Improving Patient Experience Scores Using Simultaneous Interpretation on Family-Centered Rounds

Author:

Kosack Amanda1,Carson Savanna L.2,Montenegro Eden Y. Bravo3,Owen Mary3,Dodge Sheridan3,Sim Myung4,Cagigas Xavier5,Ahumada-Mocorro Lorena6,Kamzan Audrey1,Acuna Hernandez Ernesto1,Lopez Gabriela7,Guzman Elizabeth1,Sanchez Gomez Diana1,Islas Zeuz1,Walker Valencia P.89,Lerner Carlos1,Lloyd Jessica1

Affiliation:

1. aDepartment of Pediatrics, University of California Los Angeles Mattel Children’s Hospital, Los Angeles, California

2. bDepartments of Internal Medicine, General Internal Medicine, and Health Services Research

3. cHealth Language Services, University of California Los Angeles, Los Angeles, California

4. dMedicine, Statistics Core

5. ePsychiatry

6. fDepartment of Patient Experience, Transplant Services team, and Care Coordination and Social Work program

7. gDavid Geffen School of Medicine at University of California Los Angeles, Los Angeles, California

8. hDivision of Neonatology, Department of Pediatrics, Nationwide Children’s Hospital and The Ohio State University College of Medicine, Columbus Ohio

9. iCenter for the Study of Racism, Social Justice & Health, Fielding School of Public Health

Abstract

OBJECTIVES Patients speaking a primary language other than English face barriers to equitable care, particularly patient–provider communications. There is no gold standard for providing inpatient medical interpretation on family-centered rounds (FCR). We aimed to implement simultaneous, in-person interpretation of FCR for Spanish-speaking families and hypothesized improved satisfaction in care. METHODS In-person, Spanish Equipment-Assisted Simultaneous Medical Interpretation (EASMI) was implemented in March 2018 on FCR. Child Hospital Consumer Assessment of Healthcare Providers and Systems (Child HCAHPS) experience scores on communication domains were analyzed for Spanish and English-speaking families pre- (n = 118) and postimplementation (n = 552). Postimplementation, we conducted medical team surveys (n = 104) and semistructured interviews with Spanish-speaking families (n = 25) to determine satisfaction with interpretation modalities (phone, video, and EASMI). RESULTS Spanish-speaking families exhibited statistically significant improvements in Child HCAHPS top box scores compared to English-speaking families in multiple communication and informed care-related domains. For example, "How often did your child’s doctors explain things to you in a way that was easy to understand?" top box scores improved from 58% to 95% for Spanish-speaking families, compared to 85% to 83% for English speakers, with the differential effect of the intervention showing statistical significance (P = .001). Medical team surveys demonstrated high satisfaction with EASMI. Qualitative themes from interviews and open-ended survey responses emphasized multiple care benefits with EASMI, including a perceived reduction of communication errors and increased family participation. CONCLUSIONS EASMI was associated with significant improvements in Child HCAHPS scores in communication domains and increased medical team and family members’ satisfaction with interpretation. EASMI presents a novel method for equitable FCR for Spanish-speaking families.

Publisher

American Academy of Pediatrics (AAP)

Subject

Pediatrics,General Medicine,Pediatrics, Perinatology and Child Health

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