Improving Interpreter Access in the Pediatric Emergency Department: A Quality Improvement Initiative

Area of Science:

• Healthcare Quality Improvement
• Patient Safety
• Health Equity

Background:

• Limited English proficiency (LEP) affects a growing US population.
• Federal funding mandates interpreter services in hospitals, yet access is often inadequate.
• LEP patients face higher risks for adverse events, especially in emergency departments.

Purpose of the Study:

• To improve the quality of interpreter services for patients with limited English proficiency in a pediatric emergency department.
• To enhance documentation of interpreter needs and usage for LEP patients.
• To reduce reliance on non-qualified interpreters and increase the use of professional services.

Main Methods:

• A quality improvement initiative was conducted over 14 months in a tertiary care Pediatric Emergency Department.
• Four Plan-Do-Study-Act cycles, guided by a driver diagram, were implemented.
• Data collection involved medical record review, patient surveys, and staff surveys, with outcomes tracked via run and control charts.

Main Results:

• Documentation of interpreter use for LEP patients improved significantly.
• Staff-reported use of professional interpreters increased, while ad hoc interpreter use decreased.
• No significant change was observed in the proportion of LEP patients reporting consistent interpreter availability or in overall length of stay.

Conclusions:

• The quality improvement initiative successfully enhanced appropriate documentation and reduced non-qualified interpreter use for LEP patients.
• Despite process improvements, patient-reported consistent access to interpreters did not change.
• Patient satisfaction remained unaffected by the intervention.