Professional Interpreter Use and Discharge Communication in the Pediatric Emergency Department

Families with limited English proficiency (LEP) experience communication barriers and are at risk for adverse events after discharge from the pediatric emergency department (ED). We sought to describe the characteristics of ED discharge communication for LEP families and to assess whether the use of...

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Bibliographic Details
Published in:	Academic pediatrics Vol. 18; no. 8; pp. 935 - 943
Main Authors:	Gutman, Colleen K., Cousins, Liliana, Gritton, Jesse, Klein, Eileen J., Brown, Julie C., Scannell, Jack, Lion, K. Casey
Format:	Journal Article
Language:	English
Published:	United States Elsevier Inc 01-11-2018
Subjects:	discharge instructions interpreter use limited English proficiency patient-centered communication pediatric emergency medicine pediatric emergency medicine patient-centered communication limited English proficiency interpreter use discharge instructions
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Summary:	Families with limited English proficiency (LEP) experience communication barriers and are at risk for adverse events after discharge from the pediatric emergency department (ED). We sought to describe the characteristics of ED discharge communication for LEP families and to assess whether the use of a professional interpreter was associated with provider communication quality during ED discharge. Transcripts of video-recorded ED visits for Spanish-speaking LEP families were obtained from a larger study comparing professional interpretation modalities in a freestanding children's hospital. Caregiver-provider communication interactions that included discharge education were analyzed for content and for the techniques that providers used to assess caregiver comprehension. Regression analysis was used to assess for an association between professional interpreter use and discharge education content or assessment of caregiver comprehension. We analyzed 101 discharge communication interactions from 47 LEP patient visits; 31% of communications did not use professional interpretation. Although most patients (70%) received complete discharge education content, only 65% received instructions on medication dosing, and only 55% were given return precautions. Thirteen percent of the patient visits included an open-ended question to assess caregiver comprehension, and none included teach-back. Professional interpreter use was associated with greater odds of complete discharge education content (odds ratio [OR], 7.1; 95% confidence interval [CI], 1.4–37.0) and high-quality provider assessment of caregiver comprehension (OR, 6.1; 95% CI, 2.3–15.9). Professional interpreter use is associated with superior provider discharge communication behaviors. This study identifies clear areas for improving discharge communication, which may improve safety and outcomes for LEP children discharged from the ED.
Bibliography:	ObjectType-Article-1 SourceType-Scholarly Journals-1 ObjectType-Feature-2 content type line 23 Present Address: Department of Pediatrics, Emory University, Atlanta, Ga (CK Gutman); Present Address: American Cancer Society, Seattle, Wash (J Gritton); and Present Address: School of Clinical Medicine, University of Cambridge, Cambridge, United Kingdom (J Scannell)
ISSN:	1876-2859 1876-2867
DOI:	10.1016/j.acap.2018.07.004