Pavesi-Krieger Clara, Yang Rachel, Plezia Alex, Hamill Veena, Barriga Tatiana, Rech Megan A, Nguyen Theresa
J Emerg Nurs. 2025 Jan 18. doi: 10.1016/j.jen.2024.12.012.
Emergency department encounters include an increasing number of patients with limited English proficiency, yet little is known about the impact of interpreter services on unplanned revisits to the emergency department. This study aims to assess interpreters' utilization and unplanned ED revisits, serving as an indicator of care quality.
This was a single-center, retrospective chart review of ED visits at an urban academic center between January and April 2019. Inclusion criteria involved patients aged >18, discharged after evaluation, and with at least 1 ED revisit in the study period. Demographic data, interpreter modality, and revisit incidences within 72 hours and 30 days were analyzed using Chi-squared and Wilcoxon rank-sum tests.
Of 786 reviewed charts, 401 limited English proficiency patients and 294 controls matched by gender, race, and ethnicity were included. Among limited English proficiency patients, the majority identified as Hispanic (84.8% vs 36%, P<.01) and showed higher 72-hour unplanned revisit rates (2.8% vs 0.7%, P = .05). Interpreter documentation for limited English proficiency patients was only 49.6%, with in-person modality prevailing (45.8%). Trained interpreters were underutilized (13% in-person vs 7.7% video, P<.0001). Only 78% (P<.01) of patients with limited English proficiency received discharge instructions in their preferred language.
This study reveals a higher unplanned ED revisit rate among limited English proficiency patients, potentially linked to varying interpreter modality effectiveness and underutilization of trained interpreters. Emphasizing the critical role of trained interpreters, these findings offer an opportunity to enhance care quality for limited English proficiency patients in the emergency department.
急诊科接待的英语水平有限的患者数量日益增加，但关于口译服务对急诊科非计划复诊的影响却知之甚少。本研究旨在评估口译服务的使用情况以及非计划的急诊科复诊情况，以此作为护理质量的指标。
这是一项对某城市学术中心2019年1月至4月急诊科就诊情况进行的单中心回顾性病历审查。纳入标准包括年龄大于18岁、评估后出院且在研究期间至少有一次急诊科复诊的患者。使用卡方检验和威尔科克森秩和检验分析人口统计学数据、口译方式以及72小时和30天内的复诊发生率。
在786份审查病历中，纳入了401名英语水平有限的患者以及按性别、种族和民族匹配的294名对照患者。在英语水平有限的患者中，大多数为西班牙裔（84.8%对36%，P<0.01），且72小时非计划复诊率更高（2.8%对0.7%，P = 0.05）。英语水平有限患者的口译记录仅为49.6%，其中面对面方式占主导（45.8%）。受过培训的口译员未得到充分利用（面对面方式为13%，视频方式为7.7%，P<0.0001）。只有78%（P<0.01）的英语水平有限的患者收到了其首选语言的出院指导。
本研究揭示了英语水平有限的患者中非计划急诊科复诊率较高，这可能与口译方式的不同有效性以及受过培训的口译员未得到充分利用有关。这些发现强调了受过培训的口译员的关键作用，为提高急诊科英语水平有限患者的护理质量提供了契机。
