Evaluating the Feasibility of Incorporating In-Person Interpreters on Family-Centered Rounds: A QI Initiative.
Evaluating the Feasibility of Incorporating In-Person Interpreters on Family-Centered Rounds: A QI Initiative.
复制标题
DOI：
10.1542/hpeds.2017-0208
复制
发表时间：
2018-08-01
影响因子：
--
通讯作者：
Moses, James M
中科院分区：
文献类型：
--
作者：
Cheston, Christine C;Alarcon, Lizzeth N;Moses, James M
目的：对于英语水平有限（LEP）的患者，将现场口译员纳入以家庭为中心的查房（fcr）中，尚未定义最佳实践。我们假设，解决安排面对面口译的障碍将使FCR接触更有可能，从而确保对LEP患者的更公平的护理。方法：2014年10月至2016年3月开展了一项质量改进计划，在波士顿一家大型城市三级医疗中心儿科住院服务的fcr期间为LEP患者安排现场口译员。主要的干预措施包括制定一项安排口译员巡房的协议，并实施一项跟踪进程遵守情况的表格。我们的主要结局是在翻译在场的情况下，FCR遇到LEP患者的百分比。我们的平衡措施是患者满意度，这是通过每周由非医生团队成员通过方便的在病房的家庭抽样和查房时间进行的有效调查来评估的。结果：干预期间有614例LEP患者，其中367例包括现场口译员。与LEP患者接触的口译员比例从0%增加到63%。表单完成率，我们的主要过程度量，在最近阶段达到了87%。英语熟练和LEP患者在轮询时间适度增加的情况下对舍入体验的满意度相似（干预前，105分钟；干预后，130分钟；P = 0.056）。结论：利用质量改进作为解决关键障碍的框架，我们成功地实施了一个流程，在繁忙的儿科服务中增加了现场口译员对fcr的参与。
OBJECTIVES: No best practice has been defined for incorporating in-person interpreters into family-centered rounds (FCRs) for patients with limited English proficiency (LEP). We hypothesized that addressing barriers to scheduling in-person interpreters would make FCR encounters more likely, and thus ensure more equitable care for LEP patients.METHODS: A quality improvement initiative was conducted from October 2014 to March 2016 to arrange in-person interpreters for LEP patients during FCRs on the inpatient pediatric service of a large, urban, tertiary care center in Boston. Main interventions included establishing a protocol for scheduling interpreters for rounds and the implementation of a form to track process adherence. Our primary outcome was the percentage of FCR encounters with LEP patients with an interpreter present. Our balancing measures were patient satisfaction, which was assessed using validated surveys administered weekly by nonphysician team members through convenience sampling of families present on the wards, and rounds duration.RESULTS: There were 614 encounters with LEP patients during the intervention, 367 of which included in-person interpreters. The percentage of encounters with LEP patients involving interpreters increased from 0% to 63%. Form completion, our primary process measure, reached 87% in the most recent phase. English-proficient and LEP patients reported similar satisfaction with their rounding experience amid a modest increase in rounds duration (preintervention, 105 minutes; postintervention, 130 minutes; P = .056).CONCLUSIONS: Using quality improvement as a framework to address key barriers, we successfully implemented a process that increased the participation of in-person interpreters on FCRs on a busy pediatric service.