Project Summary
This research project is in progress. PCORI will post the research findings on this page within 90 days after the results are final.
What is the research about?
Patients who speak languages other than English may not get health care that meets their needs. For example, in U.S. hospitals, these patients get healthcare updates less often than English speakers. Also, interpreters aren’t used as often as would be helpful. For these reasons, patients who speak languages other than English are at increased risk of adverse events, or harms from health care.
A program called Patient and Family Centered I-PASS, or PFC I-PASS, can help reduce adverse events in the hospital. PFC I-PASS helps clinicians, such as doctors and nurses, talk to patients and families during medical rounds. Rounds are daily meetings where clinicians review patients’ progress and make a plan for the day. PFC I-PASS teaches clinicians to use simple words, talk in a clear way, and include families in discussions. But PFC I-PASS hasn’t been fully tested among patients who speak languages other than English.
In this study, the research team is adapting PFC I-PASS to focus on the needs of patients who speak languages other than English. The team is comparing the new program, called PFC I-PASS+, with PFC I-PASS and usual care. The team wants to see how well each way of doing rounds prevents adverse events. The team is also looking at patients’ and families’ experiences with care in the hospital.
Who can this research help?
Results may help hospital administrators and clinicians when considering ways to communicate with patients and families who speak languages other than English.
What is the research team doing?
First, the research team is adapting PFC I-PASS to better meet the needs of patients and families who speak languages other than English. To do so, the team is using interpreters during and after rounds. Also, the team is teaching clinicians communication skills and cultural humility, or how to treat people from different backgrounds respectfully.
Next, the research team is recruiting 14,400 patients and their families from eight hospitals across the United States. Patients are ages 13 and older. During the study, each hospital starts the study by providing usual care. Usual care consists of hospitals’ regular approach to rounds and the use of interpreters. Then, each hospital switches, one at a time, from usual care to either PFC I-PASS or PFC I-PASS+. The team is assigning the hospitals by chance to PFC I-PASS or PFC I-PASS+. With this approach, the team can compare the two programs to each other and to usual care.
During each patient’s hospital stay, the research team is reviewing medical charts, hospital safety reports, and reports from patients and families to measure rates of adverse events. The team is also surveying patients and families about their experiences with care, discrimination, hospital safety, and communication.
Finally, the research team is interviewing patients, families, and hospital staff to learn what parts of the programs worked and what could be improved.
Parents and families who speak languages other than English, clinicians, social workers, interpreters, and hospital administrators are helping to design and conduct this study.
Research methods at a glance
| Design Element | Description |
|---|---|
| Design | Randomized controlled trial |
| Population | 14,400 patients who were admitted to the pediatric inpatient unit of 8 hospitals and their families; half speak English, and half speak a language other than English |
| Interventions/ Comparators |
|
| Outcomes |
Primary: adverse events Secondary: patient and family experiences with care, patient and family experiences with discrimination, patient and family perceptions of hospital safety, direct observation of the quality and frequency of communications between patients and families and providers |
| Timeframe | 2-year follow-up for primary outcome |