Medical Interpretation Resource Guide

Organizational Structure

Does my organization want to "make" or "buy" interpretation services?
The structure for providing language services will depend on the organization and the community it serves. Facilities need to think about whether they want to deliver services using in-house staff (make) or outside groups (buy.) Based on the organizational assessment, the organization will identify how best to meet the needs of its patients depending on the variety of languages needing interpretation, the frequency of interpretation needed and resources available. The Office of Minority Health's Culturally and Linguistically Appropriate Services (CLAS) standards reinforce the need to have plans, policies and procedures to assure successful delivery of language services. Standard 8 states; "Health Care Organizations should develop, implement, and promote a written strategic plan that outlines clear goals, policies, operational plans, and management accountability/oversight mechanism to provide culturally and linguistically appropriate services."

What can my organization do to build capacity for delivering appropriate interpreter services?

• Decide whether your organization wants to "make or buy" interpretation services.
• Develop an internal infrastructure to coordinate with staff and interpreters directly or contract with a language bank.
• Identify job responsibilities to assure competence in interpreting, coordinating roles, establishing processes.
• Establish policies for bilingual individuals who have a primary job function, but who also interpret. Policies need to assure that individuals are not unfairly judged for spending time interpreting instead of performing their regularly scheduled duties. Organizations should consider the impact on time away from scheduled job, and consider how this dual role is reflected in the performance evaluation process. Pay differentials for bilingual staff may also be considered.
• Develop language access policy for communication with non-English speakers, deaf and hard of hearing individuals, and low literacy patients.
• Incorporate language access policies and procedures in organization-wide orientation to new staff and at annual training meetings.

Resources:

• The Language Bank: 261 Sheep Davis Road, Concord, NH 03301, 603-224-8111, www.lssnorth.org/languagebank.html
• Commonwealth of Massachusetts, EOHHS, Mass. Department of Public Health, "Best Practice Recommendations for Hospital-Based Interpreter Services", www.mass.gov/dph/bhqm/2bestpra.pdf
Southern NH Area Health Education Center: www.snhahec.org
• DiversityRx: "Overview of Models and Strategies for Overcoming Linguistic and Cultural Barriers to Health", www.diversityrx.org
• Cross Cultural Health Care Program (CCHCP) "Models of Interpreter Services, http://www.xculture/interpreter/overview/models.html
• National Council on Interpreting in Health Care, "Models for the Provision of Language Access in Health Care Settings", Downing, B and Roat, C, March 2002, www.ncihc.org
• Providing Language Services in Small Health Care Provider Settings: Examples from the field. The Commonwealth Fund, www.cmwf.org/publications
• Pacific Interpreters: 1-800-311-1232
• Language Line: 1-877-886-3885, or www.languageline.com