Increasing Rounds Participation for Caregivers Who Prefer a Language Other Than English.

Abstract

Objectives: For patients admitted to our hospital medicine resident services, we found that caregivers who were present at bedside and who preferred a language other than English (LOE) participated in family-centered rounds (FCRs) 53% of the time compared with 92% for English-preferring caregivers. We conducted a quality-improvement initiative with the aim of improving monthly FCR participation for LOE-preferring caregivers from 53% to 92%, regardless of preferred language.

Methods: We identified drivers of the FCR participation disparity and tested interventions in 3 plan-do-study-act (PDSA) cycles, including changing the rounding order (PDSA 1), sending biweekly emails to raise awareness about the disparity (PDSA 2), and scheduling rounding times with interpreters for LOE-preferring caregivers (PDSA 3). Our primary outcome measure was the percentage of LOE-preferring caregivers participating in FCRs, stratified by Spanish and non-Spanish LOEs. Nurse attendance, FCR participation by an English-preferring caregiver, and average rounds duration per patient were balancing measures. Measures were evaluated using statistical process control charts.

Results: We analyzed 17 024 rounding encounters occurring from July 3, 2023, to May 30, 2025. Participation of LOE-preferring caregivers in FCRs increased from 53% to 81%. FCR participation improved for Spanish-preferring caregivers from 57% to 87% and for non-Spanish-LOE-preferring caregivers from 46% to 75%. There was no significant change in English-preferring caregiver FCR participation (92%), nurse FCR attendance (70%), or average rounds duration per patient (13 minutes).

Conclusions: Raising awareness of disparities in FCR participation and streamlining interpreter scheduling logistics was associated with improvement in FCR participation for LOE-preferring caregivers without adversely affecting English-preferring caregiver participation, rounds duration, or nurse participation.