Discordance Between Satisfaction and Health Literacy Among Spanish-Speaking Patients with Limited English-Proficiency Seeking Emergency Department Care

Introduction: The emergency department (ED) is one clinical setting where issues pertaining to health communication uniquely manifest themselves on a daily basis. This pilot study sought to understand satisfaction with care, perceptions of medical staff concern, awareness, and comprehension of medical care among Spanish-speaking patients with limited English-language proficiency (LEP). Methods: A two-phase, mixed-methods approach was employed among Spanish-speaking patients with LEP that presented to an ED in West Central Florida. The prospective phase consisted of semistructured interviews ( n = 25). The retrospective phase analyzed existing patient satisfaction data collected at the study site ( n = 4,940). Results: Content analysis revealed several linguistic barriers among this patient population including limited individual autonomy, self-blame for being unable to effectively articulate concerns, and lack of clarity in understanding follow-up care plans. Retrospective analysis suggested differences between responses from Spanish-speaking patients when compared with their English-speaking counterparts. Conclusions: Our findings suggest discordance between satisfaction and health literacy in this unique patient population. Although high satisfaction was reported, this appeared to be secondary to comprehension of follow-up care instructions.

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Assessment of Interpretation Modality and Patient Comprehension in Spanish-speaking Limited English Proficiency (LEP) Patients Presenting to the Emergency Department

Journal of Health Care for the Poor and Underserved ◽

10.1353/hpu.2021.0187 ◽

2021 ◽

Vol 32 (4) ◽

pp. 2143-2153

Author(s):

Cassidy Muir ◽

Amaury Michel ◽

Cara Joyce ◽

Theresa Nguyen

Keyword(s):

Emergency Department ◽

Limited English Proficiency ◽

English Proficiency ◽

Spanish Speaking ◽

Patient Comprehension

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Tracking the Rise of Geriatric Emergency Departments in the United States

Journal of Applied Gerontology ◽

10.1177/0733464818813030 ◽

2018 ◽

Vol 39 (8) ◽

pp. 871-879 ◽

Cited By ~ 2

Author(s):

John G. Schumacher ◽

Jon Mark Hirshon ◽

Phillip Magidson ◽

Marilyn Chrisman ◽

Terisita Hogan

Keyword(s):

Emergency Department ◽

Emergency Care ◽

Emergency Departments ◽

The United States ◽

Transitions Of Care ◽

Emergency Department Care ◽

Equipment And Supplies ◽

Care Services ◽

Physical Environments

The traditional model of emergency care no longer fits the growing needs of the over 20 million older adults annually seeking emergency department care. In 2007 a tailored “geriatric emergency department” model was introduced and rapidly replicated among hospitals, rising steeply over the past 5 years. This survey examined all U.S. emergency departments self-identifying themselves as Geriatric Emergency Departments (GEDs) and providing enhanced geriatric emergency care services. It was guided by the recently adopted Geriatric Emergency Department Guidelines and examined domains including, GED identity, staffing, and administration; education, equipment, and supplies; policies, procedures, and protocols; follow-up and transitions of care; and quality improvement. Results reveal a heterogeneous mix of GED staffing, procedures, physical environments and that GEDs’ familiarity with the GED Guidelines is low. Findings will inform emergency departments and gerontologists nationwide about key GED model elements and will help hospitals to improve ED services for their older adult patients.

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Low-Income Senior Housing Residents’ Emergency Department Use and Care Transition Problems

Journal of Pharmacy Practice ◽

10.1177/0897190017734763 ◽

2017 ◽

Vol 31 (6) ◽

pp. 610-616 ◽

Cited By ~ 2

Author(s):

Antoinette B. Coe ◽

Leticia R. Moczygemba ◽

Kelechi C. Ogbonna ◽

Pamela L. Parsons ◽

Patricia W. Slattum ◽

...

Keyword(s):

Emergency Department ◽

Low Income ◽

Personal Health Record ◽

Primary Care Providers ◽

Adverse Outcomes ◽

Transitions Of Care ◽

Care Providers ◽

Senior Housing ◽

Follow Up Care

Older adults may be at risk of adverse outcomes after emergency department (ED) visits due to ineffective transitions of care. Semi-structured interviews were employed to identify and categorize reasons for ED use and problems that occur during transition from the ED back to home among 14 residents of low-income senior housing. Qualitative thematic and descriptive analyses were used. Ambulance use, timely ED use or a wait-and-see approach, and lack of health-care provider contact before ED visit were emergent themes. Delayed medication receipt, no current medication list, and medication knowledge gaps were identified. Lack of a personal health record, follow-up care instruction, and worsening symptoms education emerged as transition problems from ED to home. After an ED visit, education opportunities exist around seeing primary care providers for nonurgent conditions, follow-up care, medications, and worsening condition symptoms. Timely receipt of discharge medications and medication education may improve medication-related transition problems.

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Implementing a Diversion Clinic To Treat Lower-Acuity Emergency Department Patients and Provide Follow-Up Care

Annals of Emergency Medicine ◽

10.1016/j.annemergmed.2013.07.107 ◽

2013 ◽

Vol 62 (4) ◽

pp. S102-S103

Author(s):

J.M. Lansburg ◽

P. Roque ◽

P. Debartolo ◽

N. Anand

Keyword(s):

Emergency Department ◽

Follow Up Care ◽

Emergency Department Patients

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Minimizing Variability in Interpretation Modality Among Spanish-Speaking Patients With Limited English Proficiency

Hispanic Health Care International ◽

10.1177/1540415319856329 ◽

2019 ◽

Vol 18 (1) ◽

pp. 32-39

Author(s):

Seiichi Villalona ◽

Christian Jeannot ◽

Mery Yanez Yuncosa ◽

W. Alex Webb ◽

Carol Boxtha ◽

...

Keyword(s):

Limited English Proficiency ◽

English Proficiency ◽

Cross Sectional ◽

Time Points ◽

Spanish Speaking ◽

History Of ◽

Vas Scores ◽

Communication Modalities ◽

The Impact

Introduction: Provider–patient language discrepancies can lead to misunderstandings about follow-up care instructions and decreased adherence to treatment that may contribute to disparities in health outcomes among patients with limited English proficiency (LEP). This observational study aimed to understand how emergency department (ED) staff went about treating patients with LEP and examine the impact of consistent interpretation modality on overall patient satisfaction and comprehension. Method: A cross-sectional study was conducted among Spanish-speaking patients with LEP presenting to the ED. A survey was administered at two different time points: after patients provided their history of present illness and after the patient received information regarding follow-up treatment. Results: Analysis of average visual analog scale (VAS) scores by consistency of interpretation suggested higher overall scores among participants that received care via the same communication modalities during both the history of present illness and at disposition, when compared with patients that did not. At both time points, video-based interpretation was associated with higher VAS scores in comparison to other modalities, whereas phone-based interpretation was associated with lower VAS scores. Conclusion: Providing consistent modes of interpretation to patient’s with LEP throughout their ED visits improved their overall satisfaction of care provided and understandings of discharge instructions.

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Follow-up Care After an Emergency Department Visit for Asthma in a Pediatric Military Population: Clinical Interventions and Outcomes

CHEST Journal ◽

10.1378/chest.2215462 ◽

2015 ◽

Vol 148 (4) ◽

pp. 674A

Author(s):

Michael Smiley ◽

Nick Sicignano ◽

Elizabeth Allen ◽

Rees Lee ◽

Deena Chisolm

Keyword(s):

Emergency Department ◽

Emergency Department Visit ◽

Military Population ◽

Clinical Interventions ◽

Follow Up Care

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Follow-Up Care after an Emergency Department Visit for Asthma and Subsequent Healthcare Utilization in a Universal-Access Healthcare System

The Journal of Pediatrics ◽

10.1016/j.jpeds.2012.02.038 ◽

2012 ◽

Vol 161 (2) ◽

pp. 208-213.e1 ◽

Cited By ~ 22

Author(s):

Patricia Li ◽

Teresa To ◽

Astrid Guttmann

Keyword(s):

Emergency Department ◽

Healthcare System ◽

Healthcare Utilization ◽

Emergency Department Visit ◽

Universal Access ◽

Follow Up Care

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Variations in recommended surveillance in colorectal cancer survivorship care plans.

Journal of Clinical Oncology ◽

10.1200/jco.2020.38.29_suppl.13 ◽

2020 ◽

Vol 38 (29_suppl) ◽

pp. 13-13

Author(s):

Alaina Chodoff ◽

Katherine Clegg Smith ◽

Aishwarya Shukla ◽

Amanda L. Blackford ◽

Nita Ahuja ◽

...

Keyword(s):

Colorectal Cancer ◽

Cancer Risk ◽

Controlled Trial ◽

Center Frequency ◽

Cancer Center ◽

Survivorship Care Plans ◽

Survivorship Care ◽

Care Plans ◽

Follow Up Care

13 Background: Survivorship care plans (SCPs) outline pertinent information about a cancer survivor’s treatment and follow-up care. We describe the content of colorectal cancer (CRC) SCPs, completed as part of a randomized controlled trial of SCPs, and evaluate whether follow-up recommendations are guideline concordant. Methods: We analyzed 74 CRC SCPs from an academic and community cancer center. Frequency distributions and descriptive statistics were calculated for the entire cohort and separately by recruiting site. Follow-up recommendations were compared to American Cancer Society (ACS), American Society of Clinical Oncology (ASCO) and National Comprehensive Cancer Network (NCCN) guidelines (Table). Results: Content routinely provided in SCPs (>80%) included patient demographics, cancer diagnosis, treatment details (surgery, chemotherapy, radiation therapy) as well as treatment-related side effects. SCP content specified less frequently included cancer stage, cancer risk (predisposing conditions), and recommendations for genetic counseling/testing and health promotion. Nearly all SCPs from the community site provided uniform, guideline-concordant follow-up. At the academic site, on average, more than 15 follow-up recommendations were listed for each surveillance modality, except colonoscopy. Among the SCPs that specified the frequency of follow-up care, the rate of guideline-concordant recommendations was 15/42 (36%) for follow-up visits, 29/43 (67%) for imaging, 12/45 (27%) for laboratory and 39/39 (100%) for colonoscopy. Conclusions: SCPs consistently provided information about CRC diagnosis and treatment, but often omitted information about cancer risk, staging and prognosis. There was considerable variation between cancer centers in the follow-up recommendations suggested for CRC survivors. Future work to improve the consistency of SCP follow-up recommendations with guidelines may be needed. Clinical trial information: NCT03035773 . [Table: see text]

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