Purpose

The investigators will test the impact of a package of linguistically appropriate discharge teaching tools against current standard of care for patients with Limited English proficiency (LEP) in an unblinded randomized controlled trial. The tools include an expanded medication calendar in English and the patients' preferred language, pictographics to illustrate return precautions (what signs/symptoms require further evaluation), an audio recording of the nurse reviewing the After Visit Summary (composed by providers) to allow for review by patients and caretakers after discharge. The investigators will evaluate the effectiveness of the package of discharge teaching tools on patients' understanding/recall, key implementation outcomes, and secondary clinical outcomes via a structured interview 1-2 weeks after discharge and chart review 30 days after discharge. The objectives of this research study are: 1. test the effectiveness of a linguistically appropriate toolkit for improving patient understanding of discharge instruction content 2. Assess the feasibility and fidelity of the intervention in anticipation of a multi-site implementation trial 3. assess the feasibility and appropriateness of the linguistically appropriate toolkit to nurses and in-person interpreters 4. to assess the acceptability of the intervention to patients and their satisfaction with it 5. to collect data on implementation context in anticipation for a multi-site trial 6. to collect preliminary data on the toolkit's impact on clinical outcomes including medication adherence and hospital re-utilization.

Condition

Eligibility

Eligible Ages
Over 18 Years
Eligible Genders
All
Accepts Healthy Volunteers
No

Inclusion Criteria

Patients - Labeled in medical record as preferring one of the following four languages: Spanish, Haitian Creole, Cape Verdean Creole, or Vietnamese - Admitted to medicine team at BMC - Age 18 years or older - Being discharged home (to the community) - Admitted to Boston Medical Center (BMC) hospital units (Menino 7 East, 7 West, and Menino Observation) Nurses and Interpreters - Caring for patient enrolled in trial Family/Visitors - Present at time of discharge for patient enrolled in trial

Exclusion Criteria

Patients - On airborne infections precautions - On clostridium difficile (C diff) precautions - On suicide precautions - Nurse report of participant displaying cognitive impairment, delirium, or aggression - Enrolled in trial during a prior admission Nurses and Interpreters - None Family/Visitors - None

Study Design

Phase
N/A
Study Type
Interventional
Allocation
Randomized
Intervention Model
Parallel Assignment
Intervention Model Description
Block randomization stratified by language and level of care (observation unit versus inpatient floor)
Primary Purpose
Health Services Research
Masking
None (Open Label)

Arm Groups

ArmDescriptionAssigned Intervention
Experimental
Discharge equity tools
Participants randomized into this arn will receive the toolkit of linguistically appropriate discharge teaching aids at hospital discharge.
  • Other: Toolkit to improve discharge equity
    Linguistically appropriate discharge teaching aids: a medication calendar, pictographics added to the after visit summary (AVS), and an audio recording of the discharge teaching.
No Intervention
Standard of hospital discharge care
Participants randomized into this arm will receive the standard of care at hospital discharge.

Recruiting Locations

Boston Medical Center
Boston, Massachusetts 02118
Contact:
Kirsten Austad, MD MPH
817-414-4459
kirsten.austad@bmc.org

More Details

Status
Recruiting
Sponsor
Boston Medical Center

Study Contact

Kirsten Austad, MD MPH
(617) 414-4459
kirsten.austad@bmc.org

Notice

Study information shown on this site is derived from ClinicalTrials.gov (a public registry operated by the National Institutes of Health). The listing of studies provided is not certain to be all studies for which you might be eligible. Furthermore, study eligibility requirements can be difficult to understand and may change over time, so it is wise to speak with your medical care provider and individual research study teams when making decisions related to participation.