Patients and families speaking languages other than English (LOE) often face significant challenges when navigating the healthcare system. Children of parents who prefer LOE may be more likely to have healthcare disparities and worse healthcare outcomes compared to their English-speaking counterparts. A recent Health Equity Rounds article published in Hospital Pediatrics, titled “It’s More Complicated Than Interpreter Use: Improving Care for non-English Speaking Families,” spotlights multiple communication breakdowns, despite interpreter use, and critical areas of improvement through the lens of a patient case (10.1542/peds.2024-007927).
A two-week-old male infant and his Spanish-speaking family presented for evaluation of neonatal fever. He was found to have pyelonephritis and bilateral grade IV vesicoureteral reflex, necessitating both treatment and prophylactic antibiotics. However, a perfect storm of individual and systemic factors contributed to a failure in administering prophylactic antibiotics, ultimately resulting in a readmission for E. coli pyelonephritis and bacteremia.
This case emphasizes that providing high-quality, equitable care for patients and families speaking LOE not only requires interpreter use, but also comprehensive strategies addressing health literacy, follow-up coordination, and effective communication during care transitions. First, providers may clarify language, avoid jargon, and have pre-briefing sessions with professional medical interpreters to set clear goals. Second, using health literacy informed communication strategies, such as the teach-back method and reviewing written and pictograph materials with the family, may help improve comprehension of discharge instructions. Third, healthcare teams may reduce barriers to follow-up care by proactively scheduling appointments, mobilizing social work services, and filling prescriptions so they are available in hand prior to discharge. Finally, hospitalists are encouraged to have direct, closed-loop communication with primary care providers, particularly if there are concerns of barriers to care.
The authors also call for critical systems-based interventions. This includes expanding access to in-person and/or video interpretation availability, improved reimbursement models for interpreter services, and formal training for new hires on effective communication with interpreter use.
This article offers practical, actionable steps for pediatric hospitalists to improve care for patients and families speaking languages other than English. Check out the full article to explore health disparities related to LOE, and additional insights and strategies on bridging communication gaps in an increasingly diverse pediatric population.
