Disparities During Family-Centered Rounds for Families Using Languages Other Than English

Patient- and family-centered rounds (PFCR) have become a pediatric standard of care. However, rounds experiences of families using languages other than English (LOE)-particularly languages other than English or Spanish (LOES; eg, Arabic)-receive less focus. We aimed to identify differences in PFCR communication and engagement by language.

We analyzed postintervention data from a 21-center structured PFCR study, assessing communication practices, quality, and family and nurse engagement during PFCR. Logistic regression adjusted by site compared PFCR between families using (1) LOE vs English, (2) Spanish vs English, and (3) LOES vs English.

Among 3051 PFCR encounters, 348 (11.4%) involved LOE (Spanish = 260; LOES = 85). Interpretation was not used in 7.2%, 5.8%, and 9.4% of encounters using LOE, Spanish, and LOES, respectively. PFCR in the following groups had lower adjusted odds (adjusted odds ratio [95% CI]) for the following domains: (1) LOE vs English: including providing verbal patient summaries (0.66 [0.46-0.95]), explaining diagnoses and differentials (0.62 [0.44-0.88]), family engagement (0.34 [0.20-0.57]), nursing inclusion (0.75 [0.60-0.93]), and nursing engagement (0.69 [0.52-0.90]). (2) Spanish vs English: diagnoses/differentials being explained (0.56 [0.37-0.85]), family engagement (0.35 [0.18-0.67]), nursing inclusion (0.77 [0.59-1.00]), and nursing engagement (0.68 [0.52-0.89]). (3) LOES vs English: families sharing concerns (0.66 [0.47-0.93]), family engagement (0.30 [0.16-0.54]), and nursing inclusion (0.74 [0.55-0.99]).

Even after implementing a PFCR intervention, families using LOE-especially LOES-experienced significant disparities in communication and engagement. Future approaches to improving PFCR should emphasize language access and promote nurse and family engagement for families using LOE, particularly LOES.