Health Care Interpreters : A Profession
in the Making
Shiva Bidar-Sielaff, MA
Manager of Interpreter Services &
Minority Community RelationsUniversity of Wisconsin Hospital &
Clinics
Board Member, NCIHC
Child Heath Services Research Meeting
June 2005
The National Council on Interpreting in
Health Care (NCIHC)
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1994 - informal working group
1998 - formally established
Multidisciplinary membership:
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medical interpreters
interpreter service coordinators and trainers
clinicians
policymakers
advocates
researchers
Mission: to promote culturally competent
professional health care interpreting as a
means to support equal access to health
services for individuals with limited English
proficiency
Website: www.ncihc.org
Building a Profession
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Create and build support for a single Code of Ethics that
will guide the practice of interpreters working in health
care venues
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Develop a nationally accepted, unified set of Standards of
Practice based on the Code of Ethics that will define
competent practice in the field
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Develop standards for health care interpreter training
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Possibly create a national certification process that will set
a standard for qualification as a professional health care
interpreter (needs to be further discussed by profession
and NCIHC)
The National Code of Ethics for Interpreters in
Health Care (published in 2004)
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Code of ethics based on a national consensus
building process (focus groups/survey)
Final draft was also reviewed by a select
number of health care providers and medical
ethicists
Companion document was created that offers
a more thorough discussion of the issues
raised
 places the code in the context of ethical behavior in
general
 provides an elaboration and discussion of each principle
and the interrelationships among them, acknowledging
that controversies still exist while offering the working
interpreter a way to think about these controversies
National Code of Ethics for Interpreters in
Health Care
“The role of interpreter is
a‘tightrope’ balancing act: A code
of ethics is a good guide for the
‘bar’ carried on such a walk on the
tightrope. It offers balance, some
security and especially is a
comfortable way to face the
unknown risks faced on the
interpreter’s path.”
Anonymous Respondent to Code of Ethics
Survey
Core Values
Support health and well-being of patient
and do no harm
 Remain faithful to original message
 Take into consideration culture and
cultural differences to ensure
understanding
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National Standards of Practice for
Interpreters in Health Care Project
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Co-funded by The Commonwealth Fund
and The California Endowment
Project Directors: Shiva Bidar-Sielaff &
Karin Ruschke
Project Committee: NCIHC Standards,
Training & Certification Committee
Target date of completion – June 2005
Goal
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To define competent practices in the field
To lead to more professional interpreting,
resulting in clearer communication and better
outcomes in health care
To lead to standards for health care interpreter
training
To lay the foundation for a possible national
certification process that will set a standard for
qualification as a professional health care
interpreter
Initial Efforts in This Area
The Massachusetts Medical Interpreter
Association, 1995. Reflected initial thinking;
included feedback from national leaders in the
field at the time it was created.
 Minnesota, 1999. Standards developed by a
committee without much input from the field;
not widely acknowledged.
 The California Healthcare Interpreter
Association, 2001. Most recent document;
only includes thinking of California.
= > Learnings from these efforts are an integral
part of the NCIHC Project
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Creating National Standards of Practice for
Interpreters in Health Care
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Conducted an environmental scan
Conducted a series of seven targeted
focus groups across the country
Analyzed the focus group and
environmental scan results and draft the
standards document
Presented draft standards document for
national feedback
Finalize, publish and distribute the
standards document (in progress)
Over 23 regional interpreter association in
the US
 Increasing number of hospital/clinics with
staff interpreters and coordinated
language access programs
 Increasing number of agencies/companies
offering medical interpreter services
 Increased availability of interpreter
training programs
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Resources
NCIHC www.ncihc.org
 Resources for Cross Cultural Health Care
www.diversityrx.org
 Massachusetts Medical Interpreters
Association www.mmia.org
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