Written by Shannon Markus
Spoon Feed
Implementing Spanish-language discharge instruction videos, interpreter-needed EMR icons, and standardized communication processes in a pediatric ED eliminated a 10% communication equity gap between Spanish- and English-speaking families without increasing length of stay or ED return visits.
Y justicia para todos! (And justice for all!)
This quality improvement study addressed communication disparities for Spanish-speaking families in a pediatric emergency department. Spanish-speaking caregivers were significantly less likely than English speakers to report receiving enough information about their child’s diagnosis and treatment (56% vs. 66%). The team implemented several interventions: adding an interpreter-needed icon in the EMR, creating Spanish-language discharge instruction videos, improving video visibility and ordering workflows, using in-room bilingual signage and bedside tablets, and adding Best Practice Alerts to prompt video use. Among families with common pediatric illnesses (fever, URI symptoms, vomiting), positive responses to the key communication survey question increased from 56.1% to 70.7% for Spanish-speaking caregivers, eliminating the 10% communication equity gap. Video use rose to 27.6%, ED reuse remained stable, and length of stay was unaffected. The study demonstrates that structured, language-concordant communication interventions can meaningfully reduce disparities in pediatric ED care.
How does this change my practice?
I work in Texas, and a whopping 40% of patients in my ED face language barriers. In the diverse country that we live in, we as physicians have an ethical and professional responsibility to provide clear, adequate information about diagnosis, treatment, and discharge to all of our patients—not just those who speak English! The interventions and outcomes in the article demonstrate how systematic supports could meaningfully improve understanding and equity in emergency care, and I think we should all take note by supporting, promoting, and using these tools in our daily practice to provide equitable, patient-centered emergency care.
Source
Advancing Equity in Emergency Department Discharge Communication for Spanish-Speaking Families. Pediatrics. 2025 Nov 1;156(5):e2024067346. doi: 10.1542/peds.2024-067346. PMID: 41120116.
