Partnering with the Visiting Nurse Service of New York to improve outcomes as limited English proficiency patients’ transition from the hospital to home care.

Partnering with the Visiting Nurse Service of New York to improve outcomes as limited English proficiency patients’ transition from the hospital to home care.

New York University College of Nursing was awarded a three-year, $750,000 R01 grant from the Agency for Healthcare Research and Quality to help improve healthcare providers’ understanding of how language barriers impact 30-day readmission rates from home care and home health care resource utilization among limited English proficiency (LEP) patients recently discharged from the hospital, with a secondary aim of understanding their impact on functional status. Allison Squires, PhD, RN will serve as the study’s principal investigator.

“We know that LEP status increases a patient’s risk for readmission between 15 and 25% and that there are effective means for reducing these barriers, e.g. adequate interpreter services,” said Dr. Squires. “Yet there is a critical gap in our understanding of how language barriers impact the transition to home health care and the personnel, patient, and organizational factors that might influence post-acute discharge outcomes in LEP patients. Our overall goal is to understand how language barriers impact 30-day re-hospitalization and home health care resource utilization among LEP patients recently discharged from the hospital, with a secondary aim of understanding their impact on functional status.”

The study will be the first of its kind to capture the impact on patient outcomes of having bilingual nurses care for patients with limited English proficiency. Spanish, Korean, Russian, Cantonese, and Mandarin speakers will be the patients included in the mixed-methods study.

Dr. Squires and her team will be partnering with the Visiting Nurse Service of New York (VNSNY) to conduct the study.
“VNSNY documents the language skills and abilities of its employees and patients thereby allowing us to identify linguistically concordant visits in its extensive database of over 1 million LEP patient visits coming from 86,000 clients” said Dr. Squires.

According to the 2010 US census, immigrants comprise 13% of the US population and 25.2 million US residents are categorized as having limited English speaking skills, defined as the inability to understand healthcare communication in English. The number of limited English proficiency (LEP) individuals living in the US grew 80% between 1990 and 2010 and they represent 10% or more of the populations in the 13 most highly populous states. As a result, healthcare workers in the US are more likely than ever to regularly encounter LEP patients in their practice.

Language barriers likely pose a particularly vexing problem for the complex care coordination processes that occur when patients transition from the hospital to home care, representing an understudied problem. This unique but nationally representative dataset and the New York City location of the study offers an appropriate environment to study this problem.

“To the best of our knowledge, this study will be the largest and most diverse study of the influence of language barriers on critical clinical patient outcomes in the U.S.,” said Dr. Squires.” Results from this study will have policy and research implications for the organization and management of care coordination for LEP patients.”

This study will complement existing initiatives at the Agency for Healthcare Research and Quality focused on improving patient-provider communication for LEP patient populations, reducing racial and ethnic health disparities, improving care for vulnerable populations, improving post-hospital discharge processes, and addressing patient safety across the healthcare system.

 

About New York University College of Nursing
NYU College of Nursing is a global leader in nursing education, research, and practice. It offers a Bachelor of Science with major in Nursing, a Master of Science and Post-Master’s Certificate Programs, a Doctor of Nursing Practice degree and a Doctor of Philosophy in Research Theory and Development. For more information, visit https://nursing.nyu.edu/

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