title: Impact of interpretation method on clinic visit length.
abstract: OBJECTIVE
  To determine the impact of interpretation method on outpatient visit length.
  
  
  METHODS
  Time-motion study.
  
  
  METHODS
  Hospital-based outpatient teaching clinic.
  
  
  METHODS
  Patients presenting for scheduled outpatient visits.
  
  
  RESULTS
  Over a 6-week study period, a research assistant recorded the following information for consecutive patient visits: patient age, gender and insurance type; type of interpreter used (none, hospital interpreter, telephone interpreter or patient-supplied interpreter); scheduled visit length; provider type (nurse practitioner; attending physician; resident in postgraduate year 1, 2 or 3, or medical student); provider gender; amount of time the patient spent in the examination room with the provider (provider time); and total time the patient spent in the clinic from check-in to checkout (clinic time). When compared to patients not requiring an interpreter, patients using some form of interpreter had longer mean provider times (32.4 minutes [min] vs 28.0 min, P <.001) and clinic times (93.6 min vs 82.4 min, P =.002). Compared to patients not requiring an interpreter, patients using a telephone interpreter had significantly longer mean provider times (36.3 min vs 28.0 min, P <.001) and clinic times (99.9 min vs 82.4 min, P =.02). Similarly, patients using a patient-supplied interpreter had longer mean provider times (34.4 min vs 28.0 min, P <.001) and mean clinic times (92.8 min vs 82.4 min, P =.027). In contrast, patients using a hospital interpreter did not have significantly different mean provider times (26.8 min vs 28.0 min, P =.51) or mean clinic times (91.0 min vs 82.4 min, P =.16) than patients not requiring an interpreter.
  
  
  CONCLUSIONS
  In our setting, telephone and patient-supplied interpreters were associated with longer visit times, but full-time hospital interpreters were not.
authors.affiliation: Division of General Internal Medicine, Department of Medicine, Brown Medical School, Providence, RI, USA. MFagan@lifespan.org
authors.forename: Mark J
authors.initials: MJ
authors.lastname: Fagan
authors.forename: Joseph A
authors.initials: JA
authors.lastname: Diaz
authors.forename: Steven E
authors.initials: SE
authors.lastname: Reinert
authors.forename: Christopher N
authors.initials: CN
authors.lastname: Sciamanna
authors.forename: Dylan M
authors.initials: DM
authors.lastname: Fagan
mesh_terms: D003144:Communication Barriers; D005260:Female; D006801:Humans; D007802:Language; D007902:Length of Stay; D008297:Male; D015999:Multivariate Analysis; D010044:Outpatient Clinics, Hospital / Q000458:organization & administration*; D011369:Professional-Patient Relations; D012237:Rhode Island; D017748:Time Management / Q000458:organization & administration / Q000523:psychology; D013996:Time and Motion Studies