Abstract
Objective: Improve the institution of NIH Stroke scale (NIHSS) and outcomes of Stroke codes in low English proficiency population (LEP) at a comprehensive stroke center. Background: LEP individuals are those with limited ability to read, write, speak, or understand English. The 2000 national census showed 47 million U.S. citizens/residents aged 5 years and older spoke a language other than English at home. This is projected to grow by 67 million by 2050. For patients from culturally and linguistically diverse backgrounds, language barriers contribute to poorer quality of care. Stroke is a leading cause of serious long-term disability and death and our aim is to ensure that time-sensitive interventions during a Stroke code are available to our LEP patients in the most efficient and fastest manner. Design/Methods: 1) Pre-intervention survey of providers 2) Creating a set of English words that are more internationally used to assess dysarthria 3) Interpreter Education (for select languages) regarding stroke, acuity of Stroke codes, NIHSS content, tPA and thrombectomy 4) Easy access for providers to the trained interpreters and use of the new Dysarthria words 5) Post-intervention survey of providers running Stroke code 6) Compare post-intervention door-to-needle and door-to-thrombectomy times in languages intervened to other languages in the same period of time. Results: Pre-intervention survey shows that 84.6% of the providers (n=26) deemed running LEP stroke codes in a time-efficient manner as difficult or very difficult. 50% found getting a telephonic interpreter to start the communication to be slow/very slow. 88.5% found the telephonic providers to be either somewhat helpful or not so helpful during the code. 92% of the providers found the words to test dysarthria on the NIHSS to be not helpful in LEP stroke patients. ConclusionS: It is apparent that LEP Stroke codes can be improved based on the above provider opinions. Therefore, we have set into motion a multi-pronged strategy by rethinking the contents of NIHSS, interpreter education and finally instituting an intervention based on the same. The study has started the final phase of having providers access the trained interpreters. The data of the latter will be collected in about 2 years’ time.
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have