Information Exchange in English and Interpreted Pediatric Serious Illness Care Conferences

Children whose families use a language other than English are known to experience poorer medical care, including during serious illnesses. Information sharing is essential to achieve optimal communication outcomes, but little is known about differences across caregiver language.

We explored differences in quantity and complexity of bidirectional information sharing in English and interpreted care conferences for seriously ill children.

Care conferences for pediatric patients with serious illness from linguistically diverse families at a single institution were audio-recorded, transcribed, and analyzed using content analysis. Clinician and caregiver information sharing statements were characterized as biomedical, logistical, or psychosocial; caregiver categories also included patient wellness and values/goals. Clinician communication practices known to impact information sharing were also tabulated. Mann-Whitney U tests compared median information shared by conference language.

We analyzed 29 inpatient care conferences from 2018 to 2021, including 11 (38%) professionally interpreted conferences. On average, clinicians made 156 statements per conference while caregivers made 71 (P < .001). Clinicians made significantly fewer biomedical statements in interpreted conferences than English ones (117 vs 176, P = .01). Caregivers made a similar number of statements per conference, regardless of language (78 vs 66, P = .95). Overall, clinicians rarely used practices supporting information sharing, only asking about information preferences in 1 conference and prior understanding in 3 conferences and checking for understanding open-endedly in 0 conferences. Jargon was rampant, particularly in English conferences (P = .02).

Strategies to reduce disparities in information sharing may support equitable outcomes for patients and families from all language backgrounds.