Nursing at Seattle Children’s

Language of Care Signs Support Patient Needs

Early in the pandemic, groups across the organization took on projects to improve interpreter offerings for patients and families, which had primarily transitioned to a virtual format. As a quality improvement project, teams wanted to decrease barriers facing families and help provide an equitable and inclusive environment to improve care.

Colin Crook, unit based clinical quality leader in the Cardiac Intensive Care Unit (CICU) was interested in this work. He began brainstorming with others how they could expand the use of interpreters, specifically in the CICU. Simultaneously, the Pediatric Intensive Care Unit (PICU) launched their own program, led by Hector Connolly Valdivia, clinical nurse specialist, who had previously done extensive work expanding the availability of video interpreter devices in both the PICU and CICU and was also inspired by work led in the Emergency Department (ED), where individual language signs were placed on patient room doors as a means of communicating to all care team members.

Currently, families can receive interpretive services three different ways – through phone, video or in-person interpreter. However, before Crook and Valdivia’s work, there was no standardized, forward-facing way of knowing which families needed an interpreter while being cared for in the ICUs.

“We are aware there are inequities that exist in healthcare – whether they are unconscious or conscious,” Crook says. “We don’t have a different approach in the way we care for children who speak a language other than English, but when we look at the data, we can see the outcomes are different. We asked ourselves, ‘What can we do as individuals, as anti-racist allies and as an organization to help advance awareness and reduce risk to patients?’ Addressing language barriers was one area where we identified we could make a difference, so we learned from our colleagues, like the ED, and decided to try language of care signs.”

The signs serve as a visual cue to help nurses, providers and other workforce members know what language is spoken by a patient family. 

“We saw immediate benefits for our team members and patients and families,” Crook says. “Being able to effectively communicate is a human need – regardless of race, ethnicity and language. When your primary language is something other than English, it can be a barrier to care. When a child is in the ICU, we need to be able to facilitate a discussion that is clear and ensure the family can understand conditions and changing statuses quickly. Being able to effectively communicate is key to collaboration and building trust.”

Nurses interact with and provide care to patients and families daily. Having a simple tool to be able to communicate a patient’s language is a great way to ensure connection with families, not only for medical needs, but at a more personal and human level. It not only supports nurses to be effective in their work, but for the entire care team – providing a bright, visual cue that helps normalize the need for interpreters.

Learn about this work and more in the 2021 Nursing Annual Report. (PDF)