Impact of Remote Interpreter Modality on Comprehension, Communication Quality, and Consistency of Interpreter Use in the Pediatric Emergency Department
Overview
- Phase
- Not Applicable
- Intervention
- Not specified
- Conditions
- Limited English Proficient Patients and Families
- Sponsor
- Seattle Children's Hospital
- Enrollment
- 208
- Locations
- 1
- Primary Endpoint
- Communication Quality
- Status
- Completed
- Last Updated
- 10 years ago
Overview
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.
Investigators
K. Casey Lion
Assistant Professor of Pediatrics
Seattle Children's Hospital
Eligibility Criteria
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
Outcomes
Primary Outcomes
Communication Quality
Time Frame: Once, 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 Quality
Time Frame: Once, 1-7 days after ED visit
Interpretation quality will be measured with the Interpreter Satisfaction Survey (7 items).
Diagnosis Comprehension
Time Frame: Once, 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 Use
Time Frame: Once, 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 Outcomes
- Length of ED stay(Once, after ED visit)