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This Expert Panel is Archived.
This Expert Panel is no longer active as of December 2018. Thanks to those who posted here and made this information available to others visiting the site.
According to the Health Literacy Universal Precautions Toolkit, 2nd Edition "Patients who do not speak English very well, including those who speak American or other sign language, often do not get the health information they need. Addressing language and sensory differences is an important part of addressing health literacy and is required by law. Practices participating in Medicare or Medicaid can be legally required to provide language assistance for patients who do not speak or understand English well. Failing to use acceptable forms of language assistance can expose a practice to liability" This resource .provides wonderful guidance on the best practices on meeting the needs of patients who do not speak the primary language of a country.
Link leads to: http://www.ahrq.gov/professionals/quality-patient-safety/quality-resources/tools/literacy-toolkit/healthlittoolkit2-tool9.html
First and foremost, qualified interpreters are needed for limited English proficiency patients. Using a qualified interpreter is best practice #1. Unfortunately, it is common for healthcare providers to turn to whomever is nearest for interpretation. Whether it's a family member, bilingual staff member, or someone else in the hospital. It's an understandable move since healthcare communication is often time-sensitive, but it's important to remember that using ad hoc interpreters like that leads to higher instances of miscommunication. Imagine accompanying a loved one to an appointment, only to have the physician turn to you and say "Please tell your mother her tumor is malignant and that she'll need treatment right away." You may not be familiar with that medical terminology in both languages, your personal relationship and emotions will be involved...it is impossible to be impartial there.Fortunately, there is a growing understanding of the importance of qualified interpreters. Section 1557 of the Affordable Care Act (which went into effect earlier this year), calls for qualified interpreters, specifically, and we are seeing a rising demand for professional language access services. Beyond the use of a qualified interpreter, we advise our clients to consider how they would want to receive healthcare news, and schedule interpreters accordingly. Is it an appointment reminder? Over-the-phone works great. Is it a short conversation? Go with video for the added communication benefits of visual connection. Is it a sensitive, lengthy conversation? Then it's best to bring someone in on-site. Best practice is to put yourself in the shoes of the LEP patient. Consider how you would like to be treated, then build a language access plan around that. Audio ,video, and in-person are all important components of an effective language access plan.
David, I agree, I have always worked from the premise of if it were me or a loved one, what would I do...
I also like to tell our clients to get an interpreter involved as quickly as possible. If you're patient really needs an onsite interpreter (let's say it's a diagnosis or treatment discussion), but the interpreter is running a bit late, don't hesitate to call an audio or video interpreter to clue the patient in to what's going on. You can always start with one form of interpretation and transition to another. That way no time is wasted and the patient isn't sitting there bored or afraid.
The attached Joint Commission ( although dated) provides a good overview of the state of language serves, gaps and considerations of options... One area that I find compelling is the need to culturally competent care. What is the role of language services in this arena of care?
Link leads to: http://www.jointcommission.org/assets/1/6/hlc_paper.pdf
Emerging best practices are also taking into consideration options and technology! While it is always more preferable to have a warm body in the room, OnSite interpreting is costly, subject to mileage, cancellation and premium fees, requires advance notice, and is limited to the local pool of resources. Telephonic interpreting has made it possible to access qualified interpreters in over 200 languages, in less than a minute.... a fantastic contingency for when OnSite interpreters are not available, little notice is given, in emergent situations, etc. Beyond even that, Video Remote Interpreting technology is now making significant headway - some platforms offer on-demand access to video interpreters in 35 languages, and 24/7 ASL support is becoming an industry standard! While document translation has and continues to have a critical role in providing quality care across language barriers.The point being, best practice is not to rely on one type of modality, but to take advantage of the full suite of support that individual interpreters and technology have afforded us.One way to do this is for healthcare systems to partner with their interpreting services departments, and likewise their Language Service Provider(s) to make sure they are taking advantage of all the tools and resources available: Multiple modalities, industry and market updates, staff access to training and education, usage reports, QA processes, and ensuring the overall program is thorough, and effective