• Hospital pediatrics · Aug 2018

    Evaluating the Feasibility of Incorporating In-Person Interpreters on Family-Centered Rounds: A QI Initiative.

    • Christine C Cheston, Lizzeth N Alarcon, Julio F Martinez, Scott E Hadland, and James M Moses.
    • Departments of Pediatrics and christine.cheston@bmc.org.
    • Hosp Pediatr. 2018 Aug 1; 8 (8): 471-478.

    ObjectivesNo best practice has been defined for incorporating in-person interpreters into family-centered rounds (FCRs) for patients with limited English proficiency (LEP). We hypothesized that addressing barriers to scheduling in-person interpreters would make FCR encounters more likely, and thus ensure more equitable care for LEP patients.MethodsA quality improvement initiative was conducted from October 2014 to March 2016 to arrange in-person interpreters for LEP patients during FCRs on the inpatient pediatric service of a large, urban, tertiary care center in Boston. Main interventions included establishing a protocol for scheduling interpreters for rounds and the implementation of a form to track process adherence. Our primary outcome was the percentage of FCR encounters with LEP patients with an interpreter present. Our balancing measures were patient satisfaction, which was assessed using validated surveys administered weekly by nonphysician team members through convenience sampling of families present on the wards, and rounds duration.ResultsThere were 614 encounters with LEP patients during the intervention, 367 of which included in-person interpreters. The percentage of encounters with LEP patients involving interpreters increased from 0% to 63%. Form completion, our primary process measure, reached 87% in the most recent phase. English-proficient and LEP patients reported similar satisfaction with their rounding experience amid a modest increase in rounds duration (preintervention, 105 minutes; postintervention, 130 minutes; P = .056).ConclusionsUsing quality improvement as a framework to address key barriers, we successfully implemented a process that increased the participation of in-person interpreters on FCRs on a busy pediatric service.Copyright © 2018 by the American Academy of Pediatrics.

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