The Hispanic Clinic for Pediatric Surgery

Purpose #

A dedicated language-concordant outpatient clinic model at Lucile Packard Children's Hospital (Stanford) in which Spanish-speaking LEP families of pediatric surgery patients are cared for directly by a fluent Spanish-speaking medical team, rather than through an interpreter. The clinic operationalizes bilingual-provider concordance as a scheduling/staffing arrangement — Spanish-speaking patients are routed to the concordant team through the hospital's outpatient scheduling templates.

"LEP concordant Spanish-speaking patients were obtained from the Hispanic Clinic for Pediatric Surgery at Lucile Packard Children's Hospital where Spanish-speaking families receive care from a fluent Spanish-speaking medical team [26]." (Jaramillo, 2016, p. 672)

Mechanism #

Direct communication between the family and a bilingual surgeon removes the interpreter as an intermediary, which the study associates with more patient-initiated questions, higher-rated communication, and stronger patient preference relative to interpreter-mediated (discordant) care. The authors frame the model as a low-cost use of existing human resources — strategic scheduling of Spanish-speaking patients to fluent Spanish-speaking surgeons.

"Direct communication with a bilingual surgeon positively impacted the patient experience compared to indirect communication through a professional medical interpreter." (Jaramillo, 2016, p. 674)

"Because many departments already have fluent Spanish-speaking surgeons, strategic scheduling of Spanish-speaking patients for non-urgent visits could take advantage of human resources we already have with minimal cost." (Jaramillo, 2016, p. 673)

Example(s) #

In this study, the LEP concordant-Spanish arm (n = 52 of 156 enrolled families) was drawn from the Hispanic Clinic; the discordant arm (n = 47) received the same surgical care mediated by a trained interpreter, and the concordant-English arm (n = 57) was the English-proficient comparison group.