Increasing Interpreter Use for Pediatric Cardiology Units: A Quality Improvement Initiative

Effective communication between healthcare teams, patients, and families is critical to achieving high-quality care. Despite US regulations requiring language services, interpreters remain underutilized, and there is no standardized approach to communication in hospital settings. This quality improvement project aimed to increase interpreter use for families who speak a language other than English (LOE) from 94 to 122 occurrences/100 LOE-patient-days, the average interpreter interaction time/patient/month from 10 to 13 minutes, and the average interpreter use percentage during emergencies from 29% to 44% by December 31, 2025, in the acute care cardiology and cardiothoracic settings.

Baseline data from January 2022 to August 2024 were evaluated, and implemented interventions focused on 3 categories: increased interpreter accessibility, interpreter-use education, and the creation of translated documents. The number of interpreter occurrences and average interpreter minutes/patient/month, indexed to LOE-patient-days, were tracked monthly using statistical process control charts. A statistical process control p-chart was used to track the number of patients for whom an interpreter was used during emergencies as a function of total LOE patients who experienced an emergency with parents present.

Interpreter use increased from 94 to 212 occurrences/100 LOE-patient-days whereas the average interpreter minutes/patient/month increased from 10 to 23 minutes following the interventions. The percentage of interpreter use during emergencies increased from 29% to 91%. Process and balancing measures tracked intervention utilization and unintended consequences.

Interventions that directly increased interpreter use helped standardize care for families who spoke an LOE, thereby enhancing healthcare communication, literacy, and family engagement.