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 ElementDescription
DesignRandomized controlled trial
Population14,400 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
  • PFC I-PASS +
  • Usual care

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  Timeframe Length of follow-up for collecting data on primary outcomes. View Glossary 2-year follow-up for primary outcome

*Increase Diversity and Advance Health Equity Funding Supplement
This study received supplemental funding to build on existing PCORI-funded comparative clinical effectiveness research (CER) studies to leverage meaningful engagement of affected/relevant communities to ensure that a diverse and inclusive study population can be achieved.

Project Information

Alisa Khan, MD, MPH
The Children's Hospital Corporation
Comparing Three Approaches to Communication with Hospitalized Children with Limited English Proficiency

Key Dates

July 2022
February 2029


Award Type
Health Conditions Health Conditions These are the broad terms we use to categorize our funded research studies; specific diseases or conditions are included within the appropriate larger category. Note: not all of our funded projects focus on a single disease or condition; some touch on multiple diseases or conditions, research methods, or broader health system interventions. Such projects won’t be listed by a primary disease/condition and so won’t appear if you use this filter tool to find them. View Glossary
Populations Populations PCORI is interested in research that seeks to better understand how different clinical and health system options work for different people. These populations are frequently studied in our portfolio or identified as being of interest by our stakeholders. View Glossary
Intervention Strategy Intervention Strategies PCORI funds comparative clinical effectiveness research (CER) studies that compare two or more options or approaches to health care, or that compare different ways of delivering or receiving care. View Glossary
State State The state where the project originates, or where the primary institution or organization is located. View Glossary
Last updated: March 27, 2024