Patients who have limited English proficiency or patients who are partially or fully hearing impaired may need an interpreter while receiving medical care. It is important to use qualified health care interpreters to provide language or sign interpretation. Such interpreters have specific training in:

• Medical interpretation or sign language
• Medical knowledge and terminology
• Ethical practices
• Patient confidentiality
• Completeness and accuracy

When to Use an Interpreter

Use a qualified health care interpreter in all situations where translation of complex diagnostic or treatment information is needed to:

• Obtain a history and physical
• Explain a diagnosis or plan of treatment or care
• Explain procedures where on-going communication with the patient is required to do the procedure
• Get informed consent
• Provide patient education
• Review discharge information
• Discuss legal issues such as guardianship, advance directives and DNR
• Obtain a psychiatric evaluation
• Provide insurance and other billing information
• Make or process a complaint
• Meet the need anytime the patient, family or hospital staff request one

Do's

• Decide if an onsite interpreter or telephone interpretation is needed. When in doubt, get an interpreter.
• Ask the patient in what language they would prefer to receive their health care. Use a language identification poster if needed.
• Try to schedule an interpreter at least 48 hours in advance if possible.
• Greet the interpreter. Review with the interpreter what you plan to discuss with the patient. Provide basic information about the patient. Ask the interpreter to point out cultural misunderstandings that may come up.
• Speak directly to the patient, not the interpreter.
• Speak at an even pace, pausing often to allow the interpreter to interpret.
• Ask the patient to repeat back information and instructions to ensure they understand.
• Be culturally aware of your use of eye contact, space and touching.
• Plan and allow more time. The interpreter may have to paint word pictures of terms you use. This may take longer.
• Document the use of an interpreter in the chart with arrival time, departure time, name of interpreter and write, "per the bedside interpreter the patient reports…"
• Do explain. Do not count on the interpreter to explain or answer questions. An interpreter is there to interpret only what is said and to help explain cultural issues if needed.

Don'ts

• Do not write notes to deaf people unless it is their preferred method of communication.
• Do not say anything that you do not want interpreted.
• Never use minor children to interpret.
• Do not use friends, family members or staff to interpret unless it is for basic information only—no private or medical information. Exceptions include emergency or life threatening situations and then only until a qualified interpreter arrives.
• Do not make assumptions about a patient’s education level. An inability to speak English or to hear does not mean lack of education or intelligence.

An interpreter is not a translator. Translators translate written information while interpreters communicate verbal information. Written handouts are intended as a reinforcement of verbal communication.

There are organizations that provide contract service of qualified healthcare interpreters and translators. For more information, go to the websites below.