483 - An Explanation on Interpretation: a Needs Assessment Investigating Interpreter Practices

Poster Number: 483
Publication Number: 483.221

Cassandra Nelson, The Hospital for Sick Children, Toronto, ON, Canada; Zia Bismilla, The Hospital for Sick Children, Toronto, ON, Canada; Hosanna Au, University of Toronto, Toronto, ON, Canada

Background: Encounters with patients with limited English proficiency (LEP) are at high risk for worse outcomes, including higher readmission rates, receiving less health education, and decreased health equity for diverse populations. Conversely, concordant language use is associated with increased patient satisfaction, treatment adherence, and decreased adverse events. Despite this, many healthcare providers have minimal or no formal education in how to use an interpreter during patient encounters. This skills gap leads to decreased comfort and improper utilization of interpreters, impacting communication and patient care.

Objective: To assess local interpreter utilization practices and satisfaction within the inpatient general pediatric medicine unit at a large academic children’s hospital.

Design/Methods: A needs assessment was distributed to pediatric hospital faculty and trainees who practiced in the pediatric inpatient medicine unit.

Results: We received 62 responses with representation from faculty (N=13), physician assistants (N=1), fellows (N=18), residents (PGY1-4) (N=28) and medical students (N=2). 73% of those surveyed had not received any formal education in using interpreters with no difference in education rates among the groups. 100% of respondents had used phone interpreters, but only 11% of respondents received education on how to use them (see Figure 1). Respondents either strongly agreed (43%) or agreed (48%) that they were comfortable with using in-person interpreters but felt less comfortable with using phone interpreters (21% strongly agreed, 58% agreed) and video interpreters (16% strongly agreed, 40% agreed). A significant proportion of respondents felt neutral (27%) or disagreed (13%) that they were satisfied with encounters using interpreters, and rated patient satisfaction as likewise low (neutral (31%) or disagree (5%)) (see Figures 2a and 2b). Faculty were the least likely to feel satisfied with encounters using interpreters, the majority rating neutral (23%) or disagree (31%). Only 52% of respondents used an interpreter 75-100% of the time, 40% used one 50-75% of the time, 6% used one 25-50% of the time, and 2% used one 0-25%. Multiple barriers and facilitators to using interpreters were identified (see Table 1).

Conclusion(s): Formal educational initiatives need to be developed to improve provider comfort and skills and address barriers to using interpreters. These educational initiatives should encourage interpreter best practices and enhanced utilization to ultimately result in improved patient outcomes.