Evaluating the impact of translated written discharge instructions for patients with limited English language proficiency

Patients with limited English language proficiency have indicated that they believe post-operative instructions written in their native language will improve comprehension over verbal translation alone, but the effect of this has not been previously studied. We hypothesize that providing written discharge instructions in Spanish for native Spanish speakers will improve comprehension regarding post-operative care after routine otolaryngologic procedures when compared to instructions written in English.This prospective randomized controlled trial enrolled subjects who met criteria from June 2016 to November 2016. Subjects were Spanish-speaking parents and legal guardians of children undergoing tympanostomy tube insertion, adenoidectomy, and/or tonsillectomy. Subjects were given written discharge instructions in either English or Spanish. Both cohorts received standard verbal counseling in Spanish as well. Primary outcome was score on a standardized quiz assessing comprehension of discharge instructions. Patient satisfaction and preferences were secondary outcomes assessed through a survey. Participants underwent follow up one month after initial enrollment.Twenty subjects were enrolled, with ten receiving written discharge instructions in Spanish and ten receiving instructions written in English. There was no significant difference in comprehension scores between the two groups. Eleven participants completed the survey on patient satisfaction and preferences. Most subjects (91%, 10/11, p0.01) preferred written instructions in their native language and subjectively felt this would improve their comprehension. However, there was no significant effect on patient satisfaction.Spanish-speaking patients indicate a strong preference for written discharge instructions in their native language, although there was no significant difference in short-term comprehension of instructions written in English vs. Spanish on objective evaluation. Accommodating these preferences may improve long-term comprehension and patient satisfaction, and ultimately build invaluable rapport between providers and patients.