Transcript Interpreter Services Page # 6681

Health, Language and Culture
Imagine the experience of
our culturally diverse
patients.
• Language and cultural barriers
• A very different healthcare system to
navigate.
• Consider this:
– The phrase “What brought you here today?”
Improving Communication with our Patients
Interpreter Services provided by trained medical Interpreters
helps improve patient outcomes, quality and satisfaction.
It’s the Law
•Federal Laws preventing discrimination include language.
•Massachusetts Law mandates that we provide face to face
Interpreter Services in the Emergency Department and
Acute Psyche encounters in our most common spoken languages.
•Patients who are deaf and or hard of hearing are entitled to a Sign Language,
or Sign Language and Certified Deaf Interpreter under the American
Disabilities Act.
Working with Professional
Medical Interpreters
• Interpreters are part of the care team for the patient. In
addition to interpretation services, they can help providers
understand cultural differences.
•Hold a pre or post conference with the interpreter for briefing
or feedback. Very important for telephonic interpretation.
• Make sure the patient understands that interpreter services
are free of charge.
•Document in the Medical Record
•Use of Interpreter
•Refusal of Interpreter Services
Can’t I just find
someone to interpret?
•Clinical Information must be interpreter by a trained medical
interpreter- consents, information about treatment, medications,
discharge instructions….
•For non- clinical information- you may use a family member or
non-trained bilingual employee ONLY for non clinical situations
such as registration, giving directions, ordering a meal, and
informing that a medically trained interpreter is on the way.
Minor children should NEVER be asked to
interpret. It places too large a responsibility
on the child. Also, adults patients are
unlikely to be forthcoming with sensitive
information.
Can I interpret?
•At Mount Auburn Hospital only medically trained interpreters
interpret.
•Trained medical interpreters do not add, omit, distort, or
change the register of the message.
•Many providers are fluent in other languages and choose to
speak to their patients in those languages.
•Growing attention nationally. Some organizations have tested
providers language skills. Reports cite a 30%-60% pass rate.
I-POP
Interpreter
Phone on Pole
• All inpatient and most
outpatient units
• Quick access to 150
languages
• Will often stay in patient
rooms
• Turn off between
conversations
Any phone
Interpreter
Services
Page # 6681
For scheduled appointments with more than 48 hours notice fax Request Form to x5091.
Interpreter Services on Portal www.home.caregroup.org
Spoken Languages
Interpreter
Services
Page # 6681
Monday - Friday 8:30am-5pm
• Staff Languages page:
– Spanish: #6681,
– Portuguese: #6852
– Armenian/Russian: #6692
• All other languages
– Use Phone
I-POP
After 5pm, weekends + holidays
•Spanish page #6681
•Other Languages use phone
For scheduled appointments with more than 48 hours notice
fax Request Form to x5091.
Interpreter Services on Portal www.home.caregroup.org
Spoken Languages
Interpreter
Services
Page # 6681
Monday - Friday 8:30am-5pm
• Staff Languages page:
– Spanish: #6681,
– Portuguese: #6852
– Armenian/Russian: #6692
• All other languages
– Use Phone
I-POP
After 5pm, weekends + holidays
•Spanish page #6681
•Other Languages use phone
For scheduled appointments with more than 48 hours notice
fax Request Form to x5091.
Interpreter Services on Portal www.home.caregroup.org
American Sign Language
anytime Page #6681
Spoken Languages
Interpreter
Services
Page # 6681
Monday - Friday 8:30am-5pm
• Staff Languages page:
– Spanish: #6681,
– Portuguese: #6852
– Armenian/Russian: #6692
For scheduled appointments with more than 48 hours notice
fax Request Form to x5091.
Interpreter Services on Portal www.home.caregroup.org
American Sign Language
anytime Page #6681
• All other languages
– Use Phone
I-POP
After 5pm, weekends + holidays
•Spanish page #6681
•Other Languages use phone
For special patient
circumstances any time
page #6681.
• Translation services arranged thru Interpreter
Services
• JACHO requires we use certified translators
• Interpreters may translate one time, patient
specific short documents.
• DO NOT USE TRANSLATION PROGRAMS
SUCH AS Google Translator…
Cultural Quiz-What do you think?
University of Toronto www.cmeutroronto.ca/edoflife
• People have more of a “culture” than their American neighbors
if they were born in a foreign country and continue to honor
family traditions.
False
• Everything considered to be “common sense” is determined by
culture.
True
• Communication styles are rooted in culture and impact clinical
interactions.
True
• To improve cross-cultural interactions, the first step
recommended by experts is to understand the cultural values
and beliefs of others.
False
Hospital
American
Caregiver
Biomedical
Patient
In every patient encounter there are at least 5 cultures involved.
Health
Inequity
Health
Disparities
Institute of Medicine 2002
• Even among the better-controlled studies,
the vase majority indicated that minorities
are less likely than whites to receive
needed services.
• Although myriad sources contribute to
these disparities, some evidence suggests
that bias, prejudice and stereotyping on
the part of healthcare providers may
contribute to differences in care.
• Racial differences in patients’ attitudes,
such as their preferences for treatment do
not vary greatly and can not fully explain
racial and ethnic disparities in healthcare.
IOM Report-Solutions
• Report highlighted no one cause of disparities
and therefore no one solution.
• Culturally and Linguistically Appropriate
Services (CLAS) Standards
– Interpretation Guidelines
– New JACHO guidelines Communication
– Cultural Competency Education
Cultural Competence
Curiosity
Cultural Humility
From good to GREAT:
From Common Knowledge
to
Common Practice
What is “common” is related to Culture.
People from different cultures will describe
the same object differently.
“I think this would
look great in my
Living Room.”
It is a Decoration
“Let’s bring this
back from our trip
to India.”
It is a Souvenir
“I use this everyday
when I pray.”
It is a Place of Prayer
People from different cultures will describe
the same word differently.
Status
Status
A well decorated
war hero.
Status
A wise elder.
An expensive
pampered pet.
Cultural Passport
Think about the answers to these questions:
• What words or phrases describe your cultural
views of health and illness?
• If you loved ones were receiving in-patient
treatment for serious illness, what should
providers understand about your cultural view of
medical care?
• What aspects of your cultural background do
you feel could strengthen your interactions with
and care for patients and their families?
“It is much more
important to know what
sort of a patient has a
disease than what sort of
a disease a patient has.”
Sir William Osler, MD
Worlds Apart Video Series
Explanatory Models
Communication tools used to elicit increased
understanding when those communicating have
diverse cultural perspectives.
• The Explanatory Model-Kleinman
– What do you think caused your
problem?
– Why do you think it started when it
did?
– What do you think your sickness
does to you?
– How serve is your sickness? Do
you think it will last a long time, or
be better soon in your opinion?
– What kind of treatment do you
think you should receive?
– What are the most important
results you hope to get from this
treatment?
• The LEARN Model-Berlin, Fowles
– Listen with sympathy and
understanding to the patient’s
perception of the problem
– Explain your perceptions of the
problem
– Acknowledge and discuss the
differences and similarities
– Recommend treatment
– Negotiate agreement
Thank You