Improving Interpreter Presence for Pediatric Hospital Medicine Patients and Families

For hospitalized patients and families who speak languages other than English (LOE), consistent interpreter-mediated communication is necessary to ensure equitable health care delivery. Despite the availability of interpreter services, variability exists in their presence for all communication touchpoints during hospitalization. To improve interpreter presence during hospitalization, our quality improvement study aimed to increase the average number of interpreted encounters per LOE patient day within 6 months.

Our multidisciplinary improvement team tracked all interpreted in-person, phone, and remote audio and video encounters on a hospital medicine unit. Using the Model for Improvement, we performed Plan-Do-Study-Act cycles to test interventions, including provider education, increased language access devices on the unit, and in-room family language signs. Our outcome measure was the average number of interpreted encounters per LOE patient day measured weekly. We also tracked the proportion of in-person interpreted encounters per LOE patient day as a balancing measure to ensure improving remote interpreter availability did not discourage requesting in-person interpreters.

During the 6-month intervention period, there was a total of 651 LOE patient days. The average number of interpreted encounters per LOE patient day increased from a mean of 1.8 to 3.2, and the balancing measure of average number of in-person interpreted encounters per LOE patient day remained unchanged at 0.11.

We observed increased presence of interpreters per LOE patient day on a hospital medicine unit without significant changes to in-person interpreter presence. Creating standard workflows and increased availability of language access devices were key interventions.