Impact of Language Discordance on Surgical Resident Workflow

Abstract

Objective: To characterize the impact of language discordant patient encounters on resident workflow during morning rounds.

Design: The time required for a patient encounter was measured in a cohort of patients on an acute care and trauma service. Language concordance was recorded, and for language discordant encounters, a subset utilized a call-ahead strategy in order to facilitate obtaining a phone-based or video-based interpreter.

Setting: Acute care and trauma service in a Level 1 trauma center located in New York City.

Participants: About 833 patient encounters were observed, with no patient identifiers recorded other than the data as noted above.

Results: Durations of English-speaking and language concordant encounters were 123.6 ± 89.6 seconds and 129.4 ± 95.8 seconds, respectively, which were not statistically different (p = 0.95). In comparison to the English-speaking group, both the unfacilitated language discordant patients (258.3 ± 189.7 seconds) and the facilitated language discordant patients (193.0 ± 91.1 seconds) were statistically different (p < 0.001). There was a statistical difference between these 2 groups of language discordant patients (p = 0.023).

Conclusions: Language discordant encounters take twice as long as a language concordant encounter. A call-ahead strategy was able to reduce the time required for language discordant encounters. Further strategies to reduce time of encounter would benefit surgical workflow during morning rounds.

Keywords: interpreter; language; low-English proficiency; surgical workflow.