Increasing in-person interpreter participation in Pediatric Ward

 Addressing Health Disparity by Increasing In-­‐person Interpreter Par8cipa8on during Family-­‐Centered Morning Rounds Lizzeth Alarcón, BA; Julio Martínez, BA; Kathleen Xu, MPH; Vivian Wang, BS;
Christine Cheston, MD; James Moses MD,MPH
Run Chart: Percentage of Family-Centered Rounding Encounters during
which an Interpreter was Included to Communicate the Care Plan to
Patients and Families with Limited English Proficiency
100
400
90
350
80
300
70
250
60
50
200
40
150
30
100
20
50
10
0
0
Pre-­‐ Interven,on PDSA Cycles AIM PDSA 1 •  Process map of interpreter contact •  Preliminary resident orienta,on PDSA2 •  Medical students involvement PDSA3 • Refining team orienta,on, communica,on processes with interpreters PDSA4 •  Simplifica,on of data collec,on form PDSA5 •  QI ini,a,ve as part of curriculum for students PDSA6 •  Op,mizing ,ming of encounters with interpreters •  To increase the number of FCR encounters with LEP families that include IPIs to 75% on the BMC Inpa,ent Pediatric ward by January 2016 ACTIONS TAKEN •  Established a process that an,cipates the need for IPIs •  Designed interpreter scheduling forms to be used daily during FCR •  Communicated weekly with inpa,ent team to field ques,ons, obtain feedback, and share current data •  Measured pa,ent and family sa,sfac,on with a de novo survey instrument CONCLUSIONS & LESSONS LEARNED •  FCR with pediatric pa,ents and families with LEP is possible when the need for IPIs is an,cipated and there is a system in place to have them present during FCR •  Meaningful partnership between interpreter services, the medical team, and ward staff is cri,cal for achieving success •  Ensuring IPIs on FCR may represent a way to improve dispari,es in care in inpa,ent seWngs for LEP families Communica8on Sa8sfac8on Survey: Comparing LEP and EP families “Name one thing you liked about rounds this morning” LEP (n=50) EP (n=83) Miscellaneous General Don't Know Explana,ons/informa,on Checking in/upda,ng Care/Medical care AWtudes/approaches of doctors 0 5 10 15 20 % responses 25 30 35 Cumula,ve Number of Encounters that Included In-­‐
Person Interpreters •  30% of the pa,ents at Boston Medical Center (BMC) have limited English proficiency (LEP) •  There previously existed no system to ensure presence of in-­‐
person interpreters (IPIs) for family-­‐centered rounds (FCR) on the BMC Inpa,ent Pediatric Ward •  Without IPIs, benefits of FCR do not reach pa,ents with LEP; this represents a clear disparity in care for these pa,ents Percentage of Encounters with Interpreters (%) BACKGROUND