II. Precautions

  1. Professional Medical Interpreters
    1. Results in more accurate provider-Patient Communication
    2. Associated with less Malpractice risk
    3. Decreases hospital stays
    4. Increases patient satisfaction
    5. Medical Interpreters may clarify meaning, and help to frame the responses in cultural context
  2. Avoid ad hoc, non-professional Medical Interpreters (friends or family)
    1. Professional Medical Interpreters are preferred and are recommended for every patient
    2. Children should be avoided as Interpreters due to their lack of understanding of adult issues
    3. Patients may filter their responses when asked embarrassing questions with a family member or friend interpreting
    4. Family members and friends may have personal agendas
      1. May provide unsolicited advice
      2. May diverge down tangential paths or break confidentiality
    5. Non-professional Interpreters may misunderstand medical concepts
      1. Results in errors and in some cases more complicated medical care
    6. References
      1. Flores (2012) Ann Emerg Med 60(5): 545-53 [PubMed]
      2. Lindholm (2012) J Gen Intern Med 27(10): 1294-99 [PubMed]
  3. Be aware of medical interpretation pitfalls
    1. Avoid addressing the patient in the third person or speaking to the Interpreter instead of the patient
    2. Interpreters should not be witnesses to consent
    3. Redirect an Interpreter who dominates the interview or answers for the patient

III. Technique

  1. Preparation
    1. Allow for additional time for a clinical encounter with a Medical Interpreter
    2. Anticipate the need for an Interpreter prior to the encounter
    3. Patients should be notified of trained, professional Medical Interpreter services at no added cost
  2. Process
    1. Meet with the Interpreter prior to starting the clinical encounter to set goals and review background information
      1. Request sentence by sentence interpretation to maximize accuracy and avoid repetition
      2. Interpreter should avoid side conversations
      3. Interpreter should not answer for the patient
    2. Record the Interpreter's name in the documentation
    3. Interpreter should sit next to or slightly behind the patient
    4. Allow for a 10 minute break for every hour of interpretation
    5. Meet with the Interpreter after the encounter to review the findings, identifying errors and make corrections
  3. Communication
    1. Look at and speak directly to the patient (not the Interpreter)
    2. Avoid referring to the patient in the third person (refer to them as if you are speaking directly to them)
    3. Speak in short sentences encompassing a single thought or a single question and no more than three key points at a time
    4. Avoid off-handed comments you do not wish patients to hear (most patients can speak some english)
    5. Avoid interupting the Interpreter or patient prior to their finishing a question or response
    6. Avoid Idioms, acronyms, slang and jokes or humor as they translate poorly
    7. Have patients demonstrate what they have heard for instructions to confirm understanding

IV. Resources

  1. General
    1. Physician's Practical Guide to Culturally Competent Care
      1. https://cccm.thinkculturalhealth.hhs.gov/
    2. Cross Cultural Healthcare Program
      1. http://xculture.org/
    3. Diversity Rx
      1. http://www.diversityrx.org/resources
  2. Telephone Interpreter Services
    1. http://www.cyracom.com/
    2. http://www.languageline.com/
    3. http://www.mlsolutions.com/
    4. http://telelanguage.com/

Images: Related links to external sites (from Bing)

Related Studies (from Trip Database) Open in New Window

Ontology: Interpreter (C0150646)

Definition (NCI) Someone who mediates between speakers of different languages.
Concepts Professional or Occupational Group (T097)
SnomedCT 40570005
English interpreter, interpreters, Interpreter, Interpreter (occupation)
Spanish intérprete (ocupación), intérprete