Improving Satisfaction and Appointment Attendance Through Navigation for Spanish-Speaking Families
Kori B. Flower, Samuel Wurzelmann, Claudia Rojas, Kristina Morris Heredia, Myriam Peereboom, Francisco Sylvester, Kellei Agostinelli, Victor Ritter, Jason P. Fine, Michael Steiner
Abstract
OBJECTIVE: Monolingual Spanish-speaking families face linguistic barriers to care. Volunteer bilingual navigation (VBN) may increase appointment attendance and satisfaction. METHODS: Volunteer bilingual navigation was implemented in a children's multispecialty clinic and included way-finding, non-medical interpretation, and pre-visit phone calls. Outcome measures were: 1) Appointment attendance, measured by no-show percentages; 2) Mean Press-Ganey® patient satisfaction ratings. No-show percentages were evaluated using segmented linear regression. Mean patient satisfaction ratings were compared during baseline, intervention, and follow-up phases using t-tests. RESULTS: Trained VBNs provided navigation during the nine-month intervention. In-person navigation was associated with non-significantly decreased no-shows (-0.95%; [-2.43, 0.53]) from baseline (9.32%). Addition of pre-visit phone calls was associated with no-show decrease of -2.82% (-3.97, -1.66). Mean satisfaction ratings increased non-significantly (84.0 to 92.9; p=.18) and remained increased at two-year follow-up. CONCLUSION: Bilingual navigation is an effective complement to formal medical interpretation, may improve Spanish-speaking families' appointment attendance and satisfaction, and can be implemented sustainably.