improves interpreter utilization.

Objective: To determine if allowing families to initiate interpretation will lead to greater use of interpreters, compared to the current standard of care.

Design/Methods: We conducted a quasi-experimental interventional study from September 2022 – October 2023 in a 60 bed PICU. Our intervention allowed families who used an LOE to independently initiate interpretation on hospital provided tablets. A video interpreter tablet was placed in the room of every patient who used an LOE for the duration of their PICU admission. Families were given instructions in their primary language on how to use the interpretation technology. The primary outcome of interest was the difference in the number of interpreter encounters per patient day and minutes of interpretation per patient day before and during the intervention. Baseline data was collected retrospectively (September 2022 – March 2023) and intervention data was collected prospectively (April 2023 – August 2023). Number of interpreter encounters per patient day was obtained from charting in the electronic health record (EHR). Total number of interpreter minutes per patient day was obtained from the remote interpreting services vendor. Interpreter encounters and minutes were aggregated by month. Demographic data were analyzed with descriptive statistics. Tests for differences in interpreter utilization were performed using an interrupted time series analysis.

Results: Since starting the intervention, 141 families have received interpreter tablets. Pre-intervention, there were an average of 1.01 interpreter encounters per patient-day, compared to a post-intervention average of 1.35 interpreter encounters per patient-day, which was not significantly significant (p = 0.22). The total duration of interpreter use per patient-day increased from an average of 7.6 minutes pre-intervention to 16.1 minutes post-intervention (p = 0.02).

Conclusion(s): Family-initiated interpretation was associated with an increase in the number of minutes per patient day of interpreter use. There was no statistically significant difference in the number of interpreter encounters based on EHR charting.