Mary Pilarz, MD, highlights the importance of interpreter access in the PICU

In this discussion, Mary Pilarz, MD, clinical care physician at Ann & Robert H. Lurie Children’s Hospital of Chicago, explores how providing families in the pediatric intensive care unit (PICU) with direct access to interpreter technology may reshape communication dynamics and potentially improve care for non–English-speaking patients. While her study does not directly evaluate clinical outcomes or shared decision-making, it offers important early insights into how shifting interpreter access from clinician-controlled to family-initiated use affects communication patterns.

Pilarz emphasizes that professional interpreter services are currently underutilized in many PICU settings, despite strong evidence linking their use to better patient outcomes. Traditionally, clinicians have been responsible for initiating interpreter use, a model that can unintentionally limit access.

This approach may lead to inconsistent use, with clinicians sometimes bypassing interpretation because of time pressures or focusing only on their own communication needs rather than those of families. By contrast, allowing families to initiate interpreter use introduces a more bidirectional communication model, empowering families to engage more actively in their child’s care.

Her study specifically measured interpreter utilization before and after implementing family-initiated access, finding a notable increase—from 7 to 16 minutes per patient-day. Although the study did not assess downstream outcomes such as length of stay, complication rates, or family satisfaction, Pilarz suggests that increased interpreter use could help address known disparities.

Non–English-speaking families are at greater risk for adverse events and may feel less comfortable voicing concerns. Enhancing access to interpretation may reduce these barriers, encourage greater family engagement, and ultimately improve safety and satisfaction—though further research is needed to confirm these effects.

The implementation of this model does come with challenges. Operationally, hospitals must invest in sufficient interpreter devices, such as video-enabled tablets, and absorb the increased costs associated with greater interpreter usage. Cultural and technological barriers also exist, including the need for family buy-in, comfort with technology, and literacy to navigate devices. Clinician support is equally important, as teams must actively encourage families to use these tools.

To integrate interpreter technology effectively without adding clinician burden, Pilarz recommends making it a standard feature of care. Placing interpreter devices in every room serves as a visual cue that interpretation is needed and relieves clinicians of the burden of decision-making. She also highlights the continued importance of expanding access to in-person interpreters, particularly during nights and weekends.

Ultimately, this intervention represents a promising step toward advancing health equity in pediatrics. Pilarz underscores the need to move beyond simply documenting disparities and toward implementing and studying practical solutions that improve care for linguistically diverse populations.

No relevant disclosures.

Reference

When families can initiate access to interpreters in pediatric intensive care, communication time with medical team doubles, study shows. News release. Ann & Robert H. Lurie Children’s Hospital of Chicago. April 3, 2026. Accessed April 17, 2026. https://www.eurekalert.org/news-releases/1122436