scholarly journals Inpatient Communication Barriers and Drivers When Caring for Limited English Proficiency Children

2019 ◽  
Vol 14 (10) ◽  
Author(s):  
Angela Y Shoe ◽  
Ndidi I Unaka ◽  
Amanda C Schondelmeyer ◽  
Whitney J Raglin Bignall ◽  
Heather L Vilvens ◽  
...  
Keyword(s):  
Cultural Context ◽  
Limited English Proficiency ◽  
Service Use ◽  
English Proficiency ◽  
Communication Strategies ◽  
Hospital Medicine ◽  
Effective Communication ◽  
Medical Providers ◽  
Interpreter Services ◽  
Family Centered

BACKGROUND: Achieving effective communication between medical providers and families with limited English proficiency (LEP) in the hospital is difficult. OBJECTIVE: Our objective was to identify barriers to and drivers of effective interpreter service use when caring for hospitalized LEP children from the perspectives of pediatric medical providers and interpreters. DESIGN/ PARTICIPANTS/ SETTING: We used Group Level Assessment (GLA), a structured qualitative participatory method that allows participants to directly produce and analyze data in an interactive group session. Participants from a single academic children’s hospital generated individual responses to prompts and identified themes and relevant action items. Themes were further consolidated by our research team and verified by stakeholder groups. RESULTS: Four GLA sessions were conducted including 64 participants: hospital medicine physicians and pediatric residents (56%), inpatient nursing staff (16%), and interpreter services staff (28%). Barriers identified included: (1) difficulties accessing interpreter services; (2) uncertainty in communication with LEP families; (3) unclear and inconsistent expectations and roles of team members; and (4) unmet family engagement expectations. Drivers of effective communication were: (1) utilizing a team-based approach between medical providers and interpreters; (2) understanding the role of cultural context in providing culturally effective care; (3) practicing empathy for patients and families; and (4) using effective family-centered communication strategies. CONCLUSIONS: Participants identified unique barriers and drivers that impact communication with LEP patients and their families during hospitalization. Future directions include exploring the perspective of LEP families and utilizing team-based and family-centered communication strategies to standardize and improve communication practices.

The effect of limited English proficiency and interpreter service use on clinical outcomes in psychiatric inpatient units

2019 ◽  
Vol 27 (5) ◽  
pp. 465-468
Author(s):  
Conor Daly ◽  
Karen Phillips ◽  
Richard Kanaan
Keyword(s):  
Length Of Stay ◽  
Clinical Outcomes ◽  
Limited English Proficiency ◽  
Service Use ◽  
English Proficiency ◽  
Psychiatric Inpatient ◽  
Psychiatric Units ◽  
Adult Inpatient ◽  
Interpreter Service ◽  
Inpatient Units

Objective: The effects of limited English and interpreter use on clinical outcomes in mental health are poorly understood. This paper describes an exploratory study examining those effects across three adult inpatient psychiatric units, predicting it would lead to increased length of stay. Methods: Forty-seven patients with limited English proficiency (LEP) were retrospectively identified and compared with 47 patients with proficient English. Length of stay, number of consultant reviews and discharge diagnosis were recorded and compared. Results: An increased length of stay for those with LEP was not statistically significant ( p=0.155). The LEP group did undergo more consultant reviews ( p=0.036), however, and attracted different discharge diagnoses, with no primary discharge diagnoses of personality disorder made ( p=0.018). Conclusions: This study provides evidence of significant effects of limited English on both service burden and outcome.

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 Engaging Parents in Analgesia Selection and Racial/Ethnic Differences in Analgesia Given to Pediatric Patients Undergoing Urologic Surgery

Children ◽  
2020 ◽  
Vol 7 (12) ◽  
pp. 277
Author(s):  
Carl Lo ◽  
Patrick A. Ross ◽  
Sang Le ◽  
Eugene Kim ◽  
Matthew Keefer ◽  
...  
Keyword(s):  
Limited English Proficiency ◽  
English Proficiency ◽  
Care Delivery ◽  
Black Parents ◽  
Regional Block ◽  
Parental Preferences ◽  
Centered Care ◽  
Parent Decisions ◽  
Racial Ethnic ◽  
Family Centered

Background: Family-centered care aims to consider family preferences and values in care delivery. Our study examines parent decisions regarding anesthesia type (caudal regional block or local anesthesia) among a diverse sample of children undergoing urologic surgeries. Differences in anesthesia type were examined by known predictors of health disparities, including child race/ethnicity, parental English proficiency, and a proxy for household income. Methods: A retrospective review of 4739 patients (including 25.4% non-Latino/a White, 8.7% non- Latino/a Asians, 7.3% non-Latino/a Black, 23.1% Latino/a, and 35.4% others) undergoing urologic surgeries from 2016 to 2020 using univariate and logistic regression analyses. Results: 62.1% of Latino/a parents and 60.8% of non-Latino/a Black parents did not agree to a regional block. 65.1% of Spanish-speaking parents with limited English Proficiency did not agree to a regional block. Of parents from households below poverty lines, 61.7% did not agree to a caudal regional block. In regression analysis, Latino/a and non- Latino/a Black youth were less likely to receive caudal regional block than non- Latino/a White patients. Conclusions: We found disparities in the use of pediatric pain management techniques. Understanding mechanisms underlying Latino/a and non- Latino/a Black parental preferences may help providers reduce these disparities.

scholarly journals The Association between Limited English Proficiency and Sepsis Mortality

2019 ◽  
pp. 140-146 ◽  
Author(s):  
Zachary G Jacobs ◽  
Priya A Prasad ◽  
Margaret C Fang ◽  
Yumiko Abe-Jones ◽  
Kirsten N Kangelaris
Keyword(s):  
Limited English Proficiency ◽  
English Proficiency ◽  
Academic Medical Center ◽  
Tertiary Care ◽  
Hospital Medicine ◽  
Illness Severity ◽  
Sepsis Mortality ◽  
Electronic Health Record Data ◽  
Baseline Characteristics ◽  
The Impact

BACKGROUND: Limited English proficiency (LEP) has been implicated in poor health outcomes. Sepsis is a frequently fatal syndrome that is commonly encountered in hospital medicine. The impact of LEP on sepsis mortality is not currently known. OBJECTIVE: To determine the association between LEP and sepsis mortality. DESIGN: Retrospective cohort study. SETTING: 800-bed, tertiary care, academic medical center. PATIENTS: Electronic health record data were obtained for adults admitted to the hospital with sepsis between June 1, 2012 and December 31, 2016. MEASUREMENTS: The primary predictor was LEP. Patients were defined as having LEP if their self-reported primary language was anything other than English and interpreter services were required during hospitalization. The primary outcome was inpatient mortality. Mortality was compared across races stratified by LEP using chi-squared tests of significance. Bivariable and multivariable logistic regressions were performed to investigate the association between mortality, race, and LEP, adjusting for baseline characteristics, comorbidities, and illness severity. RESULTS: Among 8,974 patients with sepsis, we found that 1 in 5 had LEP, 62% of whom were Asian. LEP was highly associated with death across all races except those identifying as Black and Latino. LEP was associated with a 31% increased odds of mortality after adjusting for illness severity, comorbidities, and other baseline characteristics, including race (OR 1.31, 95% CI 1.06-1.63, P = .02). CONCLUSIONS: In a single-center study of patients hospitalized with sepsis, LEP was associated with mortality across nearly all races. This is a novel finding that will require further exploration into the causal nature of this association.

scholarly journals Developing an Electronic Search Strategy Algorithm for Detecting Professional Interpreter Use among Patients with Limited English Proficiency: A Derivation and Validation Study

2020 ◽  
Author(s):  
Jalal Soleimani ◽  
Alberto Marquez ◽  
Timothy Weister ◽  
Amelia Barwise
Keyword(s):  
Limited English Proficiency ◽  
Chart Review ◽  
Search Strategy ◽  
English Proficiency ◽  
High Sensitivity ◽  
Interpreter Services ◽  
Interpreter Use ◽  
Specificity And Sensitivity ◽  
Professional Interpreter ◽  
Time Required

Abstract Background Evidence exists that disparities occur for patients with Limited English Proficiency (LEP) that impact the quality of medical services, outcomes, and patient satisfaction. Using interpreter services can reduce these negative impacts; therefore optimizing our understanding of interpreter use during patient care is important. Manual chart review is time-consuming. The objective of this study was to develop and validate a search strategy algorithm to detect patients who used professional interpreter services during their hospitalization. Methods We identified all adults who were admitted to the hospital who had at least one Intensive Care Units (ICU) admission during the hospital stay across the Mayo Clinic Enterprise between January 1, 2015, and June 30, 2020. Three random subsets of 100 patients were extracted from 60,268 patients admitted to an ICU to develop the search strategy algorithm. A physician reviewer conducted the gold standard manual chart review and these results were compared with the search strategy algorithm each time it was refined. Iterative modification of the search strategy was performed and sensitivity and specificity were calculated by comparing the results to the reference standard for both derivation cohorts and the final validation cohort. Any uncertainties were resolved by a second physician researcher. Results The first search strategy resulted in a specificity of 95.7% and a sensitivity of 93.5%. The second revised search strategy achieved a specificity of 96.7% and a sensitivity of 92.3%. The final version of the search strategy was applied to the validation subset and specificity and sensitivity were 92.6% and 100% respectively. Conclusion We successfully derived and validated a search strategy algorithm to assess interpreter use among hospitalized patients. Developing a search strategy algorithm with a high sensitivity can reduce the time required to abstract data from the medical record compared to manual chart review. This can be used to examine and understand patient needs for research and quality improvement initiatives.

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