Increasing Rounds Participation for Caregivers Who Prefer a Language Other Than English

For patients admitted to our hospital medicine resident services, we found that caregivers who were present at bedside and who preferred a language other than English (LOE) participated in family-centered rounds (FCRs) 53% of the time compared with 92% for English-preferring caregivers. We conducted a quality-improvement initiative with the aim of improving monthly FCR participation for LOE-preferring caregivers from 53% to 92%, regardless of preferred language.

We identified drivers of the FCR participation disparity and tested interventions in 3 plan-do-study-act (PDSA) cycles, including changing the rounding order (PDSA 1), sending biweekly emails to raise awareness about the disparity (PDSA 2), and scheduling rounding times with interpreters for LOE-preferring caregivers (PDSA 3). Our primary outcome measure was the percentage of LOE-preferring caregivers participating in FCRs, stratified by Spanish and non-Spanish LOEs. Nurse attendance, FCR participation by an English-preferring caregiver, and average rounds duration per patient were balancing measures. Measures were evaluated using statistical process control charts.

We analyzed 17 024 rounding encounters occurring from July 3, 2023, to May 30, 2025. Participation of LOE-preferring caregivers in FCRs increased from 53% to 81%. FCR participation improved for Spanish-preferring caregivers from 57% to 87% and for non-Spanish-LOE-preferring caregivers from 46% to 75%. There was no significant change in English-preferring caregiver FCR participation (92%), nurse FCR attendance (70%), or average rounds duration per patient (13 minutes).

Raising awareness of disparities in FCR participation and streamlining interpreter scheduling logistics was associated with improvement in FCR participation for LOE-preferring caregivers without adversely affecting English-preferring caregiver participation, rounds duration, or nurse participation.