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.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
HEALTH_SERVICES_RESEARCH
Masking
SINGLE
Enrollment
208
Professional interpretation provided over the phone by a national network of certified medical interpreters
Professional interpretation provided over video by a national network of certified medical interpreters
Seattle Children's Hospital Emergency Department
Seattle, Washington, United States
Communication Quality
We will use the Consumer Assessment of Healthcare Providers and Systems (CAHPS) Child Visit Survey 2.0 communication composite, which includes 5 items.
Time frame: Once, 1-7 days after the ED visit
Interpretation Quality
Interpretation quality will be measured with the Interpreter Satisfaction Survey (7 items).
Time frame: Once, 1-7 days after ED visit
Diagnosis Comprehension
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.
Time frame: Once, 1-7 days after ED visit
Consistency of Interpreter Use
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.
Time frame: Once, 1-7 days after ED visit
Length of ED stay
Time from arrival in Emergency Department to discharge home or admission to the hospital.
Time frame: Once, after ED visit
This platform is for informational purposes only and does not constitute medical advice. Always consult a qualified healthcare professional.