Does staff understand how to use interpreters?
Correct access is critical
Providing interpreter services is not enough to ensure good communication between patients, family members, and clinicians. It is important to make sure staff understands when to access interpreters, what services are available, and how to use the resources.
Staff education at The Ohio State University Medical Center in Columbus begins at orientation for all newly hired employees. Interpreter Services provides information on the resources available during a half hour class that is part of the orientation and takes place every two weeks.
Education on interpretive services is important because there are laws, regulations, mandates, and accreditation standards that require the use of these services for clear communication, says Milly Valverde, MA, manager of Interpreter Services at The Ohio State University Medical Center in Columbus. "It is good to push that empathy piece also, telling employees to put themselves in that person's situation," says Valverde.
Policy at the medical center requires staff to request an interpreter any time they are interacting with a patient who does not speak English. They are also encouraged to use an interpreter with patients who are semi-fluent because medical vocabulary and technical terms are more difficult to understand.
In addition to orientation, Valverde has set in place opportunities for staff education. Once a year, a workshop is offered that focuses on working with refugees. Sometimes workshops are offered that cover communicating with Asian American patients or Hispanic patients. However, these are general to avoid stereotyping, says Valverde. (For information on key elements included in all classes see article, below.)
A computer-based learning module covers cultural competency as well as the use of interpreters. This module is offered through the healthcare system's intranet. To broaden awareness, interpreters write articles about specific ethnic holidays such as Ramadan. Also posted on the intranet is information on resources offered by Interpretive Services and video clips on how to use the resources.
A two-hour class on communicating with deaf patients is offered quarterly. Staff members may obtain continuing education credits for enrolling, and it also counts toward customer service training. Every year each employee is required to take a two-hour class that is part of the customer service curriculum, and there are about 10 selections. For three years, Interpreter Services offered a class specific to its services, which was a broad spectrum of everything the department offers.
Interpreter Services has 12 onsite interpreters that cover the top seven languages spoken by patients who access the medical center. These include Spanish, Somali, American Sign Language, Arabic, Russian, Mandarin Chinese, and French. Agencies that provide onsite interpreters in other languages also provide services, and three telephone interpreter agencies can be accessed. In addition, there is video interpretation from units throughout the healthcare system.
The use of an onsite interpreter is encouraged for more complicated encounters. For example, when a patient might have cognitive issues, a large family support system in which many people may participate in the discussion, or during emotional conversations, also when a patient is deaf.
Another resource empowers patients by providing a toll-free number by which they may access an interpreter directly to ask questions of clinic or hospital staff or make an appointment.
"We encourage all our staff at all levels to take to take our classes because it is important to create a hospital culture that really embraces the inclusiveness and respect for other cultures," says Valverde. (For more on this topic, see package of stories on language and cultural diversity in November 2010 issue of Same-Day Surgery.)
Source
For more information about providing staff education on interpretive services, contact:
- Milly Valverde, MA, Manager Interpreter Services, The Ohio State University Medical Center, Columbus. E-mail: [email protected].
Several elements necessary for training Teach how to work with interpreter While there are different class formats for staff education offered by Interpreter Services at The Ohio State University Medical Center in Columbus, certain information is included in all the classes. About 15 to 20 minutes focuses on how to work effectively with an interpreter. For example, there is discussion about looking at the encounter from a patient's perspective and considering how one would feel if two people in a room were discussing your health but never looked at you, says Milly Valverde, MA, manager Interpreter Services at the medical center. In addition, the amount of information that should be shared before pausing to allow the interpreter to speak is covered. Some clinicians will speak for five minutes before pausing for the interpreter to repeat the information, and then he or she is only able to give key points not repeat word for word, says Valverde. A few cases that have been won in court due to miscommunication are also discussed during the classes. Valverde picks a couple to read during the class, and one usually highlights a situation in which a family member or friend was allowed to interpret for the patient. These cases reinforce the need for clinicians to access Interpreter Services. Health systems in other parts of the world are covered because in many, the patient is the last to know about his or her condition, says Valverde. Healthcare decisions are made by certain family members or the head of the household on behalf of the patient. This situation reinforces the need for the use of an interpreter rather than using family members during medical discussions. Trends are another aspect of the education. The medical center tracks the requests for interpreters and the language requested. By sharing this information, staff can see the changes from year to year and the breadth of languages covered. "Last year, we offered interpreters in 96 different languages," says Valverde. A demonstration on how to use the resources including video and telephone services is given. While there are instructions on the web, some think it is too complicated, Valverde says. By demonstrating access, staff sees how easy it is to use an interpreter. Just to make sure staff members do not forget how to access an interpreter, each one receives a badge card with all the resources listed and how to access an interpreter 24 hours a day, seven days a week. |
Multilingual materials improve communication Web sites put info at your fingertips Communication with non-English speaking patients is an important factor in good health outcomes. Language barriers can impact quality education that results in an understanding of how to correctly take a medication or effectively handle postoperative care. Yet healthcare institutions have limited budgets to spend on resources for non-English speaking patients. To prevent duplication of efforts, we have assembled agencies and organizations that produce health resources for people who do not communicate well in English. • Echo Minnesota. Web: www.echominnesota.org. This organization has health and safety handouts available in a variety of languages on their web site including Spanish, Somali, Hmong, Lao, Vietnamese, and Khmer. Click the 'topics' tab, then 'health and safety' for health topic categories and languages. Topics include "Medications." • EthnoMed. Web: ethnomed.org. EthnoMed contains medical and cultural information about immigrant and refugee groups in the Seattle area but it is applicable to many geographic areas. It is produced by Harborview Medical Center. Click on "Patient Education" for resources on various topics, including "Test/Procedures/Radiology," and in a variety of languages. • Health Information Translations. Web: www.healthinfotranslations.com. Translations of health information created through a partnership of The Ohio State University Medical Center, Mount Carmel Health System, and Nationwide Children's Hospital. Select health information by topic, including "Surgeries or Treatments," or language. • Healthy Roads Media. Web: www.healthyroadsmedia.org. Free health education materials in various languages and formats is offered on this web site. There are written handouts, audio, multimedia, web video, and iPod video. Select "All Topics" to access topics such as "Medical Tests and Treatments." • MedlinePlus. Web: www.nlm.nih.gov/medlineplus/languages/languages.html. The National Library of Medicine and National Institutes of Health has posted materials in 44 languages on MedlinePlus. This section offers handouts in a variety of languages. The English equivalent of the text is included on the handout. Select "Health Topics" to access "Diagnosis and Therapy," which includes the topic "Surgery and Rehabilitation." • National Library of Medicine. Web: www.nlm.nih.gov. The web site for this organization provides resources in multiple languages. At the left of the screen, under "Databases," select "MedlinePlus." Scroll to bottom of the page and in the right corner, select "Multiple Languages." You will be able to browse information in multiple languages by health topic or by language. • Refugee Health Information Network (RHIN). Web: www.rhin.org. Information in various languages is available. At the bottom of the page, select "Health Topics in Multiple Languages," then select "A to Z Listing of Resources: An index of all RHIN documents." Topics include "Surgery" and "Surgical Procedures." • Utah Department of Health Multilingual Library. Web: http://health.utah.gov/disparities/multilinguallibrary. The Center for Multicultural Health provides health education materials in many languages to assist healthcare professionals in communicating with people who don't speak English or have a low English proficiency. The homepage has lists of languages and topics. |
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