title: Impact of English proficiency on care experiences in a pediatric emergency department.
abstract: OBJECTIVE
  To compare emergency department care experiences of Spanish-speaking, limited-English-proficient (SSLEP) and English-proficient (EP) parents and to assess how SSLEP care experiences vary by parent-perceived interpretation accuracy.
  
  
  METHODS
  The National Research Corporation Picker Institute's Family Experience Survey (FES) was administered from November 26, 2010, to July 17, 2011, to 478 EP and 152 SSLEP parents. Problem scores for 3 FES dimensions were calculated: information/education, partnership with clinicians, and access/coordination of care. Adjusted associations between language proficiency (SSLEP vs EP) and dimension problem scores were examined by multivariate Poisson regression. Unadjusted Poisson regression analysis was used to examine the association between perceived interpretation accuracy and FES problem scores for SSLEP parents who received interpretation.
  
  
  RESULTS
  SSLEP parents had a higher risk of reporting problems with access/coordination of care compared to EP parents (risk ratio 1.6, 95% confidence interval 1.2, 2.1). There were no differences in reported care experiences related to information/education or partnership with clinicians. Among SSLEP parents who received professional interpretation, those reporting poor accuracy had a higher risk of also reporting problems with information/education (risk ratio 2.1, 95% confidence interval 1.2, 3.6).
  
  
  CONCLUSIONS
  In a pediatric emergency department with around-the-clock access to professional interpretation, SSLEP parents report poorer experiences than EP parents with access/coordination of care, including perceived wait times. Their experiences with provision of information/education and partnership with clinicians approximate those of EP parents. However, SSLEP parents who perceive poor interpretation accuracy report more problems understanding information provided about their child's illness and care.
authors.affiliation: Seattle Children's Hospital and Seattle Children's Research Institute, Seattle, Wash. Electronic address: kimberly.arthur@seattlechildrens.org.
authors.forename: Kimberly C
authors.initials: KC
authors.lastname: Arthur
authors.affiliation: Seattle Children's Hospital and Seattle Children's Research Institute, Seattle, Wash; Department of Pediatrics, University of Washington School of Medicine, Seattle, Wash; Department of Health Services, University of Washington School of Public Health, Seattle, Wash.
authors.forename: Rita
authors.initials: R
authors.lastname: Mangione-Smith
authors.affiliation: Department of Health Services, University of Washington School of Public Health, Seattle, Wash.
authors.forename: Hendrika
authors.initials: H
authors.lastname: Meischke
authors.affiliation: Seattle Children's Hospital and Seattle Children's Research Institute, Seattle, Wash; Department of Pediatrics, University of Washington School of Medicine, Seattle, Wash.
authors.forename: Chuan
authors.initials: C
authors.lastname: Zhou
authors.affiliation: Seattle Children's Hospital and Seattle Children's Research Institute, Seattle, Wash.
authors.forename: Bonnie
authors.initials: B
authors.lastname: Strelitz
authors.affiliation: Seattle Children's Hospital and Seattle Children's Research Institute, Seattle, Wash.
authors.forename: Maria
authors.initials: M
authors.lastname: Acosta Garcia
authors.affiliation: Seattle Children's Hospital and Seattle Children's Research Institute, Seattle, Wash; Department of Pediatrics, University of Washington School of Medicine, Seattle, Wash.
authors.forename: Julie C
authors.initials: JC
authors.lastname: Brown
mesh_terms: D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D003144:Communication Barriers; D004636:Emergency Service, Hospital; D005260:Female; D006297:Health Services Accessibility; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D007802:Language; D008297:Male; D015999:Multivariate Analysis; D010290:Parents; D017060:Patient Satisfaction; D010372:Pediatrics; D016012:Poisson Distribution; D011446:Prospective Studies; D012044:Regression Analysis; D014175:Translating; D055815:Young Adult
keywords: communication barriers; emergency medicine; interpreters; limited English proficiency; patient satisfaction