Using Medical Interpreters in Family PACT Settings Self Study Module Presented by Office of Family Planning California Department of Public Health 0 Accompanying Documents for this Module The module evaluation form is available for you to download from the website. You can print the form by clicking on it just below the link to the module. Use arrow keys on your keyboard to manually advance or reverse slide. www.familypact.org 1 Intended Audience Any clinic staff involved in direct communication with clients about their health care: Physicians and clinicians Nurses Health educators and counselors Medical assistants 2 1
Objectives 1. Identify the role of a medical interpreter 2. List three skills of a good medical interpreter 3. Identify guidelines for using medical interpreters 4. Identify considerations and challenges of using ad hoc interpreters 3 Family PACT Standards A. Informed Consent 4. The informed consent process shall be provided to clients verbally in a language the client understands and supplemented with written materials. C. Linguistic and Cultural Competence 1. All services shall be provided in a culturally sensitive manner and communicated in a language understood by the client. 4 Family Planning Patient Rights The right to have all procedures explained and questions answered in a language that can be understood 5 2
The Law - Title VI of the Civil Rights Act of 1964 Under this law, providers must legally provide services in a language understood by the client This law applies to all health care providers and hospitals who receive federal funds. This includes Family PACT Providers 6 What We Know About Family PACT Providers and Limited English Proficiency Clients 2007 Medical Records Review found: Clients get less counseling and STI risk assessment with interpreters than bilingual providers Records do not document that an interpreter was used Records do not document when services were provided in another language. 7 Language Problems Impact Health Care Quality of care is worse When Limited English Proficiency (LEP) clients do not have interpreters who speak their language. When facilities use untrained interpreters Flores, et. al, 1998 8 3
These are: Untrained or Ad Hoc Interpreters Family members Friends Strangers from waiting rooms Workers on site 9 Conflicts When Using Family or Friends As Interpreters If the interpreter and client know each other: Domestic violence or child abuse may not be reported Talking about personal issues is harder 10 Examples of Errors by Ad Hoc Interpreters Not asking questions about drug allergies Not giving instructions about antibiotics The number of pills to take When to take the pills How long to take the pills Telling a relative not to answer personal questions. Ebden, Bhatt, Carey, & Harrison, 1988 11 4
Professional Medical Interpreters Know and understand medical terminology Provide confidential services Include all important information Do not impact family relationships Reduce liability costs David & Rhee, 1998; Flores, 2003; and Launer, 1978 12 Definition of a Medical Interpreter A specially trained professional who has knowledge and skills in a primary language or languages. This person uses their training in a health care setting. Their role is to help conversations between people speaking different languages. 13 Standards and Guidelines for Medical Interpreters Interpreters may be responsible for reading patient instructions or consent forms in the client s language (sight interpretation) Interpreters should not be expected to do written translations If a patient has trouble reading their spoken language, audio or video recordings of the information should be provided Family PACT has numerous client education materials in multiple languages. Visit www.familypact.org for translated materials and order forms. 14 5
Skills of Medical Interpreters Culturally sensitive and respectful Mastery of medical and slang terms Good memory Sensitivity and understanding of what is being said Strong language skills in listening, speaking, reading, and writing 15 Tasks of a Medical Interpreter Managing the three way relationship Patient Interpreter Provider Setting the stage Interpreting Managing the flow of communication Assisting in closing the conversation 16 Provider Guidelines For Using An Interpreter Provider should: Face the client rather than the interpreter Talk with the client in the first person (using I ) Maintain direct eye contact with the client Direct questions or inquiries to the client 17 6
Options for Obtaining a Medical Interpreter Hire a medical interpreter As a consultant through an interpretation agency As a regular staff member Use a telephone interpreting service Train an existing staff person 18 Hiring Medical Interpreters Many interpreters work through agencies for a fixed fee of $10 to $30 per hour In California, the mean annual salary for interpreters and translators is $47,000 For salary information for medical interpreters located in various parts of California, visit www.salary.com 19 Telephone Interpretation Services Certified Languages International Offers discounted Family PACT pricing www.certifiedlanguages.com call 1-800-362-3241 x308 or email kevinc@certifiedlanguages.com Language Line www.languageline.com/onsite call 1-800-752-6096 20 7
Training Resources for Current Staff ACEBO has a variety of products and materials for interpreters Interpreter's Rx Spanish-English medical interpreting study resource Cross Cultural Health Care Program provides bilingual medical glossaries and in-person training for interpreters 21 Training Resources for Current Staff (cont.) International Medical Interpretation Association has links to numerous resources at their website, www.imiaweb.org 22 Case Scenario You have a bilingual staff member This staff member has other duties besides interpreting You can't afford to employ a full-time interpreter Sometimes clients bring their own interpreter--usually a family member, and often a child 23 8
Case Scenario Continued Is it appropriate for you to use a child or other family member as an interpreter? What are your obligations to your non- English-speaking patients? Can the quality of care be affected by a language barrier? What is the best way for you to improve medical care for LEP clients? 24 Considerations If Using Ad Hoc Interpreters Respect the patient s wish to use their own interpreter. Document the request Use a minor as an interpreter only in an emergency Do not require a family member to interpret Recognize that a bilingual employee may not have the ability to interpret medical terms at the level needed 25 If Using an Ad Hoc Interpreter: Assess Their English Language Proficiency Ask the ad hoc interpreter if they are comfortable being an interpreter Test their ability with a basic conversation Ask if the interpreter can describe body parts or functions, based upon the type of appointment Give clear instructions 26 9
Resource Organizations California Health Care Interpreters Association Publication Standards for Healthcare Interpreters: Ethical Principles, Protocols, and Guidance on Roles and Intervention Cross Cultural Health Care Program Cultural competence training, interpreter training and other services 27 Provider Support Resources Family PACT Website Client Education Materials Cultural Competency Toolkit Training Calendar of Events Newsletters Family PACT Webcasts and Online Modules Toll-free Provider Resource Line 1-877-FAM-PACT (1-877-326-7228) www.familypact.org 28 Provider Support Resources Office of Family Planning general administration questions 916-650-0414 fampact@cdph.ca.gov Medi-Cal policy and information and Family PACT Policies, Procedures and Billing Instructions (PPBI) Manual www.medi-cal.ca.gov www.familypact.org HP Enterprises Provider Support Telephone Center 800-541-5555 29 10
Upon exiting this module please download the Evaluation Form by clicking the link on the Family PACT website www.familypact.org Email the completed form to: familypact@cfhc.org or fax the completed form to: (213) 368-4428 Thank You! 30 11