The overall goal of this proposed study is to characterize the experiences, barriers and facilitators related to providing effective care transitions from hospital to post-acute care settings to elucidate the failures that drive disparate outcomes using qualitative methodology and to ultimately adapt standardized processes to close the equity gap.

Current care transition requires adaptation to address persistently worse outcomes for minoritized patients. For those who speak English, there are multiple spontaneous interactions with the healthcare team in addition to formal discharge teaching. Those with LEP have limited, scheduled time (where family may not be available) to ask questions and receive the bulk of discharging instructions in one setting. Even if meeting standards, there is variation in interpreter-services practice (e.g., video-based). We strive for standardization of implementation in most hospital processes rather than adaptation to meet the needs of individuals in order to achieve equitable clinical results. Hospital care quality improvement processes rarely include contextual narratives of the impact in historically marginalized individuals. Furthermore, clinical trials often fail to describe "success" from a patient or their caregivers' perspective. This study brings an innovative team with expertise in mixed methodology to focus on patient experience and equity to improve the value of transition processes from hospitals to SNFs.

Inclusion Criteria:

• Inpatient hospitalization at the University of Washington (UW) Medical Center

Designated as Spanish- speaking in the EPIC electronic medical record (EMR)

Designated as needing an interpreter in the EMR

Being discharged to any skilled nursing facility

Exclusion Criteria: Patients who were unable to participate in a qualitative interview due to neurocognitive conditions such as dementia or schizophrenia were excluded from the study.

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patients who speak Spanish and/or their caregivers