Hospital Employee Interpreter Orientation

To Enable an effective communication flow between the patient and provider.

Bilingual vs. Interpretation You may be able to carry a conversation in

the spoken language, but interpretation is precise rendition of exchanging the different languages and maintaining the exact content of the spoken languages.

Interpretation places emphasis on neutrality, completeness, and accuracy.

Modes of Interpreting Simultaneous = same

time as the speaker. Sight Translation=

reading an English document into the patient’s language.

Consecutive = a relay in speaking, then interpreting.

Summary = important points at the end.

The Role of the Medical Interpreter Conduit = message passer Clarifier = request provider

permission to explain complex theories or terminology.

Cultural Broker = explain differences in cultural beliefs and customs.

Advocate = ensure patient is being treated properly or direct patient to appropriate resources.

Interpreter Language Services

The Interpretation Session Beginning of the Session.

Introduction of yourself Advising all parties Explains that EVERYTHING in the room will be

communicated to all parties Advises the provider and patient to address each

other. Advises that she will intervene when necessary Inquires about any special needs or concerns.

During the Session Positioning yourself Reminders to address each other Uses the first person Indicate when you are speaking for yourself

the interpreter always states “the interpreter would like to…”

Attends to the verbal and nonverbal cues Manages the smooth flow of communication by pacing the

amount of information Intervenes for clarification when the interpreter does not

understand the terminology

End of Session/Provides Closure

Did you assist in facilitating any f/u necessary appts

Complete all required documentation for this session

Provide any debriefing with the provider If it was stressful how did you handle it?

Scenarios and role play

The Interpreter Code of Ethics Maintain confidentiality in all aspects. Interpret everything said. Render message most accurately. Assures understanding. Do not advise, counsel, or interject personal opinions. Maintain low profile. Explain cultural differences. Impartiality and professional competency in assignments. Do not accept fees, gifts or gratuities from patient or patient’s family. Keep abreast of medical terminology, policies, and procedures.

Errors in Medical Interpreting and Consequences

Errors in medical interpretation are common averaging 31 mistakes per clinical encounter, and omissions are the most frequent type.

Studies show that Untrained Interpreters often: Omits questions about drug allergies. Omits instructions on the dose frequency and

duration of antibiotics and rehydration fluids. Also, have instructed patients not to answer

personal question. Often the untrained interpreter tries to

influence the patients decisions. Often summarize the message to be conveyed. Answer questions on their own,

Accurate Interpretation=Clinical Quality Reduces medical errors and increases

patient safety. Increases patient compliance. Reduces unnecessary testing, charges,

admissions. Increases patient satisfaction

The U.S. Department of Health and Human Services Office for Civil Rights (OCR) requires all recipients of federal funds to comply with the Title VI of the Civil Rights Act of 1964. Compliance prohibits discrimination based on race or national origin, such as failing to provide effective methods of communication between English-Speaking staff and patients with limited English proficiency

Title VI of the Civil Rights Act

Documentation3.4.1 Interpreters employed by the Hospitals will

document all patient encounters in the medical record. Interpreter’s notes will address the type of interpretation provided.

Date: Type:Provider:Interpreter:Comment:

Monitoring and Data Collection

ILS documentation and data collection

HR documentation and data collection.

Cross-Cultural Communication in Healthcare This country was founded by native people

and immigrants.

An abundance of languages have always been spoken here.

In the U.S. 44 million people speak another language other than English.

Most Common Languages Spanish Chinese French German Tagalog Italian Vietnamese

English Proficiency Most of us learned English as our primary

Language. For others English became an adopted

language. Millions are not proficient in English. More than 10% of the adults in CA, NY,TX,

HA and NM have limited English skills.

Communication & Behavior(Hispanic, Navajo, Vietnamese)

A “yes” answer may only indicate attention from listener

Shrugging shoulders means no comprehension Shake hands firmly and No “wet fish” touch Provide for comfortable personal space and avoid

excessive eye contact Be aware of dialectical differences that occur by

regions

The People (Hispanic) Religion Superstitions

Curanderos/Sobadora

Family Base of Society Older siblings take care

of younger children Man head of household

Health Care: Hispanics

Good Health: God given Mental health is shameful Self-medication

Herbs, other people’s advice

Lack of Pain=Health ER– PCP D words

The People: Navajo Diné Tribal diversity Generational diversity

Traditional Accommodated Assimilated

Health Care: Navajo Tend to keep problems private, avoid asking for help

until is too late People stereotype Health Care as seeing rude providers

and long wait, especially at the reservation Indian Hospitals

Most families put the elder in nursing homes, because they can’t afford the care or don’t have the skills and knowledge of patient care

Self-medication Herbs, Traditional Healers, NO “D” word

The People: Vietnamese List Family name first, then

middle, first name last About two million in Europe,

North America, Australia Primary Regions

North Central South

Migration First wave, 1975 Second wave, 1978 Third wave, 1992

Health Care:Vietnamese Self-Medication Mental illness is considered shameful Greatest stress for elders arise from lack

of English and Economic dependency A common practice done by rubbing

back, chest, neck with menthol oil can be mistaken by abuse

Women prefer female providers

Medical TerminologyGLOSSARIES

Navajo: Yáh átééh Spanish: Hola Vietnamese:Chào

How to contact us: Interpreter Language Services 272-5399

Pattie Franceschini

Pacific Interpreters 1-800-272-7442

Code Access can be obtained by the Charge Nurse or Manager