“Somebody Hug the Interpreter”: Enhancing Pediatric Palliative Care Partnership with Medical Interpreters

Outcomes 1. Utilizing a case-based approach, participants will be able to describe the unique roles embodied by in-person medical interpreters in the context of pediatric serious illness and summarize the personal, patient/encounter-level, and hospital-level challenges experienced by interpreters in the context of pediatric serious illness and pediatric palliative care.2. Participants will be able to list five strategies that they can incorporate into their daily clinical practice to enhance partnership with and support for medical interpreters in the care of families of children with serious illness. Key Message Medical interpreters mitigate structural inequity in healthcare by serving as cultural mediators, health literacy guardians, and advocates. Their work is emotionally challenging and undervalued. Enhancing partnership with and support for interpreters can improve the quality of care palliative care teams provide to families who prefer a language other than English. Abstract Families of children with serious illness who prefer a language other than English experience structural racism and health inequity. Access to professional, in-person medical interpreters is fundamental to achieving equitable, high-quality healthcare. For many families, in-person medical interpreters become essential and trusted members of the care team. Unfortunately, the unique capabilities of medical interpreters are often underrecognized and underappreciated. Additionally, despite the emotional burden interpreters carry as the individuals delivering difficult news to families in their spoken language, they are often not acknowledged as members of the medical team and their distress goes unsupported.Through a case-based approach, we will illuminate the multi-dimensional roles embodied by medical interpreters in the care of children with serious illness. We will highlight a medical interpreter's unique ability to identify and meet a family's needs, provide continuity of care by holding patient and family stories, and build trust with the medical team. We will share the insights from two professional pediatric medical interpreters (one Spanish-speaking and one Portuguese- and Cape Verdean Creole-speaking) through pre-recorded video interviews. These videos underscore the challenges experienced by interpreters at three levels: (1) the interpreter's personal experience, (2) dynamics of the patient/family encounter, and (3) the hospital system. We present five strategies that clinicians caring for seriously ill patients can incorporate into their daily clinical practice to enhance collaboration with medical interpreters: (1) recognizing and enabling the unique capabilities of interpreters, (2) huddling at the bedside before encounters, (3) seeking specific feedback on communication, (4) acknowledging the emotional burden of the work and providing opportunities for debriefing, and (5) modeling inclusivity and respect. Palliative care clinicians must model regular, effective integration of medical interpreters into interdisciplinary care teams, and find ways to provide support for the emotionally challenging work medical interpreters do. Keywords Diversity, Equity, Inclusion, Belonging, Justice / Interdisciplinary Teamwork / Professionalism