Impact of Language Discordance on Surgical Resident Workflow.

Overview

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.