WORKING WITH WORKING WITH INTERPRETERSINTERPRETERS

FOR HEALTHCARE PROVIDERSFOR HEALTHCARE PROVIDERS2016

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GOAL: GOAL: LEARN HOW TO MAKE YOUR LEARN HOW TO MAKE YOUR INTERPRETED INTERPRETED COMMUNICATIONS MORE COMMUNICATIONS MORE EFFECTIVE AND EFFICIENTEFFECTIVE AND EFFICIENT

AT THE CONCLUSION OF THIS PROGRAM YOU WILL BE ABLE TO:Identify the multiple roles of an interpreterStructure an interpreted encounterIdentify best practicesIdentify behaviors to avoid in interpreted

encountersKnow where to seek cultural consultation

WHO SHOULD INTERPRET?An interpreter, NOT a family memberAn interpreter, NOT a co-workerMedical interpreters at Harborview and UWMC

are trained and have passed the WA state DSHS medical interpreter

exam testing language proficiency and ethical knowledge Many are nationally certified

minimum of two years work experience in a hospitalIf you receive Federal funds, and you practice

in WA, you may only use the services of DSHS certified or authorized interpreters

WHY INTERPRETERS?Clear communication is an essential

tool in diagnosis and treatmentSafety issuesLiability issuesThe law requires it:

The Americans with Disabilities Act Title VI of the 1964 Civil Rights ActDSHS Guidance of August 2000

CLAS StandardsJoint Commission standards beginning

in 2004

WHY INTERPRETERS?

TAHIT-Texas Association of Healthcare Interpreters and Translators-PSA

BEFORE WE START,Do you know how to schedule an interpreter in

advance of the appointment date?EPIC uses Cadence for this, what does your

hospital use?Do you know how to reach a telephonic

interpreter? If your hospital or medical center contracts with a

video vendor, do you know where the cart is and how to use it?This presentation assumes that you, or

your facility, knows how to do the above. Today, we will focus on how to best partner with an interpreter for good clear communication, and improved health outcomes.

WHAT DO INTERPRETERS DO?

Transmit meaning from one language to another.

MODES OF INTERPRETATION

Consecutive Interpreting after the speaker or signer has

completed one or more ideas in the source language and paused, allowing the interpreter to transmit the information Most often used in community and health interpreting

Simultaneous Interpreting into the target language at nearly the

same time as the source language is being delivered Most often used in court interpreting

Sight TranslationOral translation of written text

WHAT ARE THE ROLES OF AN INTERPRETER?

Conduittransmitting everything

Clarifierchanging the form of the message, in order to preserve the intent and meaning of the message

INTERPRETER ROLES

Cultural brokerproviding the necessary framework for understanding the message being transmitted

Advocatetaking action on behalf of either the patient or the provider outside the bounds of the interpreted encounter

STRUCTURING THE INTERPRETED ENCOUNTER

Pre-sessionVerify patient’s language preferenceIntroductions

Encounter Post-conference

Record the name of the language Record the name of the interpreter

THE PRE-SESSIONIntroduction

What are the time constraints?Names

How would you prefer to be addressed?Establish the context, nature, goal of visitIs there cultural information that would be

helpful in this encounter?Encourage the interpreter to ask for clarification if something you say isn’t clear• It isn’t just the interpreter who may pronounce

English with a regional or national accent!

THE ENCOUNTERBe aware of positioning and audio clarity

Room sizes and configurations vary, but try to position yourself where the patient and interpreter can both see and hear you as well as each other, for all clinical appointments

For in-patients in recovery or critical care, have the interpreter stand on the same side of the bed as you, to avoid creating a tennis match viewpoint for the patient

For remote situations (telephone or video) make sure everyone can hear what is being said. Often, video remote interpreters can raise or lower volumes at both ends, but phone interpreters can only control their end. Sometimes you need to make adjustments on your own. phone set-up

Look at the patient while they are speakingMatch the interpreted content to what you just

observed

THE ENCOUNTERONCE YOU HAVE ESTABLISHED GOOD POSITIONINGRemember to LOOK at the patient while they are speaking• Match the interpreted content to what you just

watchedArticulate or reinforce confidentialityEstablish that anything that anyone says will be interpreted

then, and only then do youSpeak to the patient, not the interpreterSpeak in first personSpeak in relatively short segments

HARBORVIEW MEDICAL CENTER ENCOUNTER FEATURING REMOTE VIDEO INTERPRETATION

https://www.youtube.com/watch?v=ztOjmd34ayU&list=LLUhzgfp39admsuHiVIvROoA

Tap screento play video

POST-CONFERENCE

Is there additional cultural information that will help me to care for this patient?

Is there anything I could have done differently to facilitate your interpretation?

After a difficult or traumatic session, “How are you doing?”

AVOIDIdiomatic speech

E.g., “you’re out of the woods”, “feeling blue”. Better to be boring and direct in your speech

SlangThings that slow down an interpreter

Acronyms, which interrups an interpreter’s internal flow

Complicated sentence structureChanging ideas mid-sentenceAsking more than one question at a time

WHEN YOU WORK WITH A QUALIFIED AND CERTIFIED INTERPRETER YOU HELP

Reduce overutilization of the Emergency Dept. as the locus for primary care

You reduce the number of medication errors that occurYou improve LEP patients’ adherence to their care plansYou shorten LOS for LEP patientsYou reduce readmission rates for LEPYou help reduce health disparities!

REMEMBERREMEMBER

Concepts, diagnoses and treatments that can be expressed briefly in English, may have no linguistic equivalent in the target language.

This often leads to the use of:DescriptionsWord pictures Much lengthier exchanges

CULTURALLY COMPETENT RESOURCESFOR YOU TO LEARN MORE ABOUT YOUR REFUGEE & IMMIGRANT PATIENT POPULATION

• WWW.ETHNOMED.ORG WWW.ETHNOMED.ORG • WWW.DIGITALLITERACY.GOV/HEALTHY-ROADS-MEDIA WWW.DIGITALLITERACY.GOV/HEALTHY-ROADS-MEDIA • WWW.STORE.HEALTHYROADSMEDIA.ORG WWW.STORE.HEALTHYROADSMEDIA.ORG • WWW.HABLAMOSJUNTOS.ORG WWW.HABLAMOSJUNTOS.ORG • WWW.HHS.GOV/CIVIL-RIGHTS/FOR-INDIVIDUALS/WWW.HHS.GOV/CIVIL-RIGHTS/FOR-INDIVIDUALS/

SPECIAL-TOPICS/LIMITED-ENGLISH-PROFICIENCY/SPECIAL-TOPICS/LIMITED-ENGLISH-PROFICIENCY/INDEX.HTMLINDEX.HTML

QUESTIONS?QUESTIONS?Contact: Eliana LoboContact: Eliana Lobo

DirectorDirectorInterpreterTrainer@outlook.comInterpreterTrainer@outlook.com

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