Leveraging Novel Clinical Decision Support to Improve Preferred Language Documentation in a Neonatal Intensive Care...

Area of Science:

• Healthcare Quality Improvement
• Patient Communication
• Health Equity

Background:

• Effective patient-provider communication requires recognizing diverse backgrounds and language preferences.
• Accurate documentation of preferred language in electronic health records is crucial for equitable care.
• Preferred language documentation rates in the neonatal intensive care unit (NICU) were often suboptimal, hindering effective communication.

Purpose of the Study:

• To improve the rate of preferred language documentation in the NICU using the Institute for Healthcare Improvement's Model for Improvement.
• To increase preferred language documentation from a baseline of 74% to over 90% within six months.

Main Methods:

• A multidisciplinary team implemented a novel clinical decision support (CDS) tool integrated into the electronic health record.
• The CDS tool provided guidance for documenting patients' preferred language for communication.
• Primary outcome was the rate of preferred language documentation; process measures included CDS tool compliance.

Main Results:

• Preferred language documentation increased from 74% to 92% within six months, sustained at 96%.
• Follow-up assessments confirmed 100% accuracy in documented language preferences among a sample of patients.
• Overall compliance with the CDS tool remained high at 85% throughout the project.

Conclusions:

• A quality improvement initiative utilizing a CDS tool significantly and accurately improved preferred language documentation in the NICU.
• Sustained high documentation rates facilitate more equitable care for non-English speaking patients.
• Future efforts will focus on enhancing interpreter services and providing multilingual discharge instructions.