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Healthcare Interpreting in Austria : Research and Policy

Healthcare Interpreting in Austria : Research and Policy. Franz Pöchhacker Center for Translation Studies, University of Vienna. Access to Health Care for Language Minorities Bar-Ilan University, 23-24 May 2006. Outline. ● Demographic background ● Early responses

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Healthcare Interpreting in Austria : Research and Policy

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  1. Healthcare Interpreting inAustria:Research and Policy Franz Pöchhacker Center for Translation Studies, University of Vienna Access to Health Care for Language Minorities Bar-Ilan University, 23-24 May 2006

  2. Outline ●Demographic background ● Early responses ● Vienna community interpreting initiativeResearchImplementation ● Progress?Vienna / Austria / EU context

  3. Demographic background Austria

  4. Population • 8.2 million (incl. some 80,000 ethnic Croats, Slovenes and Hungarians w/ special language rights) • 9.6% foreign nationals (790,000) •Vienna: 1.6 million - 18% foreign nationals Districts: 15th: 31% 16th, 20th: 25% • 9,100 deaf persons

  5. Foreign nationals

  6. Main sources •Labor migration (“guest workers”) - 1970s •Bosnian conflict - early 1990s •Family reunification (esp. Turkish) •Asylum-seekers (Chechnya, Turkey, Nigeria, Afghanistan, India…)

  7. Early responses •getting by & making do •Cleaners (YU) as hospital interpreters • 1989: two “native-language assistants” for Turkish hospital patients in Vienna

  8. Native-language liaison workers • bilingual (Turkish/German) •some medical background •in ob/gyn (and/or pediatric) wards •2 persons, extended to 6

  9. 1992 • Study by Schmid et al. (1992) finds general lack of translation services in hospitals •City Councillor for Health states that further needs will have to be assessed, and where there is sufficient demand, the service should be offered

  10. 1995: A new impetus? • Strasbourg Forum on Community Interpreting (incl. ISM Paris, Tolkencentrum, etc.) •First Critical Link Conference in Canada ► Needs assessment study (1996) commissioned by Vienna Integration Fund

  11. Hospital survey •765 questionnaires distributed via dept. heads to doctors, nurses and therapists • in 71 departments (internal medicine, surgery, ob/gyn, ENT, pedicatrics, psychiatry) • of 12 hospitals in Vienna

  12. Principal research questions • Frequency of contacts with non-German-speaking patients (NGS patients) • Language backgrounds • Who enables communication? • Satisfaction • Preferences

  13. Response 508 questionnaires filled in and returned 184 doctors (m/f ratio = 2 : 1) 204 nurses, 120 therapists Response rate: 66.4%

  14. Main findings 95% of respondents stated that they were seeing patients with little or no command of German (NGS patients)

  15. Frequency

  16. Language backgrounds

  17. Who enables communication?

  18. Accompanying persons

  19. Shortcomings

  20. Hospital staff

  21. Satisfaction Female doctors significantly less satisfied than male doctors (38%“satisfied” vs. 57%)

  22. Respondents’ comments

  23. Respondents’ comments

  24. Respondents’ comments

  25. Respondents’ comments

  26. Preferences

  27. Recommendations (1997) • Raise awareness among service providers •Launch a training initiative • Create/extend hospital interpreting services • Establish a community interpreting agency

  28. Raising awareness CASE STUDIES • Chance interpreting in speech therapy: 2 cases (Pöchhacker 1999) • Linguistic barriers to care: 4 cases (Wimmer & Ipsiroglu 2001) • Patient mix-up in Graz (2004)

  29. Speech therapy case study Th: Therapist M: Mother Int: Niece F: Father S: Sefanur (child patient)

  30. Sefanur – he or she?

  31. Case history

  32. (cont’d.)

  33. Teddy bear

  34. They don’t understand that!

  35. Action plan (1999) • certificate training course (at University) + • community interpreting agency + • budget allocation in hospitals

  36. Training course • 30 credits (340 hours) • basic training (16) + specialization (14) • one-third of instruction in language pairs • evening & weekend schedule (over 1 yr.)

  37. Curriculum

  38. Cost Full course (no prior training): •ca. $ 125,000 per course (2 language pairs) = ca. $ 5,000 per person (25 participants) Course for T&I graduates: •ca. $ 70,000 ($ 2,800 per participant) Agency: • ca. $ 135,000 per year (staff of 2) • self-financing at 315 int. hours/month ($ 75 per one-hour assignment: 28+19+28)

  39. Pilot course (2001) Interpreter training for bilingual hospital staff • ‘Basic training’ curriculum (at half intensity) • 90 hours = 16 days of instruction (8 x 2 days) • 2 language groups (B/C/S, Turkish) • 15 participants (esp. nursing staff; various hosp.) • 9 instructors

  40. Results •course evaluation highly favorable • main criticism by participants: “Too short!” • lack of organizational arrangements for nurse-interpreters in some hospitals • lack of follow-up

  41. Policy: Hospitals • most rely on “employee language banks”(lists of bilingual staff; no interpreter training) • no legal obligation to bear cost of interpreting “The costs of any interpreting services required shall be borne by the patient.” Krepler et al. (2002:42): [Law in Hospital Practice]

  42. Policy: Hospitals • consent form (to be signed by NGS patients) “I hereby instruct the XXX Hospital of the City of Vienna to call in an interpreter for the ………….. language to assist me during my treatment and I hereby undertake to bear the costs of interpretation myself. As a patient I hereby acknowledge that there is no statutory obligation for the body operating the XXX Hospital of the City of Vienna to recruit and pay an interpreter for me.” [Date] [Signature]

  43. Policy: Vienna city gov’t. • language courses for migrants • focus on diversity management Vienna Integration Fund (1992–2004) replaced by government subdivision • native-language liaison staff/interpreters “maturing” (prospects of CPD) • some efforts toward CLAS

  44. National perspective GRAZ: •university course (30 credits) in community interpreting (Oct. 2004 – Feb. 2006) • principal hospital uses language bank + external interpreters supplied by migrant-services NGO INNSBRUCK: •employee language bank (no training; some org.)

  45. Conclusions Lack of interpreting services in healthcare persists •Lack of legal basis for professionalization •Lack of funds for purchasing and training Need for medical research (quality of care for migrants) Need for studies on quality of communication/interpreting

  46. European perspective Migrant-Friendly Hospitals Project • 10/2002 – 03/2005 (coord.: LBISHM, Vienna) • 12 hospitals – 12 countries (AT, DE, DK, EL, ES, FI, FR, IE, IT, NL, SV, UK) • 3 subprojects: A: improving interpreting services B: mf information & training for mother-and-child care C: staff training towards cultural competence

  47. Main problems (needs assessment)

  48. Interpreting: Problems

  49. MFQQ surveys (pre & post)

  50. Intervention results

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