Hospital Employee Interpreter Orientation
To Enable an effective
communication flow between the
patient and provider.
Bilingual vs. Interpretation
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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
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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
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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
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Beginning of the Session.
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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
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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
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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
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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
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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:
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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
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Reduces medical errors and increases
patient safety.
Increases patient compliance.
Reduces unnecessary testing, charges,
admissions.
Increases patient satisfaction
Title VI of the Civil Rights Act
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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
Documentation
3.4.1
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:
Provider:
Interpreter:
Comment:
Type:
Monitoring and Data
Collection
ILS documentation and
data collection
HR documentation and
data collection.
Cross-Cultural Communication
in Healthcare
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This country was founded by native people
and immigrants.
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An abundance of languages have always
been spoken here.
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In the U.S. 44 million people speak another
language other than English.
Most Common Languages
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Spanish
Chinese
French
German
Tagalog
Italian
Vietnamese
English Proficiency
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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)
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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)
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Religion
Superstitions
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Curanderos/Sobadora
Family
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Base of Society
Older siblings take care
of younger children
Man head of household
Health Care: Hispanics
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Good Health: God given
Mental health is shameful
Self-medication
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Herbs, other people’s
advice
Lack of Pain=Health
ER– PCP
D words
The People: Navajo
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Diné
Tribal diversity
Generational diversity
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Traditional
Accommodated
Assimilated
Health Care: Navajo
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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
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Herbs, Traditional Healers, NO “D” word
The People: Vietnamese
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List Family name first, then
middle, first name last
About two million in Europe,
North America, Australia
Primary Regions
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North
Central
South
Migration
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First wave, 1975
Second wave, 1978
Third wave, 1992
Health Care:Vietnamese
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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 Terminology
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GLOSSARIES
Navajo: Yáh átééh
Spanish: Hola
Vietnamese:Chào
How to contact us:
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Interpreter Language Services 272-5399
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Pattie Franceschini
Pacific Interpreters
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1-800-272-7442
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Code Access can be obtained by the Charge Nurse or
Manager