Improving Equity of Care for Patients with Limited English Proficiency Using Quality Improvement Methodology

Abstract results

Each result the abstract reports — is it captured as evidence?

• The mean of LEP-SS patients with AIUD improved from 35.7% to 64.5% without significant changes in balancing measures.

  Covered Promote Not a result

• During the postintervention period (6/1/2018-10/31/2020), no special cause variation was noted from the baseline 48-hour emergency department RV rates for LEP patients (3.1%) or English proficient patients (2.6%).

  suggested · 20% Despite the significant improvement in appropriate interpreter use and documentation, the 48-hour ED return-visit (RV) rate for LE

  Covered Promote Not a result

• While the RV rate was not affected, this project is part of a multi-faceted approach aiming to positively impact this outcome measure.

  Covered Promote Not a result

• Significant improvements in AIUD were achieved without affecting balancing measures.

  Covered Promote Not a result

Tables & figures

Map each object to the evidence it grounds (one object can ground several), add anything missed, or flag a gap.

• Figure 1 — Key driver diagram showing the project aim, and the primary and secondary drivers that contribute toward achieving the aim.

  p3
  • Improving interpreter use and documentation did not reduce the 48-hour ED return-visit rate for LEP patients (3.1%)
  • QI bundle raised appropriate interpreter use and documentation for Spanish-speaking LEP ED patients from 35.7% to 64.5%
  • The interpreter-use QI bundle did not significantly change balancing measures of ED length of stay (186 min) or VRI encounter time (16.5 min)
  Add evidence Flag gap Nothing to capture
• 

  Figure 2 — Percent of LEP-SS patients who had an interpreter used and documented in the ED. LEP-SS patients who refused or did not

  p4
  • Improving interpreter use and documentation did not reduce the 48-hour ED return-visit rate for LEP patients (3.1%)
  • QI bundle raised appropriate interpreter use and documentation for Spanish-speaking LEP ED patients from 35.7% to 64.5%
  • The interpreter-use QI bundle did not significantly change balancing measures of ED length of stay (186 min) or VRI encounter time (16.5 min)
  Add evidence Flag gap Nothing to capture

• Figure 3 — ED LEP-SS patients who had the LEP icon activated for identification and awareness along with AIUD. The red squares at

  p5
  • Improving interpreter use and documentation did not reduce the 48-hour ED return-visit rate for LEP patients (3.1%)
  • QI bundle raised appropriate interpreter use and documentation for Spanish-speaking LEP ED patients from 35.7% to 64.5%
  • The interpreter-use QI bundle did not significantly change balancing measures of ED length of stay (186 min) or VRI encounter time (16.5 min)
  Add evidence Flag gap Nothing to capture

• Figure 4 — Percent of LEP-SS patients who had an interpreter used and documented in the UCC location with the most baseline LEP

  p5
  • Improving interpreter use and documentation did not reduce the 48-hour ED return-visit rate for LEP patients (3.1%)
  • QI bundle raised appropriate interpreter use and documentation for Spanish-speaking LEP ED patients from 35.7% to 64.5%
  • The interpreter-use QI bundle did not significantly change balancing measures of ED length of stay (186 min) or VRI encounter time (16.5 min)
  Add evidence Flag gap Nothing to capture
• 

  Figure 5 — Percent of LEP ED and EP ED patients who returned to the ED within 48 hour of initial visit. A, B, Percent of LEP ED and EP

  p6
  • Improving interpreter use and documentation did not reduce the 48-hour ED return-visit rate for LEP patients (3.1%)
  • QI bundle raised appropriate interpreter use and documentation for Spanish-speaking LEP ED patients from 35.7% to 64.5%
  • The interpreter-use QI bundle did not significantly change balancing measures of ED length of stay (186 min) or VRI encounter time (16.5 min)
  Add evidence Flag gap Nothing to capture
• 

  Table 1 — Differences in Patient Characteristics in the Baseline, Postintervention, and Cumulative Study Periods

  p4
  • Improving interpreter use and documentation did not reduce the 48-hour ED return-visit rate for LEP patients (3.1%)
  • QI bundle raised appropriate interpreter use and documentation for Spanish-speaking LEP ED patients from 35.7% to 64.5%
  • The interpreter-use QI bundle did not significantly change balancing measures of ED length of stay (186 min) or VRI encounter time (16.5 min)
  Add evidence Flag gap Nothing to capture