Interventions to Reduce Health Care Utilization for Non-English Language Preference Patients After Tonsillectomy.

Abstract

Compared with those of English language preference (ELP), patients of non-English language preference (NELP) are at increased risk of postoperative complications and health care utilization. A series of interventions were initiated to reduce utilization and improve post-tonsillectomy outcomes for NELP patients. This quality improvement (QI) study was performed at a tertiary pediatric hospital. Data collection began in 2019 and interventions, including improving translated postoperative education materials, pain medication tracking charts, direct access to interpreters, consistent tonsillectomy technique, and routine postoperative nurse phone call for education, were initiated by December 2020. Postintervention data were collected through July 2024. The primary outcome measured was return to the emergency department (ED) or urgent care (UC) with same-day discharge within 30 days post-tonsillectomy. Additional data collected included demographics, language spoken, reason for surgery, and reason for return. Between January 2019 and July 2024, a total of 14,007 patients underwent tonsillectomy: 12,830 (91.6%) ELP and 1177 (8.4%) NELP. After interventions, there was a 70.2% reduction (7.73% in 2019 to 2.30% in 2024) in NELP patients who were seen and discharged same day. In 2019, NELP patients were seen significantly more often (P = .016). In 2023, there was not a statistically significant difference between the two groups (ELP = 1.28%; NELP = 2.30%, P = .55). In our patient population, a set of thoughtful interventions for NELP patients/caregivers reduced minor, potentially unnecessary, nonoperative returns to the ED/UC. Implementation may reduce complications, improve the postoperative experience for NELP patients, and reduce overall health care costs.