Moving From Knowledge to Action: Improving Safety and Quality of Care for Patients With Limited English Proficiency
Moving From Knowledge to Action: Improving Safety and Quality of Care for Patients With Limited English Proficiency
复制标题
DOI：
10.1177/0009922819900950
复制
发表时间：
2020-03-01
影响因子：
1.6
通讯作者：
DeCamp, Lisa Ross
中科院分区：
文献类型：
--
作者：
Fox, Miriam T.;Godage, Sashini K.;DeCamp, Lisa Ross
Objective.本研究评估了安全文化和工作人员与英语水平有限（LEP）患者的沟通，以确定系统级方法来增加口译员的使用和减少医疗保健差异。方法.对儿科和妇产科的医疗保健专业人员进行了一项电子调查和7个焦点小组。调查资料采用单因素描述性分析。通过迭代共识过程对焦点小组的成绩单进行编码。结果调查参与者（n = 68）报告说，与英语熟练的患者相比，他们对与LEP患者有效沟通（74%）和形成治疗关系（56%）的能力缺乏信心。焦点小组认为知识是口译员使用的促进因素。工作流程限制、供需不匹配、口译质量不稳定以及与口译服务管理层沟通方面的差距都是障碍。结论知识差距可能不是口译员使用不足的主要原因。解决工作流程障碍和参与口译服务的策略对于从知识转向行动以改善LEP患者护理至关重要。本研究评估了安全文化和工作人员与英语水平有限（LEP）患者的沟通，以确定系统级方法来增加口译员的使用和减少医疗保健差异。方法.对儿科和妇产科的医疗保健专业人员进行了一项电子调查和7个焦点小组。调查资料采用单因素描述性分析。通过迭代共识过程对焦点小组成绩单进行编码。结果调查参与者（n = 68）报告说，与英语熟练的患者相比，他们对与LEP患者有效沟通（74%）和形成治疗关系（56%）的能力缺乏信心。焦点小组认为知识是口译员使用的促进因素。工作流程限制、供需不匹配、口译质量不稳定以及与口译服务管理层沟通方面的差距都是障碍。结论知识差距可能不是口译员使用不足的主要原因。解决工作流程障碍和参与口译服务的策略对于从知识转向行动以改善LEP患者护理至关重要。
Objective. This study assessed safety culture and staff communication with patients with limited English proficiency (LEP) to identify system-level approaches to increasing interpreter use and reducing health care disparities. Methods. An electronic survey and 7 focus groups were conducted with health care professionals in pediatrics and obstetrics/gynecology. Survey data were examined with univariate descriptive analysis. Focus group transcripts were coded through an iterative consensus process. Results. Survey participants (n = 68) reported less confidence in their ability to communicate effectively (74%) and form therapeutic relationships (56%) with LEP patients versus English-proficient patients. Focus groups identified knowledge as a facilitator of interpreter use. Workflow constraints, supply-demand mismatch, variable interpretation quality, and gaps in communication with interpretation services management were barriers. Conclusion. Knowledge gaps may not be a primary cause of interpreter underuse. Strategies to address workflow barriers and engage with interpretation services are critical to move from knowledge to action to improve LEP patient care.Objective. This study assessed safety culture and staff communication with patients with limited English proficiency (LEP) to identify system-level approaches to increasing interpreter use and reducing health care disparities. Methods. An electronic survey and 7 focus groups were conducted with health care professionals in pediatrics and obstetrics/gynecology. Survey data were examined with univariate descriptive analysis. Focus group transcripts were coded through an iterative consensus process. Results. Survey participants (n = 68) reported less confidence in their ability to communicate effectively (74%) and form therapeutic relationships (56%) with LEP patients versus Englishproficient patients. Focus groups identified knowledge as a facilitator of interpreter use. Workflow constraints, supply-demand mismatch, variable interpretation quality, and gaps in communication with interpretation services management were barriers. Conclusion. Knowledge gaps may not be a primary cause of interpreter underuse. Strategies to address workflow barriers and engage with interpretation services are critical to move from knowledge to action to improve LEP patient care.