Video interpreter sessions rose to 29-33 per month after the wheeled-tablet introduction, where none existed before

Description #

Video remote interpreting was adopted on the perianesthesia unit once the wheeled video interpreter tablet was introduced in 2019 — a modality that did not exist on the unit before. In January 2019, with the tablet's introduction, 29 video sessions took place totaling 648 minutes; in March 2019, 33 video sessions were recorded totaling 368 minutes (Fig. 1). This uptake of a newly available modality accompanied continued audio interpreter use and was read by the task force as evidence that staff sustained interpreter use for LEP patients. These are uncontrolled descriptive counts from LAP call logs.

"In January 2019, with the introduction of the video interpreter tablet, 23 audio calls were made, totaling 305 minutes, and 29 video sessions took place, totaling 648 minutes. In March 2019, 20 audio calls were made, totaling 257 minutes, and 33 video sessions were recorded, totaling 368 minutes, indicating that staff continued to adhere to the use of interpreter services for patients with LEP." (Linda, 2023, p. 361)

Methods Context #

What? #ⓘ

The observable: the number of video interpreter sessions per month and their total minutes, tracked as a measure of video-remote-interpreting utilization on the unit (Fig. 1).

"Minutes per interpreter call and the number of calls per month were assessed to determine the efficacy of the intervention (see Figure 1)." (Linda, 2023, p. 361)

How? #ⓘ

An uncontrolled pre/post quality improvement evaluation of LAP interpreter call-log data (April 2018–March 2019). Video sessions became possible only after the electronic video interpreter tablet on a wheeled stand and a second in-service education session were introduced — see A-0012ArtifactA-0012Initial AI draftMSKCC perianesthesia LEP communication initiative (staff education + language assistive technology)To improve communication and foster health equity for surgical oncology patients with limited English proficiency (LEP) — and those with hearing, speech, or visual impairments — in the perianesthesia setting, by equippin….

"an electronic video interpreter tablet embedded with two video interpreter applications was provided in 2019. The tablet was attached to a stand with wheels, allowing for easy transportation to the patient's bedside (Kwok et al., 2021)." (Linda, 2023, p. 360)

Who? #ⓘ

Perianesthesia nursing staff caring for surgical patients with cancer with LEP on the main perianesthesia unit at MSKCC, admitted between January 2018 and March 2019.

"between nursing staff and a sample of surgical patients with cancer with LEP who required admission and were treated on the main perianesthesia unit between January 2018 and March 2019." (Linda, 2023, pp. 359–360)

Other Notes #

Because video interpreting was unavailable before 2019, its usage rose from zero; the finding is modality adoption rather than a change against a nonzero baseline. Total video minutes fell from 648 (January) to 368 (March) even as session count rose (29 → 33), so mean minutes per session dropped.

Caveats #

• Uncontrolled pre-post interpreter-usage counts confounded by concurrent expansion of interpreter service options [Inferred] The rise in interpreter usage is documented as uncontrolled descriptive call-log counts with no comparison unit or adjustment, and the education intervention was rolled out simultaneously with the addition of new interpreter service options (a second telephone service in June 2018, a second audio service on wearable devices in October 2018, and a video interpreter tablet in January 2019). Because more — and more convenient — services became available at the same time as the education, the increased usage cannot be cleanly attributed to staff education versus simply expanded/easier access, and part of the "increase" (video sessions) reflects a modality that did not exist at baseline rather than a behavior change. Monthly counts also fluctuated rather than rising monotonically. In addition, only utilization was measured; no patient-level clinical, safety, or satisfaction outcomes were assessed, so the effect on care quality is unmeasured.
• Single-center, single-unit QI project with COVID-limited expansion and unknown generalizability The interpreter-usage findings come from a single quality improvement project conducted on one perianesthesia unit at a single cancer center (MSKCC). The task force had planned to extend the interventions to the hospital's other medical, surgical, inpatient, and outpatient units, but that expansion was curtailed by the COVID-19 pandemic (remote LAP staff, nurse redeployment, and paused education sessions), and the authors state it is unknown whether the observed usage data would have been reproduced on other units. Generalizability beyond this single unit and institution is therefore unestablished.