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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