The Premise and Development of CHECK IN—Check-In for Exchange of Clinical and Key Information to Enhance Palliative Care Discussions for Patients With Limited English Proficiency

2020 ◽  
pp. 104990912097998
Author(s):  
Amelia Barwise ◽  
Mei-Ean Yeow ◽  
Daniel K. Partain
Keyword(s):  
Decision Making ◽  
Limited English Proficiency ◽  
English Proficiency ◽  
Quality Care ◽  
Clinical Information ◽  
Clinical Encounter ◽  
High Quality ◽  
Serious Illness ◽  
Patient Goals ◽  
Medical Interpreter

Communication regarding serious illness is challenging in most circumstances. Patients with Limited English Proficiency (LEP) have unique language and cultural needs that often require collaboration with a trained medical interpreter, especially when the clinical encounter involves serious illness decision making or elucidation of patient goals, preferences, and values. Although there is mounting evidence to support interpreter/clinician huddles before a serious illness communication encounter, no current initiatives exist to operationalize this evidence. We are currently in the process of developing, evaluating, and implementing a formal interpreter/clinician huddle process to promote high quality care for patients with LEP. Our huddle guide, called the Check-In for Exchange of Clinical and Key Information (CHECK-IN), is designed to facilitate collaboration between an interpreter and clinician during a serious illness encounter by prompting exchange of relevant sociocultural and clinical information between clinicians and interpreters.

scholarly journals Interventions for End of Life Decision Making for Patients with Limited English Proficiency

2019 ◽  
Vol 22 (4) ◽  
pp. 860-872 ◽  
Author(s):  
Amelia Barwise ◽  
Joyce Balls-Berry ◽  
Jalal Soleimani ◽  
Bibek Karki ◽  
Brandon Barrett ◽  
...  
Keyword(s):  
Decision Making ◽  
End Of Life ◽  
Limited English Proficiency ◽  
English Proficiency ◽  
End Of Life Decision ◽  
Life Decision

Providers’ Perceptions of Medical Interpreter Services and Limited English Proficiency (LEP) Patients

2014 ◽  
Vol 9 (2) ◽  
pp. 156-169 ◽  
Author(s):  
Barret Michalec ◽  
Kristin M. Maiden ◽  
Jacqueline Ortiz ◽  
Ann V. Bell ◽  
Deborah B. Ehrenthal
Keyword(s):  
Limited English Proficiency ◽  
English Proficiency ◽  
Interpreter Services ◽  
Medical Interpreter

scholarly journals Differences in Code Status and End-of-Life Decision Making in Patients With Limited English Proficiency in the Intensive Care Unit

2018 ◽  
Vol 93 (9) ◽  
pp. 1271-1281 ◽  
Author(s):  
Amelia Barwise ◽  
Carolina Jaramillo ◽  
Paul Novotny ◽  
Mark L. Wieland ◽  
Charat Thongprayoon ◽  
...  
Keyword(s):  
Intensive Care Unit ◽  
Decision Making ◽  
Intensive Care ◽  
End Of Life ◽  
Limited English Proficiency ◽  
English Proficiency ◽  
Code Status ◽  
End Of Life Decision ◽  
Life Decision

scholarly journals Promoting quality care in patients with cancer with limited English proficiency: perspectives of medical interpreters

2016 ◽  
Vol 25 (10) ◽  
pp. 1241-1245 ◽  
Author(s):  
Giselle K. Perez ◽  
Jan Mutchler ◽  
Mai See Yang ◽  
Cheyenne Fox Tree-Mcgrath ◽  
Elyse R. Park
Keyword(s):  
Limited English Proficiency ◽  
English Proficiency ◽  
Quality Care ◽  
Patients With Cancer ◽  
Medical Interpreters

scholarly journals The empirical evidence underpinning the concept and practice of person-centred care for serious illness: a systematic review

2020 ◽  
Vol 5 (12) ◽  
pp. e003330
Author(s):  
Alessandra Giusti ◽  
Kennedy Nkhoma ◽  
Ruwayda Petrus ◽  
Inge Petersen ◽  
Liz Gwyther ◽  
...  
Keyword(s):  
Decision Making ◽  
Empirical Evidence ◽  
Complete Information ◽  
Primary Data ◽  
Free Text ◽  
High Quality ◽  
Joint Decision ◽  
Quality Healthcare ◽  
Serious Illness ◽  
Free Text Search

IntroductionPerson-centred care has become internationally recognised as a critical attribute of high-quality healthcare. However, the concept has been criticised for being poorly theorised and operationalised. Serious illness is especially aligned with the need for person-centredness, usually necessitating involvement of significant others, management of clinical uncertainty, high-quality communication and joint decision-making to deliver care concordant with patient preferences. This review aimed to identify and appraise the empirical evidence underpinning conceptualisations of ‘person-centredness’ for serious illness.MethodsSearch strategy conducted in May 2020. Databases: CINAHL, Embase, PubMed, Ovid Global Health, MEDLINE and PsycINFO. Free text search terms related to (1) person-centredness, (2) serious illness and (3) concept/practice. Tabulation, textual description and narrative synthesis were performed, and quality appraisal conducted using QualSyst tools. Santana et al’s person-centred care model (2018) was used to structure analysis.ResultsPRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) flow data: n=12,446 studies screened by title/abstract, n=144 full articles assessed for eligibility, n=18 studies retained. All studies (n=18) are from high-income countries, and are largely of high quality (median score 0.82). The findings suggest that person-centred care encompasses the patient and family being respected, given complete information, involved in decision-making and supported in their physical, psychological, social and existential needs. The studies highlight the importance of involving and supporting family/friends, promoting continuation of normality and self-identity, and structuring service organisation to enable care continuity.ConclusionPerson-centred healthcare must value the social network of patients, promote quality of life and reform structurally to improve patients’ experience interacting with the healthcare system. Staff must be supported to flexibly adapt skills, communication, routines or environments for individual patients. There remains a need for primary data investigating the meaning and practice of PCC in a greater diversity of diagnostic groups and settings, and a need to ground potential components of PCC within broader universal values and ethical theory.

Why do we not use trained interpreters for all patients with limited English proficiency? Is there a place for using family members?

2011 ◽  
Vol 17 (3) ◽  
pp. 240 ◽  
Author(s):  
Ben Gray ◽  
Jo Hilder ◽  
Hannah Donaldson
Keyword(s):  
New Zealand ◽  
Limited English Proficiency ◽  
English Proficiency ◽  
Health Centre ◽  
Family Members ◽  
Primary Care Settings ◽  
Large Populations ◽  
Interpreter Service ◽  
Medical Interpreter ◽  
The Ideal

Australia and New Zealand both have large populations of people with limited English proficiency (LEP). Australia’s free telephone interpreter service, which is also used by New Zealand through Language Line (LL) but at a cost to the practices, is underused in both countries. Interpreter guidelines warn against the use of family members, yet the lack of uptake of interpreter services must mean that they are still often used. This paper reviews the literature on medical interpreter use and reports the results of a week-long audit of interpreted consultations in an urban New Zealand primary health centre with a high proportion of refugee and migrant patients. The centre’s (annualised) tally of professionally interpreted consultations was three times more than that of LL consultations by all other NZ practices put together. Despite this relatively high usage, 49% of all interpreted consultations used untrained interpreters (mostly family), with more used in ‘on-the-day’ (OTD) clinics. Clinicians rated such interpreters as working well 88% of the time in the OTD consultations, and 36% of the time in booked consultations. An in-house interpreter (28% of consultations) was rated as working well 100% of the time. Telephone interpreters (21% of consultations) received mixed ratings. The use of trained interpreters is woefully inadequate and needs to be vigorously promoted. In primary care settings where on-going relationships, continuity and trust are important – the ideal option (often not possible) is an in-house trained interpreter. The complexity of interpreted consultations needs to be appreciated in making good judgements when choosing the best option to optimise communication and in assessing when there may be a place for family interpreting. This paper examines the elements of making such a judgement.

Prescribing peritoneal dialysis for high-quality care in children

2020 ◽  
Vol 40 (3) ◽  
pp. 333-340
Author(s):  
Bradley A Warady ◽  
Franz Schaefer ◽  
Arvind Bagga ◽  
Francisco Cano ◽  
Mignon McCulloch ◽  
...  
Keyword(s):  
Decision Making ◽  
Peritoneal Dialysis ◽  
Clinical Decision Making ◽  
Quality Care ◽  
Dialysis Initiation ◽  
High Quality ◽  
Fluid Removal ◽  
Medline Search ◽  
Small Solute ◽  
Solute Clearance

Background: Peritoneal dialysis (PD) remains the most widely used modality for chronic dialysis in children, particularly in younger children and in lower and middle income countries (LMICs). We present guidelines for dialysis initiation, modality selection, small solute clearance, and fluid removal in children on PD. A review of the literature and key studies that support these statements are presented. Methods: An extensive Medline search for all publications on PD in children was performed using predefined search criteria. Results: High-quality randomized trials in children are scarce and current clinical practice largely relies on data extrapolated from adult studies or drawn from observational cohort studies in children. The evidence and strength of the recommendation is GRADE-ed, but in the absence of high-quality evidence, the opinion of the authors is provided and must be carefully considered by the treating physician, and adapted to local expertise and individual patient needs as appropriate. We discuss the timing of dialysis initiation, factors to be considered when selecting a dialysis modality, the assessment and management of volume status on PD, achieving optimal small solute clearance, and the importance of preserving residual kidney function. While optimal dialysis must remain the goal for every patient, a careful discussion with fully informed patients and caregivers is important to understand the patient and family’s expectations of dialysis and reasonable adjustments to the dialysis program may be considered in accordance with a philosophy of shared decision-making. Conclusions: There continues to be very poor evidence in the field of chronic PD in children and these recommendations can at best serve to guide clinical decision-making. In LMICs, every effort should be made to conform to the framework of these statements, taking into account resource limitations.

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