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J Hosp Med. 2019 Oct 1;14(10):607-613. doi: 10.12788/jhm.3240. Epub 2019 Jul 24.

Inpatient Communication Barriers and Drivers When Caring for Limited English Proficiency Children.

Author information

1
Division of Hospital Medicine, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio.
2
Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, Ohio.
3
James M. Anderson Center for Health Systems Excellence, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio.
4
Division of Psychology in the Department of Pediatrics, Nationwide Children's Hospital, Columbus, Ohio.
5
Allied Health Department, University of Cincinnati Blue Ash College, Cincinnati, Ohio.

Abstract

BACKGROUND:

Achieving effective communication between medical providers and families with limited English proficiency (LEP) in the hospital is difficult.

OBJECTIVE:

Our objective was to identify barriers to and drivers of effective interpreter service use when caring for hospitalized LEP children from the perspectives of pediatric medical providers and interpreters.

DESIGN/PARTICIPANTS/SETTING:

We used Group Level Assessment (GLA), a structured qualitative participatory method that allows participants to directly produce and analyze data in an interactive group session. Participants from a single academic children's hospital generated individual responses to prompts and identified themes and relevant action items. Themes were further consolidated by our research team and verified by stakeholder groups.

RESULTS:

Four GLA sessions were conducted including 64 participants: hospital medicine physicians and pediatric residents (56%), inpatient nursing staff (16%), and interpreter services staff (28%). Barriers identified included: (1) difficulties accessing interpreter services; (2) uncertainty in communication with LEP families; (3) unclear and inconsistent expectations and roles of team members; and (4) unmet family engagement expectations. Drivers of effective communication were: (1) utilizing a team-based approach between medical providers and interpreters; (2) understanding the role of cultural context in providing culturally effective care; (3) practicing empathy for patients and families; and (4) using effective family-centered communication strategies.

CONCLUSIONS:

Participants identified unique barriers and drivers that impact communication with LEP patients and their families during hospitalization. Future directions include exploring the perspective of LEP families and utilizing team-based and family-centered communication strategies to standardize and improve communication practices.

PMID:
31339836
DOI:
10.12788/jhm.3240

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