Hospital Medicine: Systems/Population-based Research
Hospital Medicine 4
Sheela Gavvala, DO, FAAP
Assistant Professor of Pediatrics
McGovern Medical School at the University of Texas Health Science Center at Houston
Houston, Texas, United States
How health care institutions tackle language barriers for the ever-growing limited English proficient patients is of utmost importance as a lack of adequate accommodations can produce negative health outcomes. Studies continue to demonstrate subpar utilization of interpreters in a multitude of clinical settings. It is unknown how the COVID-19 pandemic may have impacted interpreter usage and access within pediatric hospitals.
A 16-question online survey for pediatric hospital providers was disseminated on the Pediatric Hospital Medicine (PHM) and Community PHM LISTSERV® from February to March 2022. Survey questions included characteristics of providers and their primary practice location. The survey asked about which mode of interpreter was most commonly used, frequency of interpreter use at various points during a hospital stay and difficulty accessing a certified interpreter. The survey asked if the COVID-19 pandemic had affected access to an interpreter, wait times for an interpreter, and reliance on remote interpreters. The statistical analysis included descriptive statistics, and Kruskal Wallis with post-hoc Dunn tests or Chi-squared tests as appropriate for comparison testing. An open-ended question asking for additional comments or concerns about interpreter services allowed for qualitative analysis.
186 responses representing 40 states were captured. Table 1 describes demographic info of respondents and their practice location. Remote interpreter with video services was the most commonly used mode of interpretation. Almost a quarter of respondents reported difficulty accessing a certified interpreter. Those that reported difficulty accessing an interpreter were more likely to be affected by the COVID-19 pandemic with increased wait times for an interpreter and a greater reliance on remote interpretation. Overall, the pandemic decreased access to an interpreter for roughly a third of respondents (Table 2). Additional themes identified from qualitative analysis are listed in Table 3.
We describe wide variability in language accommodation practices across pediatric hospitals with decreased access for some during the pandemic. Areas of improvement uncovered by our study include improving access to interpreters, enhancing provider education on utilization of interpreters, and investigating methods of providing more consistent language concordant discharge instructions.