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

2. 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

3. 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 national law that protects persons from discrimination based on their race, color, or national origin in programs and activities that receive federal financial assistance.

4. 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.

5. 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.

6. Video clip of patient appointment
Observations?
Follow with discussion about what was observed – positive and negative aspects of patient encounter with healthcare provider.

7. 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

8. 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.

9. 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.

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

11. 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

12. 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.

13. resources & References
(Part 1 – 45 min.) Medical interpreting during Interdisciplinary Developmental Assessments of Children
(Part 2 – 47 min.)
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 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.