Improving Bedside Communication and Promoting Patient-Centered Care through the Development and Use of Translation Flipbooks

Topic Significance & Study Purpose/Background/Rationale: With the nature of pediatric blood and marrow transplant and the ever-expanding scope of diseases necessitating transplant, our program has seen an increasing number of patients and families coming from diverse backgrounds. In particular, patients from Middle Eastern countries - such as Saudi Arabia, Pakistan, and The United Arab Emirates – are selecting our program for their life-altering therapy. In recent months, up to 25% of our unit census has been comprised of patients who speak limited to no English, with Arabic being their primary language. This presents significant challenges to the entire healthcare team. The bedside nurse, however, is presented with the unique opportunity to communicate vital care-related details on a continual basis. Institutionally provided translational services are limited and often require advanced planning. Translational phone services can also be cumbersome and are often declined by patients and families. 

Methods, Intervention, & Analysis: To address the necessary bedside communication needs for momentary tasks and unit routines that may not necessitate full interpretation services or allow for time delays, a clinical tool was developed and implemented. This tool includes 24 key clinical phrases identified as vital by unit nurses, patients and families. The phrases were translated into both Arabic and Spanish via hospital interpreters. The phrases were then formatted into a flipbook – each phrase was listed on an individual page, written in both English and Arabic/Spanish, with an appropriate picture for age and literacy considerations. 

Findings & Interpretation: Anecdotally, patients, caregivers and bedside staff have reported great success with utilization of flipbooks for everyday communication needs. Patients, families and caregivers are eager to use this tool and report frequent satisfaction. No formal research has been completed on this clinical tool. 

Discussion & Implications: The success of this clinical tool highlights the need for easy-access, instantaneous translation materials. Research could be initiated to study this tool and its effects on patient satisfaction and clinical outcomes. In addition, a more comprehensive and evidenced-based bank of key clinical phrases could be developed for more widespread use and applicability for additional languages and patient populations.