A Quality Improvement (QI) Project to Reduce Emergency Department (ED) Readmissions Among Patients with Limited English Proficiency (LEP) Through Utilization of Interpretive Services by Healthcare Providers
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Doctor of Nursing Practice
Family Nurse Practioner
Year Degree Awarded
Month Degree Awarded
Interpreters, Limited English Speakers, Emergency department, recidivism, Humility, cultural competency, cultural awareness.
Dr. DeMartinis Jean
DNP Project Chair
Dr. DeMartinis Jean
DNP Project Outside Member Name
Dr. David Runge
Background and Review of Literature: Patients with Limited English Proficiency (LEP) are a vulnerable population with greater risk for poor health outcomes due to provider-to-patient communication barriers. Emergency Department (ED) health providers are routinely confronted with problems of ineffective communication thereby, leading to lack of patients’ knowledge of their diagnoses and medications, and subsequently lead to medication-related adverse events and ED readmissions. Purpose: The purpose of this DNP quality improvement (QI) project is to evaluate the standards of care and examine factors that contribute to underutilization of interpretive services for patients with LEP who seek care at the ED to reduce ED Recidivism, improve discharge instructions, and increase patient satisfaction. Methods: The DNP student and ED providers collaborated to implement a QI project using the QI Plan Do Check Act (PDCA) cycles model. The ED providers were presented with an evidence-based educational intervention (Power-point presentation) along with a pretest and post-test survey questionnaire. Implementation Plan/Procedure: The overall mean improvement in knowledge was 64%%, and the post-test showed that 83% of the ED providers gained the knowledge regarding the importance of increasing the utilization of interpretive services for patients with LEP. Implications/Conclusion: The project is an exemplar of how DNPs may design and facilitate efforts to optimize health care among vulnerable populations and apply health care delivery methods designed to improve language disparities that are optimal for minority populations. QI project confirmed the intervention was effective in increasing and facilitating interpretive services access. Completion of the QI project had a significant positive impact on both the Baystate Medical Center Emergency Department (BMC-ED) and on Interpreter Services.