It's More Complicated Than Interpreter Use: Improving Care for Non-English-Speaking Families

Area of Science:

• Pediatric Nephrology
• Health Equity
• Cross-cultural Communication

Background:

• Neonatal fever can indicate serious conditions like pyelonephritis.
• Communication breakdowns can negatively impact patient outcomes, especially for non-English speaking families.
• Health literacy and system issues exacerbate disparities in care.

Purpose of the Study:

• To illustrate challenges in providing equitable care to families speaking languages other than English (LOE).
• To highlight communication vulnerabilities during hospital discharge for LOE populations.
• To propose strategies for improving care for pediatric patients and families speaking LOE.

Main Methods:

• Case study analysis of a neonate with pyelonephritis, sepsis, and communication barriers.
• Review of health disparities for LOE populations in the United States.
• Qualitative and quantitative analysis of communication during hospitalization and discharge.

Main Results:

• A neonate experienced sepsis due to Escherichia coli pyelonephritis, linked to missed prophylactic antibiotics.
• Systemic issues prevented primary care provider awareness of patient's urologic diagnoses and hospitalizations.
• Despite interpreter use, significant communication gaps persisted, impacting care transition.

Conclusions:

• Consistent, evidence-based interpreter utilization is essential.
• Health literacy-informed discharge planning can mitigate risks for LOE families.
• Enhanced communication strategies, including closed-loop communication with primary care providers, are vital for reducing health disparities.