(792) Family-Initiated Interpretation: A Novel Approach to Communication in the Pediatric ICU

Introduction: Use of a language other than English (LOE) is associated with worse health outcomes for hospitalized children. Professional interpretation improves outcomes, but interpreters are still underused. Our study aimed to determine if allowing families to initiate interpretation will lead to greater use of interpreters.

Methods: This quasi-experimental interventional study took place from September 2022 – October 2023 in a 60 bed PICU. The intervention encouraged families who used an LOE to independently initiate interpretation on hospital provided tablets. There was a video interpreter tablet in every room of a patient who used an LOE throughout their admission. Families were given instructions in their primary language on how to use the tablet. The primary outcomes of interest were the number of interpreter encounters per patient day and total duration of interpreter use per patient day before and during the intervention. Interpreter use data was obtained from the electronic health record (EHR) and from the remote interpreting services vendor. The data was aggregated by month. Tests for differences in interpreter utilization were performed using an interrupted time series analysis. A validated survey of feasibility, acceptability, and appropriateness was used to determine the medical team’s perceptions of the intervention.

Results: During the intervention period, 141 families participated. Pre-intervention, there were an average of 1.01 interpreter encounters per patient-day, compared to a post-intervention average of 1.35 interpreter encounters per patient-day, which was not statistically significant (p = 0.22). The total duration of interpreter use per patient-day increased from an average of 7.6 minutes pre-intervention to 16.1 minutes post-intervention (p = 0.02). On a five point scale, the mean feasibility score was 4.5, acceptability was 4.7, and appropriateness was 4.7.

Conclusions: Family-initiated interpretation was associated with a significant increase in the total daily duration of interpreter use, though there was not a significant difference in the number of interpreter encounters. The intervention received high feasibility, acceptability, and usability scores from the medical team. This is a promising intervention; future work will investigate the patient/family perspective.