P0692 - The Unspoken Dilemma: Disparities in Resident Interactions with Patients with Limited English Proficiency

Background: Patients with limited English proficiency (LEP) experience worse health outcomes compared to fluent English speakers. Although the use of interpretation services helps mitigate these disparities, it has been well documented that these resources are underutilized. Residents are often the front-line communicators with patients with LEP. However, the frequency of and barriers to resident use of interpreter services have not been well-characterized.

Objective: Our objectives were (1) to characterize resident behaviors regarding interpreter use and (2) to evaluate the effect of LEP on frequency of resident communication with families.

Design/

Methods: We developed a literature-informed electronic survey of 20 questions regarding resident experience with various forms of interpretation services. We concurrently developed a Resident-Patient Communication Tracking Tool (Figure A), which was administered to residents weekly to assess frequency of communication with all of their patients, including those with LEP.

Results: Of the 63 residents completing the survey, 81% felt comfortable with phone interpretation and 90% with in-person interpretation. However, 30% of residents reported “sometimes” or “usually” communicating without an interpreter for families with LEP. Identified barriers included time constraints, unpredictable rounding schedules, and availability of interpreter services (Table 1). We collected data utilizing the tracking tool from 26 unique residents, regarding interactions with 119 unique patients. 24% of these patients were identified as LEP speakers. In regards to inclusion on family centered rounds: 51.1% of families speaking English were included, compared to 6.9% of families with LEP (p = 0.000). 70.0% of families speaking English were updated after rounds by a resident physician, compared to 37.9% of families with LEP (p = 0.002). Families speaking English were updated an average of 1.2 (SD ± 1.1) times per day by resident physicians; while families with LEP were updated an average of 0.5 (SD ± 0.7) times per day (p = 0.002) (Table 2).

Conclusion(s): Residents communicate significantly less with patients and families with LEP compared to families fluent in English. The most commonly identified barrier to interpreter use was time constraints. Future work will focus on identifying practical and effective ways to enhance communication between residents and families with limited English proficiency.