MedPath

Comparing Remote Interpreter Modalities in the Pediatric Emergency Department

Not Applicable
Completed
Conditions
Limited English Proficient Patients and Families
Interventions
Other: Telephone Interpretation
Other: Video Interpretation
Registration Number
NCT01986179
Lead Sponsor
Seattle Children's Hospital
Brief Summary

Professional interpretation improves quality of care for patients with limited English proficiency (LEP). However, many health care settings lack access to professional interpreters, and even in locations with good access, logistical factors and perceived barriers have limited their widespread use. Remote methods of professional interpretation, including telephone and video, hold great promise for expanding access, but only limited data exist on the relative impacts of these modalities on patient care and provider uptake. Comparing how these modalities impact multiple aspects of health care quality, including family comprehension, provider communication, and consistency of provider interpreter use will inform dissemination of strategies for delivery of safe, efficient, and equitable care to LEP families.

Aim 1: To determine whether randomly assigned remote interpreter modality (telephone versus video) impacts parent-reported quality of communication and interpretation, diagnosis comprehension, and length of stay (LOS) among LEP Spanish-speaking families seen in a pediatric Emergency Department (ED).

Hypothesis 1: Parent-reported quality of communication and interpretation and parent diagnosis comprehension will be higher among families assigned to video interpretation compared to telephone interpretation.

Hypothesis 2: LOS will not differ between families assigned to video and telephone interpretation.

Aim 2: To determine whether assigned interpreter modality is associated with provider decision to communicate without professional interpretation.

Hypothesis 3: Parent-reported provider communication without professional interpretation (e.g. using the patient or a family member to interpret for some part of the visit) will be lower for families assigned to video interpretation compared to telephone interpretation.

Detailed Description

Not available

Recruitment & Eligibility

Status
COMPLETED
Sex
All
Target Recruitment
208
Inclusion Criteria
  • Preferred language for medical care of Spanish
  • At least one primary caregiver requires interpretation
  • Presenting to Seattle Children's ED during recruiting hours
Exclusion Criteria
  • Triage level 1 (life-threatening illness)
  • No parent or legal guardian present
  • Reason for visit is concern for abuse
  • reason for visit is primary behavioral or psychiatric complaint

Study & Design

Study Type
INTERVENTIONAL
Study Design
PARALLEL
Arm && Interventions
GroupInterventionDescription
Telephone InterpretationTelephone InterpretationThese families will be assigned to use telephone interpretation throughout the ED visit.
Video InterpretationVideo InterpretationThese families will be assigned to use video interpretation throughout the ED visit.
Primary Outcome Measures
NameTimeMethod
Communication QualityOnce, 1-7 days after the ED visit

We will use the Consumer Assessment of Healthcare Providers and Systems (CAHPS) Child Visit Survey 2.0 communication composite, which includes 5 items.

Interpretation QualityOnce, 1-7 days after ED visit

Interpretation quality will be measured with the Interpreter Satisfaction Survey (7 items).

Diagnosis ComprehensionOnce, 1-7 days after ED visit

Parents will be asked to name their child's diagnosis. Clinician-recorded diagnosis will be obtained from chart review for comparison. Responses will be classified as correct, incorrect, or vague/incomplete, using a method we have employed previously.

Consistency of Interpreter UseOnce, 1-7 days after ED visit

Parents will be asked to report on the frequency with which providers used each of a list of potential communication methods (e.g. telephone interpreter, family or friend, spoke in English without an interpreter present). Response options are never, sometimes, frequently, or always.

Secondary Outcome Measures
NameTimeMethod
Length of ED stayOnce, after ED visit

Time from arrival in Emergency Department to discharge home or admission to the hospital.

Trial Locations

Locations (1)

Seattle Children's Hospital Emergency Department

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Seattle, Washington, United States

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