Association Between Parent Comfort With English and Adverse Events Among Hospitalized Children.

Area of Science:

• Pediatric patient safety
• Health communication
• Linguistic disparities in healthcare

Background:

• Limited English proficiency in parents is a potential risk factor for adverse events in children.
• Prior research has not extensively examined the link between parental language comfort and systematically collected adverse events in a multicenter setting.

Purpose of the Study:

• To investigate the association between parental limited comfort with English (LCE) and adverse events in hospitalized children.
• To assess the impact of language barriers on patient safety outcomes in pediatric care.

Main Methods:

• A multicenter prospective cohort study involving 1666 parents of pediatric patients across 7 North American hospitals.
• Parental language comfort was self-reported, defining LCE as preferring a language other than English for communication with healthcare providers.
• Adverse events were systematically collected through medical record review, clinician reports, and family safety interviews, with analysis using multivariable logistic regression.

Main Results:

• Approximately 8.8% of parents expressed LCE, with Spanish being the most preferred non-English language.
• Children of parents with LCE had significantly higher odds of experiencing adverse events (aOR, 2.1) and preventable adverse events (aOR, 2.3) compared to children of English-comfortable parents.
• These associations remained significant after adjusting for demographic and clinical factors.

Conclusions:

• Hospitalized children with parents expressing LCE are twice as likely to experience medical harms.
• There is a critical need for targeted interventions to enhance communication and ensure safety for pediatric patients with parents facing language barriers.
• Addressing linguistic disparities is essential for equitable and safe healthcare delivery in pediatric settings.