RESUMEN
OBJECTIVE: To increase understanding of current practices and perceptions of family-centered rounds (FCR) by providers for limited English-proficient (LEP) families relative to English-proficient families. METHODS: Using grounded theory methodology, we conducted ethnographic observations of FCR for LEP and English-proficient families on the pediatric wards at an urban teaching hospital. Focused coding of observation fieldnotes was performed independently, followed by regular group meetings to discuss discrepancies, refine codes, and identify theoretical direction. Data informed development of an interview guide used to conduct interviews with pediatric physicians, nurses, and interpreters. The iterative analysis process continued with interview transcriptions. RESULTS: FCR of 36 unique patient families were observed, of which 10 were LEP families. We conducted 20 interviews with 7 residents, 3 attendings, 5 nurses, and 5 interpreters. Major themes included: 1) standardization of FCR is needed to address equity issues for LEP families, 2) redefining the roles of medical interpreters would enhance the interpersonal interactions and relationships between families and health care providers, and 3) improving resources to allow interpreters to be used consistently will increase equity for LEP families. CONCLUSIONS: Many differences exist in FCR for LEP versus English-proficient families. FCR for LEP families may be optimized with standardization and training, redefining the interpreters' roles, and improving access to interpreters.
Asunto(s)
Médicos , Rondas de Enseñanza , Técnicos Medios en Salud , Niño , Barreras de Comunicación , Humanos , Percepción , TraducciónRESUMEN
Background: Patients with limited English proficiency experience disparities in health care access, quality, costs, and outcomes. Providing qualified medical interpreting services (MIS) in the health care setting can reduce these disparities. Unfortunately, health organizations face logistical and financial difficulties in meeting the need for qualified medical interpreters. Introduction: This descriptive review evaluated travel, time, and cost savings associated with video interpreting services compared to traditional in-person services. Materials and Methods: We conducted a retrospective review of all inpatient and outpatient medical interpreting encounters at a large academic hospital delivered through video and in person between 2006 and 2017. Outcome measures included interpreter travel distance, time, and cost for in-person encounters and savings associated with avoided travel for services provided through video. Results: We reviewed 281,701 interpreting encounters, including 249,357 in person and 32,344 by video. Video encounters occurred both for on-site and off-site visits. For on-site encounters, the use of video resulted in an average round trip walking distance saved of 0.75 miles (SD = 0.33) and an average round trip walking time saved of 14.75 min (SD = 6.30) per encounter. For off-site encounters, the use of video resulted in an average round trip driving distance saved of 8.63 miles (SD = 9.13), an average round trip driving time saved of 23.78 min (SD = 9.50), and an average round trip driving cost savings of $4.66 per encounter. Conclusions: This single institution review of the travel, time, and cost savings associated with providing MIS through video demonstrates the opportunity for more efficient use of time and resources.