lines of communication linguistic competence interpreter services in healthcare settings n.
Download
Skip this Video
Loading SlideShow in 5 Seconds..
Lines of Communication: Linguistic Competence & Interpreter Services in Healthcare Settings PowerPoint Presentation
Download Presentation
Lines of Communication: Linguistic Competence & Interpreter Services in Healthcare Settings

Loading in 2 Seconds...

play fullscreen
1 / 44

Lines of Communication: Linguistic Competence & Interpreter Services in Healthcare Settings - PowerPoint PPT Presentation


  • 137 Views
  • Uploaded on

Lines of Communication: Linguistic Competence & Interpreter Services in Healthcare Settings. JOHANNIE RESTO, BSB MANAGER OF INTERPRETER SERVICES VANDERBILT MEDICAL CENTER. Covered Topics Why the Provision of Interpreter Services ? Compliance Requirements Medical Interpreting Overview.

loader
I am the owner, or an agent authorized to act on behalf of the owner, of the copyrighted work described.
capcha
Download Presentation

Lines of Communication: Linguistic Competence & Interpreter Services in Healthcare Settings


An Image/Link below is provided (as is) to download presentation

Download Policy: Content on the Website is provided to you AS IS for your information and personal use and may not be sold / licensed / shared on other websites without getting consent from its author.While downloading, if for some reason you are not able to download a presentation, the publisher may have deleted the file from their server.


- - - - - - - - - - - - - - - - - - - - - - - - - - E N D - - - - - - - - - - - - - - - - - - - - - - - - - -
Presentation Transcript
lines of communication linguistic competence interpreter services in healthcare settings
Lines of Communication: Linguistic Competence & Interpreter Services in Healthcare Settings

JOHANNIE RESTO, BSB

MANAGER OF INTERPRETER SERVICES

VANDERBILT MEDICAL CENTER

slide2
Covered Topics
  • Why the Provision of Interpreter Services ?
  • Compliance Requirements
  • Medical Interpreting Overview
objectives
OBJECTIVES
  • To increase awareness of the Legal Mandates that guide institutions as it relates to patients who have limited English proficiency
  • Learn the benefits of Interpreter Services
  • Learn techniques that help manage the flow of communication when an interpreter is present.
slide4

LIMITED ENGLISH PROFICIENCY (LEP)

A LEP individual is a person who is unable to speak, read, write or understand the English language at a level that permits them to interact effectively with health care providers and social service agencies.

the top 15 languages at vumc fy 2010
The Top 15 Languages at VUMC FY 2010
  • Spanish
  • Arabic
  • Somali
  • Kurdish
  • Chinese
  • Vietnamese
  • Russian
  • Persian (Farsi)
  • Korean
  • Japanese
  • Burmese
  • Laotian
  • Amharic
  • Sign Language
  • Bosnian
interpreter services
Interpreter Services
  • Patient Safety
  • Quality Healthcare
  • Compliance Requirements
slide11

Providing Quality Healthcare

  • Communicating effectively with patients in their language
  • Clear understanding of symptoms
  • Ability to communicate their diagnosis, prognosis, explain tests, procedures, discharge instructions, how to take their medicines, follow-up appointments
  • Recognizing different cultural and religious factors that often impede our ability to perform examinations, recommend treatments, accurate diagnosis, prognosis, and treatment plan
  • Understanding financial issues
compliance requirements
COMPLIANCE REQUIREMENTS

Under Title VI of the Civil Rights Act of 1964 the denial or delay of medical care because of language barriers is discrimination.

Any medical facility that receives Medicaid or Medicare must provide language assistance to patients with LEP and take steps to ensurethat persons have meaningful access to the health services that they provide.

slide13

Title VI of the Civil Rights Act of 1964

“No person in the United States shall, on the ground of race, color, or national origin, be excluded from participation in, be denied the benefits of, or be subjected to discrimination under any program or activity receiving Federal financial assistance.”42 U.S.C. Section 2000d

slide14
Joint Commission on Accreditation

of Healthcare Organizations

  • Requires use of medical interpreters with proven competency (The 1997 Accreditation Manual for Hospitals. SectionR1.1.4. The 2001 Comprehensive Accreditation Manual for Hospitals. Standard R1.1.2.)
  • Train staff to recognize and respond appropriately to patients with language needs.
national standards on culturally and linguistically appropriate services clas issued in march 2001
National Standards on Culturally and Linguistically Appropriate Services (CLAS) Issued in March 2001

The national standards issued by the U.S. Department of Health and Human Services’ (HHS) Office of Minority Health (OMH) respond to the need to ensure that all people entering the health care system receive equitable and effective treatment in a culturally and linguistically appropriate manner.

culturally linguistic appropriate standards clas
CULTURALLY LINGUISTIC APPROPRIATE STANDARDS (CLAS)

Language Access Services (Standards 4-7)

slide17

Standard 4Health care organizations must offer and provide language assistance services, including bilingual staff and interpreter services, at no cost to each patient with limited English proficiency at all points of contact, in a timely manner during all hours of operation.

  • Standard 5

Health care organizations must provide to patients/consumers in their preferred language both verbal offers and written notices informing them of their right to receive language assistance services.

standard 6
Standard 6

Health care organizations must assure the competence of language assistance provided to limited English proficient patients/consumers by interpreters and bilingual staff.

  • Family and friends should not be used to provide interpretation services
  • Bilingual providers must demonstrate language proficiency, and adequate knowledge of technical terminology “relevant to the encounter”.
  • Crash courses or “survival language courses” pose a threat, because clinicians overestimate their fluency.
  • Minors should NEVER be used.
standard 7
Standard 7

Translated Materials

Health care organizations must make available easily understood patient-related materials and post signage in the languages of the commonly encountered groups and/or groups represented in the service area.

slide20
CASE

Inadequate communication can have tragic consequences

slide21

Case 1

A high profile case in Florida in 1984 were Spanish-speaking 18-year-old had stumbled into his girlfriend’s home, told her he was “intoxicado,” and collapsed.

slide22

When the girlfriend and her mother repeated the term, the non-Spanish-speaking paramedics took it to mean “intoxicated”; the intended meaning was “nauseated.”

slide23

After more than 36 hours in the hospital being worked up for a drug overdose, the comatose patient was re-evaluated and given a diagnosis of intra-cerebellar hematoma with brain-stem compression and a subdural hematoma secondary to a ruptured artery.

conclusion
Conclusion

Misinterpretation of a single word led to a patient’s delayed care and preventable quadriplegia.

The hospital ended up paying a $71 million malpractice settlement because of one word that was misinterpreted in the Emergency department, causing permanent damage to the patient.

References:

The New England Journal of Medicine; Language Barriers to Health Care in the US by Glen Flores,MD. Volume355:229-231 July 20, 2006 number 3

(Harsham.P. - A misinterpreted word worth $71 million. Med Econ 1984; June:289-292.)

case 2
CASE 2

An untrained bilingual staff, misinterpreted for a nurse practitioner, told the mother of a seven-year-old girl with otitis media to put (oral) amoxicillin “in the ears”.

slide26

Case 3

A Spanish-speaking woman told a resident that her two-year old had “hit herself” when she fell off her tricycle; the resident misinterpreted two words, understood the fracture to have resulted from abuse, and contacted the Dept. of Social Services (DSS). DSS sent a worker who, without an interpreter present had the mother sign over custody of her two children.

Clearly, Catastrophes can and do result from such miscommunication.

Reference- The New England Journal of Medicine; Language Barriers to Health Care in the US by Glen Flores,MD. Volume355:229-231 July 20, 2006 number 3

http://content.nejm.org/cgi/content/full/355/3/229

benefits of interpreter services in healthcare
Benefits of Interpreter Services in Healthcare
  • Patient Safety
  • Increase the Patient Loyalty for the Hospital
  • Patient Impact and Satisfaction
  • Compliance
  • Lowers Risk to the Hospital
  • Decrease Hospital stays
  • Less complications
  • Misuse of expensive Emergency Services
  • Less unpaid bills due to proper communication and handling of the insurance/financial status of the customer/patient
slide30

Interpreting

To render messages orally, from one language into another.

Interpretersare theVOICE!!

slide31

Translating

To render written text from one language to another.

basic purpose of the medical interpreter
Basic purpose of the medical interpreter

Is to facilitate understanding in communication between people who are speaking different languages.

slide35

Roles of the Medical Interpreter

ADVOCATE

CULTURAL BROKER

CLARIFIER

CONDUIT

Interpretersare theVOICE!!

tips for effectively working with an interpreter
Tips for Effectively Working with an Interpreter
  • Brief the interpreter before entering the room.
  • Position yourself to maintain eye contact with the patient.
  • Address the patient, not the interpreter using “I” and “you”, not “he or she”.
  • Remember that everything you say will be interpreted.
  • Avoid highly technical jargon and acronyms.
  • Check for understanding.
slide37

Pause often to allow the interpreter to accurately convey your message

  • Make short and precise questions or statements
  • Avoid side conversations
  • Focus your attention on the patient or family not the interpreter
  • Avoid asking the interpreter his/her opinion
slide38

AVAILABLE RESOURCES

VANDERBILT UNIVERSITY MEDICAL CENTER

15 full-time interpreters (13 Spanish, 2 Arabic)

35 plus temporary interpreters (Spanish, Arabic, Bosnian, Burmese, Chinese, Kurdish, Russian, Somali, Swahili, Farsi, Japanese, Portuguese, Vietnamese, Amharic, Urdu, Harraric)

Interpreters are assessed, trained, follow National Standards for Healthcare interpreters and Code of Ethics

Telephonic Interpreter line 24/7 “OPI” Staff calls 1-877-746-4674 Patient calls 1-866-675-2040 (If pt needs to call VUMC)

After hours (message center) has a list of the VTS temporary interpreters 2-7378

slide39
After hours Spanish interpreter available Monday thru Friday from 4:30pm to 8:00am . Saturday and Sunday 24 hour coverage. Please page 835-0507 and leave numeric message
  • Services for the Hard of Hearing and the Deaf (615-248-8828) staff calls directly
  • TTY/TDD phones available for the deaf and hard of hearing . TTY stands for telephone typewriter, teletypewriter or text, TDD stands for Telecommunications Device for the Deaf. TTY/TDD stands for a group of telecommunication devices that make it easier for deaf and/or mute people to talk over telephone lines. TDDY phones for the Hard of Hearing.
  • Signage assuring the patients that they are entitled to interpreters at no cost

`

slide40

On-site interpreters 2-SERVE (2-7378)

  • Interpretive Services Policy Communications OP 10-50.01 (will be updated)
  • Documents are translated by professional translators e-mail documents to: http://www.vanderbilthealth.com/main/23115
  • NEVER use Babble fish or any other translation system via the Internet
  • Interpreter Services website address: www.mc.vanderbilt.edu/interpreter

http://www.vanderbiltchildrens.org/interpreter

thank you
THANK YOU!

INTERPRETER SERVICES DEPARTMENT

johannie.resto@vanderbilt.edu

Office- 615-936-0837

articles of interest references
Articles of Interest/References

National Council on Interpreting in Health Care (NCIHC) http://www.ncihc.org/

Common cross-cultural communication challengeshttp://www.wwcd.org/action/ampu/crosscult.html#COMMUN

OCR list of “vital” Documents.

www.hhs.gov/ocr/lep

Office of Minority Health CLAS standards Final Report http://www.omhrc.gov/assets/pdf/checked/finalreport.pdf

Addressing Language Barriers in Health Care: What’s at Stake, by Robert Wood Johnson Foundation . March 2007

slide44

Navigating Language Barriers under difficult circumstances Annals of Internal Medicine- American College of Physicians by Yael Schenker, MC,;Bernard Lo, MD; Katharine M. Ettinger, JD; and Alicia Fernandez, MD

Language Barriers to Health Care in the United States by Glenn Flores, MD.