1. Working Effectively with an Interpreter
Nikki Lopresti
Director of Operations
All Access Interpreters, LLC
March 22, 2012

2. Video: Communicating Effectively Through an Interpreter
An instructional video for health care providers
Created by The Cross Cultural Health Care Program

3. Interpreters can do the following to ensure clear communication:
No opinions, no advice
Cultural insights
Transparent communication
Less intrusive
Pre-session
Unobtrusive position
Use of the 1st person
Accurate interpretation,
not a literal interpretation

4. Providers can do the following when working with an untrained interpreter:
Maintain control
Do a pre-session
Seat the interpreter unobtrusively
Speak to the patient, not
the interpreter
Assume and insist that everything be interpreted
Remember lack of equivalence
Speak in shorter sentences
Ask one question at a time
Avoid slang and difficult terminology
Check for understanding
Stay positive

5. Purpose of the Interpreter
To facilitate understanding in communication between people who are speaking different languages.

6. Roles that are inappropriate for an Interpreter:
Interpreters are not social workers
Interpreters are not the patient’s emotional support system
Interpreters are not the patient’s best friend
Interpreters cannot guarantee that the patient will be happy with the interview
Nor can they guarantee that the provider will be happy

7. The interpreter merely acts as a bridge between people who speak different languages.

8. Training for Medical Interpreters
Bridging the Gap
Developed by The Cross Cultural Health Care Program
A 40-hour training program for interpreters and bilingual employees who work in a medical setting.

9. BTG is a nationally recognized training program that covers:
Basic interpreting skills and managing the flow of the session.
Information on the U.S. health care system, anatomy and basic medical procedures.
Culture
Communication skills and appropriate advocacy
Professional conduct and self care.

10. Training for Mental Health Interpreters
12-week certificate program
Mental health delivery systems and the professionals who work in the field
Mental health diagnoses and interventions
Dynamics of therapy
Roles & Ethics of interpreters

11. National Council on Interpreting in Health Care (NCIHC)
The NCIHC is a multidisciplinary organization whose mission is to promote and enhance language access in health care in the United States. Developed a National Code of Ethics and Standards of Practice

12. Code of Ethics for Medical Interpreters by the NCIHC
1. Confidentiality 2. Accuracy 3. Impartiality 4. Maintain professional boundary 5. Cultural awareness 6. Be respectful 7. Advocacy 8. Professional development 9. Act in professional and ethical manner

13. Who is NOT an appropriate choice for an Interpreter?
Friends of any LEP patient
Family member of LEP patient
Minor Children
Anyone who has not demonstrated proficiency in both languages
Anyone who has not received training in interpretation
Anyone who does not have an understanding of ethics and interpreting practices

14. Reasons for encouraging Providers not to Use Friends, Family or Minor Children as Interpreters:
May cause a breach of confidentiality
LEP patient may be reluctant to reveal important information
Upsets familial relationships and hierarchies that are deeply rooted in culture
It is better to use someone who not only is a trained professional, but who is also able to be objective and who is removed from the situation.  

15. More Reasons for encouraging Providers not to Use Friends, Family or Minor Children as Interpreters:
Some family members may omit possible risks in a medical procedure in not wanting to scare the patient
Family members may answer questions for the patient without asking the patient first

16. Title VI of the Office of Civil Rights of 1964
Can not discriminate on the basis of race, color or national origin, if you are receiving federal funds
Can not require that an LEP patient bring a friend or family member to interpret
Can not ask that an LEP patient pay for an interpreter

17. Culturally and Linguistically Appropriate Services in Health Care (CLAS Standards)
Issued by the U.S. Department of Health and Human Services’ Office of Minority Health.
The aim of the standards is to contribute to the elimination of racial and ethnic health disparities and to improve the health of all Americans.

18. 14 CLAS Standards
Organized by themes: Culturally Competent Care, Language Access Services and Organizational Supports for Cultural Competence
For example: Standard #4 states:
Health Care Organizations must offer and provide language assistance services, including bilingual staff and interpreter services, at no cost to each patient / consumer with limited English proficiency at all points of contact, in a timely manner during all operations

19. Types of Interpreting
On-Site
Over-the-phone
Video

20. Demo of Video Interpreting
Interpreters at your fingertips.

21. Tools for Providers http://www.lep.gov/resources/ISpeakCards2004.pdf
“Language Identification Flashcard:
Cross Cultural Health Care Program

22. Contact Information: Nikki Lopresti Director of Operations All Access Interpreters, LLC 3225 S. Brentwood Blvd., Suite 209E St. Louis, MO