BACKGROUND Federal guidelines and equitable care mandate that patients who use a language other than English receive interpretation in their preferred language. Substantial variability exists in interpreter use in intensive care settings. We aimed to increase the rate of interpretations in our pediatric intensive care unit (PICU) through a series of targeted interventions. METHODS A multidisciplinary team developed a key driver diagram to identify areas for focused intervention. Each plan-do-study-act cycle informed the next cycle of interventions, targeting increasing interpreter (video, phone, and in-person) use. Interventions included standardizing technology, standardizing placement of interpretation devices in patient rooms, provider education, and creating accountability systems of interpreter use by care providers. We reviewed data from PICU encounters between January 2018 and January 2022 and used summary statistics and statistical process control methods to measure the impact of our interventions. RESULTS We analyzed 882 patient encounters over the 4-year study period. Demographic characteristics were similar in the preintervention and postintervention periods. The total interpretation rate increased to 2.7 interpretations per patient per day from a baseline rate of 1.4. Each individual interpretation modality demonstrated increases in use. Average time spent interpreting via phone increased from 8 to 10.5 minutes per patient per day, and average time spent interpreting via video went from 9.5 to 22 minutes per patient per day. CONCLUSIONS Iterative quality improvement methodology effectively identified barriers to equitable care, guided development of focused interventions, and improved interpreter use among pediatric patients who were critically ill.

中文翻译：

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以公平为重点的干预措施改善了儿科重症监护病房的口译员使用。


背景 联邦指南和公平护理要求使用英语以外的语言的患者接受其首选语言的口译。重症监护病房中口译员的使用存在很大差异。我们的目标是通过一系列有针对性的干预措施来提高儿科重症监护病房 （PICU） 的口译率。方法 一个多学科团队开发了一个关键驱动图来确定重点干预的领域。每个计划-执行-研究-行动周期都为下一个干预周期提供信息，旨在增加口译员（视频、电话和面对面）的使用。干预措施包括标准化技术、标准化病房中口译设备的放置、提供者教育以及创建护理提供者使用口译员的问责制。我们回顾了 2018 年 1 月至 2022 年 1 月期间 PICU 就诊的数据，并使用汇总统计和统计过程控制方法来衡量我们干预措施的影响。结果我们分析了 882 年研究期间的 4 例患者就诊。干预前和干预后时期的人口统计学特征相似。总解释率从基线 1.4 次增加到每位患者每天 2.7 次解释。每种单独的解释方式都显示出使用量的增加。每位患者每天通过电话进行口译的平均时间从 8 分钟增加到 10.5 分钟，每位患者每天通过视频进行口译的平均时间从 9.5 分钟增加到 22 分钟。结论 迭代质量改进方法有效地识别了公平护理的障碍，指导了重点干预措施的开发，并改善了危重儿科患者的口译员使用。