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

1. 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

2. ต้อนรับ
ようこそ
Bienvenue
Bienvenidos

3.  1998 - formally incorporated as 501(c)3
 Multidisciplinary membership:
Medical interpreters Interpreter service coordinators
Educators/Trainers Clinicians
Health Care Personnel Policy makers
Advocates 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

4. 1999
Systematic process of developing the building blocks for
professionalizing the healthcare interpreting field
2004
Published National Code of Ethics
http://www.ncihc.org/mc/page.do?sitePageId=57768

5. 2004
Searchable Annotated Bibliography
2005
Published National Standards of Practice based on the
Code of Ethics-define competent practice in the field

6. 2001-2010
 Published 13 NCIHC Working Papers
 Sight Translation and Written Translation: Guidelines for Healthcare Interpreters (March
 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)

7. 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 (Mar
)
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)

8. 2001-2010
 Published 13 NCIHC Working Papers
Linguistically Appropriate Access and Services; An Evaluation and Review for Hea
)
The Role of the Health Care Interpreter: An Evolving Dialogue, by Maria-Paz Belt
)Guide to Initial Assessment of Interpreter Qualifications (April 2001)

9. 2001-2010 (continued)
 Open calls on important topics for healthcare
interpreters. For example:
Mental Health Interpreting
Vicarious Trauma/Interpreter Self-Care
Best Practices

10. 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

11. 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

12.  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

13.  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

14.  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;

15.  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.

16.  Active listening skills
 Message conversion skills
 Clear and understandable speech delivery
National Health Law Program http://www.healthlaw.org/

17.  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;

18.  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;

19.  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;

20.  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.

21.  Joint Commission
Helping Organizations Help Patients
 US Department of Health and Human Services
National Standards on Culturally and Linguistically
Appropriate Services
 US HHS Office for Civil Rights
 Agency for Healthcare Research Quality

22. 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

23.  2011 New Orleans, LA
 2010 Washington, D.C.
 2009 Las Vegas, NV
 2008 Atlanta, GA
 2007 Chicago, IL

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

25.  Visit to La Clínica del Pueblo

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

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

28. Interpretini Reception – Networking

30.  Enrica J. Ardemagni, Ph.D.
Board Co-Chair, NCIHC
Professor of Spanish, Indiana
University Purdue University
Indianapolis
Adjunct Professor
Indiana University School of
Medicine
Department of Family Medicine
Tel: 1-317-274-8957
Fax:1-317-278-7375
Email: eardemagni@ncihc.org
 Wilma Alvarado-Little, M.A.
Co-Chair, Policy and Research,
NCIHC Board
Director, Community
Engagement/Outreach
Center for the Elimination of
Minority Health Disparities
University at Albany, SUNY
Tel: 1-518-442-5976
Fax: 1-518-442-4563
Email: WALittle@albany.edu
http://www.albany.edu/cemhd

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