A Patient-Initiated, Multilingual Request Conveyance System

DESCRIPTION (provided by applicant): The aim of this project is to develop a multilingual software application designed for use on a touchscreen tablet device placed at the bedside that allows hospitalized patients with limited English proficiency (LEP) to communicate frequently encountered patient requests to their English-speaking providers. Given the current paucity of linguistically appropriate services and the association between LEP status and adverse health outcomes (including inadequate use of analgesia for pain control, increased number of diagnostic tests, extended length of hospital stay, and overall dissatisfaction with care), a new paradigm for language- concordant patient-provider communication is needed. This system will also contribute to reducing the burden and stress on nurses by offering an efficient method to process reoccurring patient requests. The primary objective of Phase I is to develop a functional prototype of the envisioned software in English, Chinese and Spanish. Monolingual speakers of the target languages and English-speaking healthcare providers will be recruited to test the prototype and evaluate its efficacy and ease of use in communicating a pre-determined set of sample patient requests. In Phase II, the closed-ended request database will be markedly expanded and additional language versions will be incorporated. The system will undergo clinical testing during a 13-month multi-site trial in collaboration with a large urban medical center. Outcome measures will include patient quality of care, patient satisfaction, provider satisfaction, and workflow efficiency. PUBLIC HEALTH RELEVANCE: For the 24 million individuals in the United States with limited English proficiency (LEP), the current paucity of linguistically appropriate services poses a significant barrier to obtaining equitable healthcare. This Fast-Track proposal seeks to develop a patient-driven, multilingual software application for touchscreen use at the bedside to facilitate the communication of common requests between hospitalized LEP patients and hospital staff. Effective communication is essential to ensuring quality of care for LEP patients, mitigating documented adverse health outcomes such as inadequate use of analgesia for pain control, excess number of diagnostic tests, extended length of hospital stay, and overall dissatisfaction with care.