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Health, Language and Culture
Imagine the experience of our culturally diverse patients.
• Language and cultural barriers• A very different healthcare system to navigate.
• Consider this:– The phrase “What brought you here today?”
Improving Communication with our PatientsInterpreter Services provided by trained medical Interpreters helps
improve patient outcomes, quality and satisfaction.
It’s the Law
•Federal Laws preventing discrimination include language.•Massachusetts Law mandates that we provide face to faceInterpreter Services in the Emergency Department and Acute Psyche encounters in our most common spoken languages.
•Patients who are deaf and or hard of hearing are entitled to a Sign Language, or Sign Language and Certified Deaf Interpreter under the American Disabilities Act.
High Cost of Language Barriers in Health Care
• A National Health Law Program study analyzing 35 claims filed in four state between January 2005 and May 2009 for one liability insurer found the insurer paid $2.3 million in damages or settlement and $2.8 million in legal fees for case where the provider failed to offer a professional interpreter.
• Among the cases studied, five patients died and others suffered permanent damages, such as leg amputations and organ damage.
Interpreter Roles
Conduit
Clarifier
Conduit
Interpreter Roles
Cultural Broker
Clarifier
Conduit
Interpreter Roles
Advocate
Cultural Broker
Clarifier
Conduit
Interpreter Roles
Working with Professional Medical Interpreters
• Interpreters are part of the care team for the patient. In addition to interpretation services, they can help providers understand cultural differences. https://www.youtube.com/watch?v=ABn0sE1aiGo
•Hold a pre or post conference with the interpreter for briefing or feedback. Very important for telephonic interpretation.
• Make sure the patient understands that interpreter services are free of charge.
•Document in the Medical Record • Use of Interpreter• Refusal of Interpreter Services
Can’t I just find someone to interpret?
•Clinical Information must be interpreter by a trained medical interpreter- consents, information about treatment, medications, discharge instructions….
•For non- clinical information- you may use a family member or non-trained bilingual employee ONLY for non clinical situations such as registration, giving directions, ordering a meal, and informing that a medically trained interpreter is on the way.
Minor children should NEVER be asked to interpret. It places too large a responsibility on the child. Also, adults patients are unlikely to be forthcoming with sensitive information.
Hospitals have lost law suits when children have been utilized as interpreters.
Can I interpret?• At Mount Auburn Hospital only medically trained interpreters
interpret.• Trained medical interpreters do not add, omit, distort, or
change the register of the message.
• Many providers are fluent in other languages and choose to speak to their patients in those languages.
• Growing attention nationally. Some organizations have tested providers language skills. Reports cite a 30%-60% pass rate.
Can a patient refuse interpreter services?
• Yes. If a patient wishes to refuse interpreter services:• Make sure the patient knows the services are free of charge• Have the patient sign a Refusal Form . You must utilize an
interpreter to have the form signed. (This form is located on the portal)
• Note, even if the patient refuses an interpreter the clinician may choose to have an interpreter. Call x5750 or pg. 6681 for assistance.
Spoken Language• In Person• TelephonicAmerican Sign Language • In Person• Video Relay
Other:• Flash Cards• Amplifier
Interpreter Department x5750 or pg 6681
Interpreter Services The Telephone Language Line is available to all clinicians 24/7.
• Call 1-800-481-3293• At prompt enter account # 501-013-162• At prompt enter pin # • Follow instructions to select language• Write Interpreter ID number in patient’s medical record.
** Customer Service is available for help.
4. Document that the interpreter was utilized for the conversation.
When you need to call a non-English speaking patient.
2. Interpreter calls patient
1. Call the telephonic interpreter from ANY phone
-1-800-481-3293
-Account # 501-013-162
-Pin #
3. Talk to patient through interpreter
4. Document that the interpreter was utilized for the conversation.
When a non-English speaking patient calls you.
3. Tell the Interpreter you are going to connect a patient. Connect the call.
1. Get the patient’s language and phone number if possible. Put the patient on hold.
2. Conference call the telephonic interpreter from
-1-800-481-3293
-Account # 501-013-162
-Pin # XXXX (each areas has their own specific PIN)
4. Talk to patient through interpreter
American Sign Language
• Legal obligation• Limited resources• Call x5750 as early as
possible to arrange• Video Relay
Interpretation may be alternative
• Document steps taken to arrange interpreter.
• Translation services arranged thru Interpreter Services• Joint Commission requires we use certified translators• Interpreters may translate one time, patient specific short
documents.• DO NOT USE TRANSLATION PROGRAMS SUCH AS Google
Translator.
Phrase Translated Sample or Most Common Error % Correct
Your wife is stable Your wife cannot fall over53.8
Your husband had a cardiac arrest
Your husband's heart was imprisoned 53.8
Your wife needs to be ventilated
Your wife needs to be aired26.9
We will need your consent for operation We need your consent for
operating (such as machinery) 61.5
Did he have a high fever at home? Your home temperature was
high. 65.4
Thank You
