To serve you well, I have to keep all issues in context. This paper, Overwork in America, covers some important concepts. The following paragraphs explain how I intend to apply what I gleaned from this article. As a freelancer, I am responsible for determining my schedule.
- I have to take care of my health. In my case, exercise is essential to stay healthy. It takes time.
- I need to manage some family issues so they do not distract me when I work. As some of you may be aware, my mother-in-law has been needing more support since January of 2016.
My schedule in 2017 will be approximately as follows:
- Mondays, Wednesdays and Thursdays: work from 9 to 5
- Tuesdays: Family issues
- Fridays: Combination of family issues and work
- Saturdays: Rarely available
- Sundays: Not available
In 2017, my work time will be more efficient. And my play time and home time will be more focused on those issues, so I can come back to you ready to work!
Translators and interpreters face a common problem: lack of clarity in the source message. Interpreters have a standard formula for addressing this: “the interpreter requests clarification”. Although translators deal with the same issue, a standard formula is missing. We deal with acronyms that are company-specific, missing terms, etc. and clarify them with clients over email. In the middle of email chains, however, it is easy to lose track of the changes and of our role. We need a better, more rigorous, method of recording these conversations.
The first things the provider notices are your timeliness and your appearance.
Check in with the provider on time, but…
Never check in early to any appointment. Go elsewhere until 10 min. before the appointment and then check in. Hospitals/clinics do not want to pay for checked in time earlier than 10 min. before an appointment.
Interaction with the LEP:
Once you check in: If the LEP is there, introduce yourself very briefly and keep a professional distance, with a courteous demeanor.
Working with professional interpreters saves time… and money!
How much time do patients spend in the Emergency Room? The following chart compares how much time they spend there with different types of language assistance.
- Telephonic interpreters: 141 minutes
- Bilingual provider: 153 minutes
- In-person interpreter: 116 minutes.
The in-person interpreter is the clear winner. Having interpreted in the Emergency Department, I know the anxiety of the patients in that environment, and the pace the medical providers have to maintain. I remember getting a phone call.
“Helen, the ambulance is on the way to Lahey Clinic. Can you be there in 15 minutes?”
“Let me take a few minutes to shut down what I’m doing. What’s up?”
“There were five Hispanics in a car crash. They need you now.”
“I’m on my way.”
This is a sampler of some resources from around the country on how to work with a medical interpreter.
Highline Public Schools has also put together a free, online, ~30 minute tutorial on how to work together with spoken language interpreters.
The Washington State Health Care Authority Interpreter Services Program has developed this checklist for working with an interpreter.
Some items on the checklist:
- Look and speak directly to the patient, not the interpreter.
- Please wait for the interpreter you requested before starting the appointment.
- Always speak in first person, just as you would in a normal conversation.
- Some terminology may not have an equivalent in the target language. Be prepared to explain some things in more detail, or for the interpreter to ask for clarification.
- Avoid asking the interpreter for his opinion.
- Expect the interpreter to leave the room when a provider is not present.
These are recommendations from the Minnesota Refugee Health Provider Guide 2013 for Medical Interpreters.
And from the Massachusetts General Hospital Medical Interpreter Services…
Keeping in mind some health literacy issues published by the American Medical Association about English-speaking patients might be helpful. Watch this video from the AMA: Health Literacy and Patient Safety
There are certainly more resources available, but as of January 19, 2015, these links are helpful and may be useful.
Several of my students are dual-role employees. They have told me that interpreting sneaks up on them, and we have discussed how to work this out.
I created this spreadsheet to help them with this challenge, per their request. Well, I did offer to do it… Interpreting log for dual-role employees
The National Technology Transfer and Advancement Act (NTTAA) was signed into law March 7, 1996. The Act made a direct impact on the development of new industrial and technology standards by requiring that all Federal agencies and departments shall:
- Use technical standards developed or adopted by voluntary consensus standards bodies if compliance would not be inconsistent with applicable law or otherwise impracticable; and
- Consult with voluntary, private sector, consensus standards bodies and shall, when such participation is in the public interest and is compatible with agency and departmental missions, authorities, priorities, and budget resources, participate in the development of technical standards.
The following worksheets are based on ASTM Standards for Translation and Interpretation.
GT Translations process filled in oct 2014
GT Interpreting Specs rv oct 2015
Medical providers are required to have proof that those who work with them have HIPAA training. The Department of Health and Human Services has published a summary of HIPAA.
Interpreters are Business Associates under HIPAA. I believe that voluntary compliance will help interpreters demonstrate that they are proactive about complying with HIPAA requirements and will also help interpreters understand the legal boundaries of the information they can share.
The HIPAA Group, Inc. has been in business for more than 12 years and serves hundreds of universities and thousands of healthcare entities and business associates. This is a link to their Compliance Guide for Business Associates and Covered Entities.
This is a link to the course description for the online course for Business Associates, which applies to medical interpreters. This is the link to register. The cost is $25 and it takes about an hour to complete it. They issue a certificate of successful completion immediately, online.
An article published by the American College of Pediatrics listed certain types of errors interpreters make:
- Omission: not interpreting a word or phrase
- Addition: adding a word or phrase not uttered
- Substitution: substituting a word or phrase for a different word or phrase
- Editorialization: providing ones own views as the interpretation of a word or phrase
- False fluency: using a word or phrase that does not exist in the language or is incorrect and substantially alters the meaning.
In this study, there was an average of 31 errors per interpreting encounter. 18% of the errors had potential clinical consequences overall. However, the percentage of errors with potential clinical consequences varied significantly.