Implementation of an SBAR Pre-Brief with Medical Interpreters: An Improvement Project

BACKGROUND: The Hispanic/Latino population is disproportionately affected by sexual assault but simultaneously faces barriers that keep them from accessing care, including language barriers and fear of discrimination. As many as 28% of Latinos in the United States are not fluent in English, demonstrating a need for high-quality medical interpretation.

LOCAL PROBLEM: National guidelines recommend that interpreters be pre-briefed to facilitate communication with traumatized individuals with limited English proficiency (LEP). This project aimed to improve patient satisfaction by implementing a Situation, Background, Assessment, Recommendation (SBAR) briefing between the sexual assault nurse examiner (SANE) and interpreter. The specific aims of this project were to 1) Increase overall satisfaction in patients with LEP to ≥4.5, 2) Achieve 60% adherence to SBAR pre-briefing, and 3) Increase the number of patients with LEP seeking SANE services by 10% by 12 weeks.

METHODS: The Model for Improvement guided this evidence-based quality improvement project.

INTERVENTIONS: When a patient with LEP presented after sexual assault, the SANE used SBAR to brief the interpreter before the medical-forensic exam. Community outreach efforts focused on providing awareness of services and patient rights. Data was collected using pre- and post-implementation satisfaction surveys.

RESULTS: During the 13-week implementation period, 86 patients sought acute sexual assault care through SACET. There were no encounters where an interpreter was needed for the patient and 2 where the interpreter was considered for family. Sixteen organizations were contacted to spread awareness of services. Of those, 4 organizations expressed interest in distributing educational materials and/or organizing an event for sexual assault awareness.

CONCLUSIONS: Patients with LEP face significant barriers to reporting sexual assault. This project was implemented during a time of reduced healthcare-seeking behaviors related to immigration enforcement concerns. These findings demonstrate the importance of ongoing engagement with immigrant communities and ensuring culturally and linguistically appropriate services.