# Improving Outcomes for Spanish-Speaking Surgical Patients with Limited English Proficiency

> **NIH NIH K23** · BRIGHAM AND WOMEN'S HOSPITAL · 2022 · $172,720

## Abstract

Project Summary
In 2018, nearly 67 million people in the US spoke a language other than English at home and, among them, 40%
met criteria for limited English proficiency (LEP). People with LEP are at higher risk of adverse events during
medical care. In fact, 1 in 12 patients is at risk for adverse events because of barriers created by language
discordance, which occurs when the patient and provider do not share a common spoken language. Surgical
disparities have been studied in various disciplines, but very few studies have focused on the impact of language.
Understanding the impact that language and language discordance or concordance have on surgical outcomes
represents a vital component of providing effective, high-quality patient care. Our overall objective is to improve
outcomes for surgical patients with LEP. The central hypothesis is that socioeconomic and sociodemographic
factors impact outcomes of surgical care for patients with LEP and that identifying those factors through
quantitative and qualitative research rooted in a social ecological model (SEM) will provide an opportunity to
design interventions that address these risk factors and reduce surgical disparities. Building on a deeper
understanding of patient experiences and social risk factors, this project will test the use of a mobile technology
for live medical interpretation provided directly to patients. We seek to determine if such a solution can improve
communication and promote patient-initiated language concordant encounters, thereby leading to better surgical
outcomes. While some research suggests the effects of language discordance may be mitigated by the use of
trained interpreters, qualified interpreters are not reliably used for all patients with LEP, even at resource-rich
health centers. These barriers threaten to compromise the provision of equitable and patient-centered care for
this patient population. To that extent, we will test our central hypothesis by pursing three specific aims: (1)
Determine whether language concordance is associated with surgical outcomes in a large retrospective surgical
patient cohort; (2) Identify the social factors that influence the use of formal interpreter services to treat primary
Spanish-speaking surgical patients with LEP; and (3) Evaluate if an immediate interpreter mobile application
enables language concordant communication for primary Spanish-speaking patients with LEP. Likewise,
studying the complex interaction of structural, interpersonal, and individual factors will enrich our understanding
of the impact of language across the continuum of surgical care. The research proposed in this application is
innovative because no one has sought to elucidate precisely how LEP may influence surgical outcomes and nor
have they applied the SEM in an attempt to have a profound impact for vulnerable populations. Also, by providing
the mobile interpretation application directly to patients (in addition to surgeons and nurses), we hope to e...

## Key facts

- **NIH application ID:** 10448774
- **Project number:** 1K23MD016129-01A1
- **Recipient organization:** BRIGHAM AND WOMEN'S HOSPITAL
- **Principal Investigator:** Gezzer Ortega
- **Activity code:** K23 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2022
- **Award amount:** $172,720
- **Award type:** 1
- **Project period:** 2022-05-19 → 2027-02-28

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10448774

## Citation

> US National Institutes of Health, RePORTER application 10448774, Improving Outcomes for Spanish-Speaking Surgical Patients with Limited English Proficiency (1K23MD016129-01A1). Retrieved via AI Analytics 2026-05-25 from https://api.ai-analytics.org/grant/nih/10448774. Licensed CC0.

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