Interpreting via VRI in the Medical Setting 1 Presenter: Vanessa J. Niño MPA, CMI

Objectives Understand key areas in the New patient- centered communication standards by The Joint Commission Become familiar with new requirements Prepare for Interpreting VRI in the Medical Setting

New Hospital Requirements for Patient Centered Communication

The Joint Commission An independent, not-for-profit organization, which accredits and certifies more than 19,000 health care organizations and programs in the United States. Joint Commission accreditation and certification is recognized nationwide as a symbol of quality that reflects an organization’s commitment to meeting certain performance standards. http://www.jointcommission.org/about_us/about_the_joint_commission_main.aspx

Joint Commission’s New Standards for Patient-Centered Communication Health Care is dependent on accurate communication between patient and provider Communication has been identified as a root cause for Sentinel Events reported to The Joint Commission – The Joint Commission Sentinel Event database shows that communication is cited as a root cause in nearly 70 percent of reported sentinel events, surpassing other commonly identified issues such as staff orientation and training, patient assessment and staffing. http://www.jcrinc.com/Products-and-Services/Conferences-and-Seminars/Robert-Wood-Johnson-Foundation- 5 Communication/

Admission ) Identify the patient’s preferred language for Inform patients of their rights. Identify the patient’s preferred language for discussing health care. Identify whether the patient has a sensory or communication need. Determine whether the patient needs assistance completing admission forms. Collect patient race and ethnicity data in the medical record. Identify if the patient uses any assistive devices. Ask the patient if there are any additional needs that may affect his or her care. • Communicate information about unique patient needs to the care team.

Assessment ) Identify and address patient communication needs during assessment. Begin the patient–provider relationship with an introduction. Support the patient’s ability to understand and act on health information. Identify and address patient mobility needs during assessment. Identify patient cultural, religious, or spiritual beliefs or practices that influence care. Identify patient dietary needs or restrictions that affect care. Ask the patient to identify a support person. • Communicate information about unique patient needs to the care team.

Treatment ) Address patient communication needs during treatment. Monitor changes in the patient’s communication status. Involve patients and families in the care process. Tailor the informed consent process to meet patient needs. Provide patient education that meets patient needs. Address patient mobility needs during treatment. Accommodate patient cultural, religious, or spiritual beliefs and practices. Monitor changes in dietary needs or restrictions that may impact the patient’s care. Ask the patient to choose a support person if one is not already identified. • Communicate information about unique patient needs to the care team.

End of Life Care ) Address patient communication needs during Monitor changes in the patient’s communication status during end-of-life care. Involve the patient’s surrogate decision maker and family in end-of-life care. Address patient mobility needs during end-of-life care. Identify patient cultural, religious, or spiritual beliefs and practices at the end of life. Make sure the patient has access to his or her chosen support person. 9

Discharge and Transfer Address patient communication needs during discharge and transfer. Engage patients and families in discharge and transfer planning and instruction. Provide discharge instruction that meets patient needs. Identify follow-up providers that can meet unique patient needs. 10

How it pertains to VRI )

New Joint Commission HR Requirement ) Requires hospitals to define qualifications (staff or agency) specific to job responsibilities. Requires hospitals to specifically ensure that individuals who provide interpreting services in the hospital have defined qualifications and competencies – For contracted services, the hospital contract includes information about how the service provider defines competencies consistent with each hospital’s defined expectations.

New Joint Commission RI Requirements ) The hospital respects the patient’s right to receive information in a manner he or she understands. EP 2 The hospital provides language interpreting and translation services, as necessary. Language interpreting options may include hospital-employed language interpreters, contract interpreting services, or trained bilingual staff. These options may be provided in person or via telephone or video. EP 3 The hospital provides information to communicate with the patient who has vision, speech, hearing, or cognitive impairments in a manner that meets the patient’s needs.

How this Affects VRI ) VRI Interpreters who are not Certified may be unable to provide medical Interpretation Most hospitals around the country are updating their policies regarding Interpreter qualification For Sign Language Certification will be required For Spoken Language Medical/Healthcare Certification or Qualification (based on Language) will be required.

Challenges while Interpreting in the Medical Setting What Every Interpreter Needs to Know

Difficult Situations ) Unfamiliar with Medical Terminology being used Difficulty understanding the Patient/Provider Inappropriate lighting Cultural differences Health Literacy

Encountering Situations Inappropriate for VRI Situations such as Patients with cognitive, psychiatric or linguistic difficulties; Patients in certain physical positions (e.g., while lying down); Patients who are under the influence of medication or who are tired; Patients using regional sign language dialects, which require the use of a local interpreter; Equipment or technical difficulties; The need to match up specific interpreters or communication styles with certain deaf patients. 17 www.nad.org/2008VRIadvocacystatement.