401 - Family-Centered Rounds and Interpreter Partnership: Exploring Factors that Promote Quality

Publication Number: 401.4698

Yuri Takabatake, Ann & Robert H. Lurie Children's Hospital of Chicago, Chicago, IL, United States; Nichole Ng, Ann & Robert H. Lurie Children's Hospital of Chicago, Chicago, IL, United States; Cynthia E. Castiglioni, Dell Children's Medical Center of Central Texas, Austin, TX, United States; Jessica E. Pryor, Ann & Robert H. Lurie Children's Hospital of Chicago, Chicago, IL, United States; Edward Marchese, Ann & Robert H. Lurie Children's Hospital of Chicago, Chicago, IL, United States; Susan Woo, Ann & Robert H. Lurie Children's Hospital of Chicago, Chicago, IL, United States; Dhwanil Thakkar, Ann & Robert H. Lurie Children's Hospital of Chicago, Chicago, IL, United States; Victoria A. Rodriguez, Northwestern University, Lurie Children’s, Chicago, IL, United States

Background: Patients and caregivers preferring languages other than English (LOE) experience communication challenges during hospitalization. While family-centered rounds (FCR) is the gold standard in inpatient pediatric care, little is known about utilization of FCR with LOE families.

Objective: Describe the association of medical team characteristics, rounding behaviors, and various interpreter partnership models with the quality of FCR and interpreter-use for LOE patients and caregivers.

Design/Methods: In this prospective observational study at a tertiary free-standing children’s hospital in a large metropolitan area, investigators collected data through chart review and direct observation of FCR with LOE patients and families on hospital medicine teaching services from March to October 2024. Investigators observed rounds using a standardized Observer Form and previously published checklists. Independent variables were patient demographics, and medical team composition, rounding behaviors, and interpreter partnership models. Primary outcomes were quality of FCR (checklist from Agency of Health Research and Quality), and quality of interpreter-use (scored with Faculty Observer Rating Scale). Data was analyzed using descriptive statistics and multivariate analyses.

Results: 66 FCR encounters on the general pediatric inpatient wards were observed, 58 of which used interpreters. Top two languages were Spanish (83.3%) and Arabic (9.1%). Median length of stay (LOS) was 3.43 days. FCR lasted 12.06 minutes on average (avg). Modes of interpretation were in-person (56.92%), video (18.46%), and ad hoc (no formal interpreter training) (12.31%). Top two methods of interpretation were round without caregiver, then update with interpreter (42.42%), and continuous interpretation of the entire FCR (33.33%)(Table 1). Avg score for FCR Quality was 4.75/9 (SD=1.54) and for Interpreter-Use Quality was 37.09/55 (SD=17.44)(Table 2). In an adjusted multivariate analysis, interpreter-use had significantly higher quality scores for FCR by 3.31 points (p < 0.0001) compared to no interpreter-use. In unadjusted sub-analyses, FCR with interpreters had 81% shorter LOS compared to FCR without interpreters (p=0.0007). There were no significant differences in FCR duration when comparing video (p=0.07) and ad hoc (p=0.09) to in-person, and between “round without, update now” and “continuous” interpretation (p=0.45)(Table 3).

Conclusion(s): Interpreter-use significantly improved FCR quality, and was associated with shorter LOS. There was no significant difference in time required between continuous FCR interpretation and updating family after rounds.

Table 1: Sample Demographics


Table 2: Scores for Qualities of FCR and Interpreter-Use
Interpreter-Use Quality Checklist: "patient" may be interchangeable with "caregiver" in a pediatric setting. *=missing 1 data point. **=missing 2 data points. ***=missing item was mean imputed

Table 3: Effects of Interpreter Characteristics on LOS and FCR duration
Results are from unadjusted regression analyses. LOS uses gamma distribution. FCR Duration uses poisson distribution.