Interpreting: The Missing Link in Helping to Decrease Health Care Disparities

Wilma Alvarado-Little, M.A.Enrica J. Ardemagni, Ph.D.

WONCA World Conference of Family Doctors Cancun, Mexico, May 18-23, 2010

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Bienvenue

Bienvenidos

1998 - formally incorporated as 501(c)3 Multidisciplinary membership:

Medical interpreters Interpreter service coordinatorsEducators/Trainers CliniciansHealth Care Personnel Policy makersAdvocates Researchers

Mission: to promote culturally competent professional health care interpreting as a means to support equal access to health services for individuals with limited English proficiency www.ncihc.org info@ncihc.org

1999 Systematic process of developing the building blocks for

professionalizing the healthcare interpreting field2004 Published National Code of Ethicshttp://www.ncihc.org/mc/page.do?sitePageId=57768

2004 Searchable Annotated Bibliography

2005 Published National Standards of Practice based on the Code of Ethics-define competent practice in the field

2001-2010 Published 13 NCIHC Working Papers

Sight Translation and Written Translation: Guidelines for Healthcare Interpreters (March 2010)

The Terminology of Health Care Interpreters: A Glossary of Terms (Revised 2008)

Are We Ready for National Certification of Health Care Interpreters? A Summary

of NCIHC Open Forums. (October 2007)

2001-2010 Published 13 NCIHC Working Papers

Language Service Resource for Health Care Providers (October 2006)

The Interpreter's World Tour; The Environmental Scan of Standards of Practice for Interpreters (March 2005)

Guide to Interpreter Positioning in Health Care Settings (November 2003)

Final Report on a Pilot of a Certification Process for Spanish-English Interpreters in Health

Care, Conducted in 2003 (November 2003)

Models for the Provision of Health Care Interpreter Training (February 2002)

2001-2010 Published 13 NCIHC Working Papers

Linguistically Appropriate Access and Services; An Evaluation and Review for Healthcare Organizations By Charles C. (Mike) Anderson, M.P.A., (June 2002)The Role of the Health Care Interpreter: An Evolving Dialogue, by Maria-Paz Beltran Avery, Ph.D. (April 2001)Guide to Initial Assessment of Interpreter Qualifications (April 2001)

2001-2010 (continued) Open calls on important topics for healthcare

interpreters. For example:Mental Health InterpretingVicarious Trauma/Interpreter Self-CareBest Practices

2009 - 2010 Develop standards for healthcare interpreter training

programs Collaborate on a national certification process that will

set a standard for qualification as a professional healthcare interpreter

2010 Co-authored “What’s in a Word: A Guide to

Understanding Interpreting and Translation in Health Care” and “Resource Guide for Pharmacists” published by the National Health Law Program – target audience are healthcare workers

http://www.healthlaw.org/ NCIHC Policy and Research Committee Toolkit

Provide consistency in performance of role, leading to a dangerous potential for incomplete and inaccurate communication

Make health care providers and interpreters aware of the clinical and financial ramifications from using unqualified interpreters

Provide guidance when addressing ethical dilemmas during an interpreting encounter

Assure that the ethics and protocols identified as fundamental by the interpreting community are reflected in standard-based training

Help assure consistency and accountability in healthcare interpreter training programs

Define the role Standards of Training will play in national certification

Familiarity with regionalisms and slang in both languages;

Ability to identify differences in meaning due to dialects/regionalisms to ensure effective and accurate message conversion;

Ability to communicate in all registers/levels of formality;

Understanding of colloquialisms and idiomatic expressions in all working languages;

Working knowledge of anatomy and physiology;

Extensive knowledge of the vocabulary and terminology related to diagnosis, prevention, treatment and management of illness and disease;

Thorough understanding of key concepts in health care such as confidentiality, informed consent and patients’ rights;

Thorough command of the vocabulary related to the provision of health care in both languages.

Active listening skills Message conversion skills Clear and understandable speech delivery

National Health Law Program http://www.healthlaw.org/

Intimate knowledge of one’s own native language. Unless an individual has been raised in more than one culture and formally educated in more than one language, writing skills in one’s native language are superior to those of an acquired language. Someone may be able to speak in a second language but this is no indication that the second language may be flawless when writing;

Translators have mastered writing in the idiomatic and natural patterns of their native language;

Medical translators must be experts in the area of the variety of fields that exist in the healthcare system. This includes everything from vocabulary and terminology to a basic knowledge of illnesses, procedures, medications and how healthcare systems function;

Translators must know the extent of their professional boundaries, especially when accepting to translate a document they know they feel qualified to translate as well as the time frame in which they can produce an accomplished product;

A professional translator must have exceptional research skills, and be able to access reference materials that are essential for producing high-quality translations;

Medical translation today relies on everything from hand-written notes to advanced Computer-Assisted Translation software. Medical translators skills range the gamut from being able to work adeptly with handwritten notes to a vast array of computer and technology skills;

Medical translators often translate documents that fall into the legal realm, such as informed consent forms, HIPAA laws, etc., and a qualified medical translator includes these legal-medical documents among his/her repertoire of translation skills;

Medical translators continuously stay abreast of new developments by reading professional literature in the healthcare fields;

Medical translators continuously hone their skills through professional development courses or trainings.

Joint CommissionHelping Organizations Help Patients

US Department of Health and Human ServicesNational Standards on Culturally and Linguistically Appropriate Services

US HHS Office for Civil Rights Agency for Healthcare Research Quality

Center for the Elimination of Minority Health Disparities – University at Albany, SUNY

Presentation of materials to community Utilization of resources with local healthcare

organizations Implementation of programs

2011 New Orleans, LA 2010 Washington, D.C. 2009 Las Vegas, NV 2008 Atlanta, GA 2007 Chicago, IL

Congressional visits in Washington, D.C. to advocate for language access

Visit to La Clínica del Pueblo

Advocacy Café - members had the opportunity to engage a leader from another organization in a discussion centered around the theme of advocacy

Ignatius Bau, Estela McDonough, Kaiser Permanente-Northern California (Carolyn Wang Kong)

Interpretini Reception – Networking

Enrica J. Ardemagni, Ph.D.Board Co-Chair, NCIHC Professor of Spanish, Indiana University Purdue University Indianapolis Adjunct ProfessorIndiana University School of MedicineDepartment of Family MedicineTel: 1-317-274-8957Fax:1-317-278-7375Email: eardemagni@ncihc.org

Wilma Alvarado-Little, M.A.Co-Chair, Policy and Research, NCIHC BoardDirector, Community Engagement/OutreachCenter for the Elimination of Minority Health DisparitiesUniversity at Albany, SUNYTel: 1-518-442-5976Fax: 1-518-442-4563Email: WALittle@albany.eduhttp://www.albany.edu/cemhd

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