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Changes in Rates and Modality of Interpreter Use for Pediatric Emergency Department Patients in the COVID-19 Era

BACKGROUND: As the COVID-19 pandemic continues, health care systems around the world have changed care delivery in significant ways. Racial and ethnic disparities have emerged for COVID-19 infection rates, morbidity, and mortality. Inequities in care and underutilization of interpretation for patien...

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Autores principales: Hartford, Emily A., Carlin, Kristen, Rutman, Lori E., Lion, K. Casey
Formato: Online Artículo Texto
Lenguaje:English
Publicado: The Joint Commission. Published by Elsevier Inc. 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8590502/
https://www.ncbi.nlm.nih.gov/pubmed/35058161
http://dx.doi.org/10.1016/j.jcjq.2021.11.003
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author Hartford, Emily A.
Carlin, Kristen
Rutman, Lori E.
Lion, K. Casey
author_facet Hartford, Emily A.
Carlin, Kristen
Rutman, Lori E.
Lion, K. Casey
author_sort Hartford, Emily A.
collection PubMed
description BACKGROUND: As the COVID-19 pandemic continues, health care systems around the world have changed care delivery in significant ways. Racial and ethnic disparities have emerged for COVID-19 infection rates, morbidity, and mortality. Inequities in care and underutilization of interpretation for patients who use a language other than English (LOE) for care existed prior to this era. This study sought to evaluate interpreter use in a pediatric emergency department (ED) as changes associated with COVID-19 were implemented. METHODS: ED records were reviewed from December 1, 2019, to July 31, 2020. Patients were classified as having LOE if they preferred a language other than English and consented to interpretation. Statistical process control was used to analyze changes in interpreter use over time, relative to the onset of COVID-19–related operational changes. Beginning March 1, 2020, in-person interpreters were no longer available and staff were encouraged to communicate from outside the patient room when possible; this change served as the exposure of interest. Interpreter use for LOE patients, overall and by triage acuity level, was the study outcome. RESULTS: A total of 26,787 encounters were included. The weekly mean proportion of encounters that used interpretation for patients with LOE increased from 59% to 73% after the onset of COVID-19. This increase met criteria for special cause variation. Interpretation modality changed to being mostly by phone from previously by video or in-person. CONCLUSION: Operational changes in the ED related to COVID-19 were associated with increased interpreter use. Possible explanations include lower patient volumes or changes in model of care that encouraged interpreter use by a variety of modalities.
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spelling pubmed-85905022021-11-15 Changes in Rates and Modality of Interpreter Use for Pediatric Emergency Department Patients in the COVID-19 Era Hartford, Emily A. Carlin, Kristen Rutman, Lori E. Lion, K. Casey Jt Comm J Qual Patient Saf Article BACKGROUND: As the COVID-19 pandemic continues, health care systems around the world have changed care delivery in significant ways. Racial and ethnic disparities have emerged for COVID-19 infection rates, morbidity, and mortality. Inequities in care and underutilization of interpretation for patients who use a language other than English (LOE) for care existed prior to this era. This study sought to evaluate interpreter use in a pediatric emergency department (ED) as changes associated with COVID-19 were implemented. METHODS: ED records were reviewed from December 1, 2019, to July 31, 2020. Patients were classified as having LOE if they preferred a language other than English and consented to interpretation. Statistical process control was used to analyze changes in interpreter use over time, relative to the onset of COVID-19–related operational changes. Beginning March 1, 2020, in-person interpreters were no longer available and staff were encouraged to communicate from outside the patient room when possible; this change served as the exposure of interest. Interpreter use for LOE patients, overall and by triage acuity level, was the study outcome. RESULTS: A total of 26,787 encounters were included. The weekly mean proportion of encounters that used interpretation for patients with LOE increased from 59% to 73% after the onset of COVID-19. This increase met criteria for special cause variation. Interpretation modality changed to being mostly by phone from previously by video or in-person. CONCLUSION: Operational changes in the ED related to COVID-19 were associated with increased interpreter use. Possible explanations include lower patient volumes or changes in model of care that encouraged interpreter use by a variety of modalities. The Joint Commission. Published by Elsevier Inc. 2022-03 2021-11-13 /pmc/articles/PMC8590502/ /pubmed/35058161 http://dx.doi.org/10.1016/j.jcjq.2021.11.003 Text en © 2021 The Joint Commission. Published by Elsevier Inc. All rights reserved. Since January 2020 Elsevier has created a COVID-19 resource centre with free information in English and Mandarin on the novel coronavirus COVID-19. The COVID-19 resource centre is hosted on Elsevier Connect, the company's public news and information website. Elsevier hereby grants permission to make all its COVID-19-related research that is available on the COVID-19 resource centre - including this research content - immediately available in PubMed Central and other publicly funded repositories, such as the WHO COVID database with rights for unrestricted research re-use and analyses in any form or by any means with acknowledgement of the original source. These permissions are granted for free by Elsevier for as long as the COVID-19 resource centre remains active.
spellingShingle Article
Hartford, Emily A.
Carlin, Kristen
Rutman, Lori E.
Lion, K. Casey
Changes in Rates and Modality of Interpreter Use for Pediatric Emergency Department Patients in the COVID-19 Era
title Changes in Rates and Modality of Interpreter Use for Pediatric Emergency Department Patients in the COVID-19 Era
title_full Changes in Rates and Modality of Interpreter Use for Pediatric Emergency Department Patients in the COVID-19 Era
title_fullStr Changes in Rates and Modality of Interpreter Use for Pediatric Emergency Department Patients in the COVID-19 Era
title_full_unstemmed Changes in Rates and Modality of Interpreter Use for Pediatric Emergency Department Patients in the COVID-19 Era
title_short Changes in Rates and Modality of Interpreter Use for Pediatric Emergency Department Patients in the COVID-19 Era
title_sort changes in rates and modality of interpreter use for pediatric emergency department patients in the covid-19 era
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8590502/
https://www.ncbi.nlm.nih.gov/pubmed/35058161
http://dx.doi.org/10.1016/j.jcjq.2021.11.003
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