Improving Spanish-Speaking Caregivers' Experience with Standardized Discharge Instructions for Asthma Exacerbation in the Pediatric Emergency Department.

BACKGROUND

Pediatric asthma is a leading cause of emergency department (ED) utilization, with higher rates among minority populations. Families with limited English proficiency, particularly Spanish-speaking caregivers, may face discharge communication barriers that contribute to outcome disparities.

OBJECTIVE

To describe Spanish-speaking caregiver-reported experiences with discharge communication and follow-up support after receipt of a standardized Spanish-language asthma discharge protocol and to explore 72-hour ED revisit rates among participating patients.

METHODS

We conducted a prospective observational study of Spanish-speaking caregivers of children presenting with asthma exacerbations to a tertiary pediatric ED between April 2023 and March 2025. Caregivers completed a REDCap survey assessing demographics, language preferences, interpreter use, discharge communication, and follow-up support. The primary outcome was return ED visits for asthma exacerbation within 72 h, compared with a pediatric ED population using Fisher's exact test.

RESULTS

Fifty-four Spanish-speaking caregivers were included. Most preferred discharge instructions in Spanish (94.4%); 30% reported effective English communication. Although satisfaction with interpreter services (92.0%) and provider explanations of asthma (92.6%) was high, 61.1% needed help scheduling follow-up appointments. Contributors to discharge confusion included provider time (23.1%), terminology (15.4%), and language barriers (15.4%). The surveyed group had a significantly higher 72-hour ED revisit rate than the control population (7.7% vs. 2.1%, p = 0.039).

CONCLUSIONS

Despite high satisfaction with interpreter services and provider explanations, gaps remained in follow-up support. The participating group also had a higher 72-hour revisit rate; however, the observational design cannot determine whether discharge communication or the standardized protocol contributed to this difference.