P3C201: Using Family-directed Interpretation to Improve Language and Communication Equity Among Patients with Limited English Proficiency in Ambulatory Care Clinics: a Quality Improvement Study

Purpose/Objectives: Disparities in health communication can result in vast health inequities. In our diverse, urban pediatric primary care clinic we frequently witness health disparities and their direct impact on our patients, including errors. The impact of language barriers during care is established in the literature. However, little is known about how to ensure interpretation services are used at every interaction in ambulatory clinics and there are no published studies using family-directed interpretation in primary care. The aim of this quality improvement study is to improve communication with families with limited English proficiency by increasing appropriate interpreter use for Spanish-speaking families at each clinical and ancillary interaction to 90% by September 2023.

Design/Methods: Setting: A multi-disciplinary team of primary care clinic staff, including pediatric residents, medical assistants, patient service coordinators, and clinic leadership is being used in identifying opportunities for improvement and implementing an intervention in a large academic pediatric primary care clinic in Baltimore, Maryland. Intervention: The intervention allows families to direct interpreter access at each point of contact with a clinical staff member. Implementation will start June 2023 and planned improvement bundle includes 1) families and care-partners keep a tablet loaded with interpretation software with them throughout the clinic visit giving them the ability to access the interpreter using video and audio interpretation at their convenience and 2) reeducation of clinical staff in ambulatory care interpretation best practices.

Results: Outcome measures include: percent of interactions between clinic staff and Spanish-speaking families for which appropriate interpretation services are used, family satisfaction with their ability to access interpretation services, and evaluation of parental trust in the physician. Process measures include: percent of eligible families who receive a tablet at the start of the visit. Balancing measures include: time from start to finish of visit and provider satisfaction with efficiency of visit.

Conclusion/Discussion: We will present study outcomes and discuss scalability, sustainability, and spreadability of this intervention in primary care and beyond to promote health equity and reduce disparities.

Funding: American Academy of Pediatrics Health Equity Grant for Trainees.