What would you do if it were your baby?

Have you seen the public service announcement from the Texas Association of Healthcare Interpreters and Translators? 



What must it be like for the thousands of people living in Maine who are still learning English, who live this experience every day?  What would you do if this were your child?

Tips from the trenches

I'm going to let you in on a dirty little department secret: you don't always need an interpreter.  That's right, even sitting on our pile of golden interpreters, the proverbial Midas of language services, we don't always immediately run to the language line.

It's ironic, right?  We're supposed to be in the business of selling interpreters.   

As we discussed this odd phenomenon and compared notes over the refugee-services water cooler, we came up with these "how-to" tips for confident cross-cultural communication.  We realized that we all do the same things when working with limited-English proficient clients. It's not rocket science, but it is powerful stuff:

• Assess your statement - what are the implications if they don't understand?  Use these steps below for simple, concrete communication.  For complex issues, run--don't walk--to your nearest intepreter service.
• Slow down (speaking louder doesn't help, slower does).
• Shorten your statements
• Avoid compound sentences
• Explain processes and don't assume they'll know how systems work
• Draw a picture
• Watch body language for furrowed brows or glazed eyes
• Ask open-ended questions to make sure they understood
• When you have to repeat something two different ways and it's clear that they still don't get it then reach for the interpreter. 

This last point is important.  It's a glorious victory for a client when they can explain their needs without having to use an interpreter; they are one step closer to independence.  But don't ever let a client continue to struggle or leave with questions.  Use a phone interpreter service for five minutes at the end of the appointment to make sure all was understood.  Your time--and theirs--is worth getting it right.

Article review: The debate over remote interpreting

Recently an two interesting studies came out comparing various forms of interpretation.

The Annals of Emergency Medicine showed that on-site interpretation lead to greater patient and provider satisfaction.   This reinforces what on-site interpreters have known for years: there's something special about being in the room.  I was once told by a medical practitioner that over 70% of their diagnosis comes from the conversation before they ever touch a patient.  Wouldn't you want that conversation to be as accurate as possible, capture every gesture, every nuance?  Additionally, our health system is overwhelming and disorienting to many who are new to this country.  On-site interpreters provide a comforting presence to patients--a piece of the familiar in an intimidating new environment.

On the other hand, the another study in the Journal of Internal Medicine found that patients preferred to have simultaneous interpreters via a remote wireless feed.  Technology is revolutionizing our field.  Phone interpreter companies are growing exponentially, with national and international reach.  They are able to offer more languages and at a cheaper price than many local interpreters can afford.  In these lean economic times, that's an important consideration.  Also these jobs enable freelance interpreters who speak rare languages enough work to stabilize their income, leading to a professionalization of the field.  That's 100% fantastic.

Obviously, both articles found that trained, professional interpreters increased patient and provider satisfaction.  However, as a profession we have very little data as to the best practices of phone vs. on-site interpreters.  When does it make sense?   Which settings can use the phone, and which need an on-site interpreter?   What is key to good outcomes? And is satisfaction the same as good health?

These articles give us some marvelous first steps towards quantifying how we create good interpreting outcomes.  As a manager who advises hospitals about the best interpreting tools for the job, I look forward to more such studies.