586 - Development and Evaluation of a Health Literacy-Informed, Multilingual Caregiver Electronic Rounds Summary

Publication Number: 2571.586

Alexander F. Glick, New York University Grossman School of Medicine, New York, NY, United States; Nicholas Kuzma, St. Christopher's Hospital for Children, Philadelphia, PA, United States; Glenn Rosenbluth, University of California, San Francisco, School of Medicine, San Francisco, CA, United States; Daniel Kats, Boston Children's Hospital, Boston, MA, United States; H. Shonna Yin, NYU Grossman School of Medicine, New York, NY, United States; Andy Weng Zheng, New York University Grossman School of Medicine, Wilmington, MA, United States; Angela Fan, Boston Children's Hospital, Waco, TX, United States; Rachel K. D'Anna, Boston Children's Hospital, Boston, MA, United States; Marwa Elborki, Boston Children's Hospital, Boston, MA, United States; Kathryn P. Gray, Boston Children's Hospital/Harvard Medical School, Boston, MA, United States; Cara E. Texler, Ohio State University College of Medicine, Columbus, OH, United States; Dale Ann Micalizzi, Boston Children's Hospital, Schenectady, NY, United States; Joelle Kane, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, United States; Helen Haskell, Mothers Against Medical Error, COLUMBIA, SC, United States; Sally C. McDonald, n/a, San Francisco, CA, United States; Erin Abu-Rish Blakeney, University of Washington, Seattle, WA, United States; Zia Bismilla, SickKids, Toronto, ON, Canada; Wilma Alvarado-Little, NYS Dept of Health, Albany, NY, United States; Alisa Khan, Boston Children's Hospital and Harvard Medical School, Boston, MA, United States

Background: Communication failures are a key driver of adverse outcomes for hospitalized children. Health literacy-informed and language-concordant written materials promote caregiver understanding of care plans but are not commonly used during family-centered rounds.

Objective: We sought to 1) develop a health literacy-informed, multilingual electronic real-time summary of rounds for families of hospitalized patients (Rounds eSummary), 2) evaluate the characteristics and usage of eSummaries, and 3) conduct an assessment of health literacy-related features (readability, understandability, actionability) of a subset of eSummaries.

Design/Methods: We conducted a descriptive, secondary analysis of data from a multicenter study aiming to enhance communication with families and ensure equitable communication for those who use a language other than English. A multidisciplinary team developed the Rounds eSummary tool using health literacy, communication, and language equity best practices and multiple rounds of piloting. To generate the eSummary in real-time during rounds, clinicians completed an online form with closed-ended options for various rounds components (e.g., illness severity, plan), caregiver's preferred language, and contact information (Figure 1). This generated a low literacy electronic PDF rounds summary (available in 15 languages) that could be emailed or texted to the family (Figure 2). We evaluated the content, languages used, and usage characteristics of eSummaries shared with caregivers. We used descriptive statistics to analyze eSummaries (n=437) created from 10/25/2024-2/1/2025. Separately, for a purposive sample of English eSummaries (n=12) that represented different diagnoses and plans, two independent raters examined reading grade level (average of five formulas), understandability, and actionability (Patient Education Materials Assessment Tool for Printable Materials).

Results: Rounds eSummaries were generated in eight languages across three sites; most common languages were English (89%), Spanish (6.2%), and Portuguese (1.8%). Plans commonly included medicines (42%), nutrition (30%), and oxygen (24%). More than half (61%) were accessed at least once by the patient/caregiver; of the eSummaries accessed, the average engagement time was 29.1 seconds (standard deviation 25.2). Among the 12 eSummaries analyzed further, the average reading grade level was 6.8 (standard deviation 0.6, range 5.8-7.8) (Table 1). Overall understandability and actionability scores were 87% and 60%, respectively.

Conclusion(s): We designed a usable Rounds eSummary that addressed health literacy and language barriers.

Figure 1
Rounds eSummary Workflow and Close-up of Clinician Input

Figure 2
Rounds eSummary Patient/Family Output

Table 1
Readability Analysis of a Purposive Sample of 12 Generated English Language Rounds eSummaries