In this post, I will quote the CLAS Standard 5 in normal font, and will give the Gaucha TI response in italics.
The purposes of offering communication and language assistance are:
- To ensure that individuals with limited English proficiency and/or other communication needs have equitable access to health services
- To help individuals understand their care and service options and participate in decisions regarding their health and health care
- To increase individuals’ satisfaction and adherence to care and services
- To improve patient safety and reduce medical errors related to miscommunication
- To help organizations comply with requirements such as Title VI of the Civil Rights Act of 1964; the Americans with Disabilities Act of 1990; and other relevant federal, state, and local requirements to which they may need to adhere
Interpreting overcomes language barriers to make communication possible.
Quality interpreting reflects cultural terms, expressions, and idioms that have bearing on the meaning of the content. Interpreting must capture any expressions or nuances in meaning to maintain the impact of the original message.
Often, these nuances in meaning are reflected in gestures, tone of voice, regional terms. The interpreters often need to request clarification to fully understand these expressions. Therefore, face-to-face contact, when the interpreter has just as much information as the rest of the people in the interaction, is the best way to provide interpreting services.
Interpreting is an action that, once having taken place, is done.
Because there is only one opportunity to get it right, the best possible setting for accuracy must be provided: the best interpreters, in the best setting. In Oregon, that would ideally be Certified or Qualified interpreters, in on-site settings.
Interpreters commonly work by themselves as part of a triad with the patient and provider. Interpreters must have an advanced level of proficiency in both languages and must possess exceptional listening and memory skills for accuracy and completeness in verbal expression.
Interpreters have to focus more intensely than anyone else in the encounter. Their linguistic skills in both languages need to be exceptionally high to be able to handle the variety of language needs they can encounter at a moment’s notice. Therefore, interpreters often work in pairs in conference settings, and work with each other for relief in extended consecutive settings. Interpreters cannot create their own message, as the other participants of the encounter can. Interpreters have to be 100% faithful to the message the other participants have given. This is why court interpreters take notes…
Special language aptitude is required in both the language of medical terminology and in health care systems. Traditionally, interpreters prepare and conduct research prior to the encounter, using resources such as dictionaries and consultation with professionals in a specific field to complete their work.
Interpreters need to be able to interact with the medical staff before the encounter, when possible, to know what the encounter is about and research the key terms that will be used, and refresh the key concepts that will be communicated. Interpreters often go from an appointment at an ingrown toenail surgery clinic to a dialysis clinic to a hand therapy clinic to a pediatric well baby checkup. Having a few minutes to prepare for each setting in a secure area enhances their ability to be well equipped to provide an excellent service.
Interpreters work “in the moment” and are compelled by the mode of interpreting. Interpreters may consult dictionaries or utilize other resources, but the time between each exchange is only a matter of seconds or minutes.
In the moment of the exchange, the interpreters don’t have time to check resources. That is why interpreters need to know what the encounter is about before the encounter, so they can take a few minutes to prepare. Interpreters receive training in managing the session, both in managing the flow, asking for clarification, asking for a repetition, taking notes, giving the notes to the provider, introducing themselves to the participants in the encounter so their roles are clear, so the sessions are controlled by the participants in the session, not by the interpreters.
Interpreters work bidirectionally, going back and forth between two languages.
Interpreters convert the message to the best of their ability. They need to understand the message very precisely and be able to express it very clearly. This requires a very high level of language proficiency, but language proficiency itself is not enough. Message conversion is a special skill.
The interpreter functions as a conduit, clarifier, cultural broker, and advocate. Interpreters must be able to perform each role appropriately throughout the encounter.
When interpreters render an accurate and complete interpretation and provide a proper introduction to the session, establishing their professional role, the participants in the session often assume their roles and communicate directly, doing the cultural brokering and advocacy themselves.
Interpreters must be sensitive and considerate of both cultures. The goal is to have the listener understand the message as if it were heard directly from the original speaker.
As a matter of fact, interpreters should empower the parties to discuss the cultural issues themselves, since they are the ones who understand the issues best.
The National Council for Interpreting in Health Care has published a Code of Ethics and Standards of Practice for interpreters (National Council on Interpreting in Health Care, 2004, 2005).
Interpreting takes place at a specific time and place.
Interpreters work in public (in a hospital or clinic, for example) or in private (in the case of telephonic and video interpreters who work either from a home office or in a call center).
Interpreters must be present at a specific location; i.e., onsite at a hospital or clinic, or at a location that has dedicated resources for telephonic interpreting or video remote interpreting.
Remote interpreting is more challenging, in many ways, than on-site interpreting.
Studies have shown that interpreters decline in quality twice as quickly in remote delivery as compared to live in-person delivery of interpreting services.