Tools and Tips for working with a medical Interpreter Presented by Kay Kopp, OTR/L October 2, 2017

Learning Objectives After completion of this in-service, participants will: Learn the importance of using a medical interpreter Be able to state components of working effectively with a medical interpreter

Use of Medical interpreters To facilitate communication between patients and health care providers who speak different languages Good communication is essential for quality patient-centered care Title VI of the Civil Rights Act requires all healthcare institutions that accept federal funds to provide interpreter services for all patients with limited English proficiency1 When patients cannot explain their symptoms/concerns or readily understand questions or instructions because of communication challenges, this increases barriers to care, and often creates delays in service, unnecessary procedures, it increases chances of negative outcomes, and increases healthcare costs. Title VI of the Civil Rights Act of 1964 -national law that protects persons from discrimination based on their race, color, or national origin in programs and activities that receive federal financial assistance.

Types of interpretation In person Telephonic Video remote Interpretation is the oral transfer of one language into another. Translation is the written transfer of one language to another.

Medical Interpreter Skill base Trained as an interpreter – preferably certified Knowledgeable about medical terminology Understands ethics of interpreting Familiar with cultural concepts that affect delivery of effective health care Using an unskilled interpreter (e.g. a family member, non-trained individual) risks the quality of patient care. Need to know ethics of interpreting, how to facilitate patient-provider comm., medical vocabualry.

Video clip of patient appointment https://www.youtube.com/watch?v=D9s3sl5AoMg Observations? Follow with discussion about what was observed – positive and negative aspects of patient encounter with healthcare provider.

Medical interpreting during pediatric developmental assessment Interpreter is present to assist patient(child) and parent Much of clinician’s communication is directly with child not parent Use of standardized testing requires specific guidelines to be followed in interpreting All communication from child, between clinician/child and child/parent is interpreted Interpreter needs to follow clinician’s lead

How to work effectively with a medical interpreter Clarify interpreter’s role at outset; define expectations Positon interpreter next to patient or where best for setting Speak directly to patient, not interpreter Use regular voice volume Keep phrases short and pause often to allow interpreter to speak Important to tell interpreter what is expected, a little about patient, any key information they should know.

How to work effectively with a Medical interpreter Check frequently for understanding Be aware that some words are not translatable or have different meanings Have interpreter alert you to potential cultural misunderstandings Acknowledge and respect the interpreter as a professional in communication Best to avoid complex terminology, phrases with unclear meanings Include example about interview around utensil use at home.

Video clip of patient appointment Interpreter working with family in Child Development Clinic Observations?

Use of interpreters for CHDD evaluations Interpreter is present to assist patient(child) and parent When child uses English 50% of time or less at home When parent uses English 50% of time or less at home No interpreters for babies 6 months and younger

UWMC Interpreter Services Top languages: Spanish, Russian, Mandarin, Vietnamese, Cantonese, Korean Less common languages: Japanese, Amharic, Portuguese, Farsi, Arabic, ASL No Somali or Cambodian interpreters available at this time UWMC provides interpreters for CHDD from staff of 28 plus contracted interpreters in community.

resources & References https://vimeo.com/223649960 (Part 1 – 45 min.) Medical interpreting during Interdisciplinary Developmental Assessments of Children https://vimeo.com/224335320 (Part 2 – 47 min.) http://depts.washington.edu/pfes/CultureClues.htm www.ethnomed.org http://xculture.org/medical-interpreter-training/about-medical-interpreting/ The ACA and Application of § 1557 and Title VI of the Civil Rights Act of 1964 to the Health Insurance Exchanges, January 2011, short paper by Mara Youdelman http://www.healthlaw.org/issues/health-care- reform/the-aca-and-application-of-1557-and-title-vi-of-the-civil-rights-act-of-1964-to-the-health-insurance- exchanges#.V-qay00VC70 Ethnomed: Contains info. about cultural beliefs, med. issues & related topics pertinent to healthcare of immigrants to Seattle and entire US, may of whom are refugees. Culture Clues: UW website with tip sheets designed to increase awareness about concepts and preferences of patients from the diverse cultures. Xculture: Non-profit training & consulting org. in Seattle. Have nationally recognized interp. Training program called Bridging the Gap.