All-inclusive - one stop linguistic service shop with transcription, translation and interpreting to and from over 200 native languages, including sign language. Around-the-Clock Availability - all linguistic services provided on a 24/7/365 basis – including last-minute/same day, overnight, off-hour/weekend, and holidays. Accredited – interpreter talent pool of native speakers trained and certified by Ad Astra, many accredited by ATA, NCRA, NAD, RID, and government/state agencies. Experienced - Ad Astra managers are experienced and degreed linguists/interpreters and provide regularly scheduled free training and workshops. Top Choice – of healthcare institutions in the metro DC area, including National Institutes of Health, Johns Hopkins Medicine International, and the Adventist Group Welcome to our interpreter team!
Someone who has completed a medical interpreting training course (just like this one!)
Someone who provides onsite, spoken language services (Not to be confused with translation, which ONLY applies to written text)
We will first discuss each of the 9 components of the National Council of Interpreters in Health Care’s Standards of Practice, their objectives and their ethical principals.
The NCIHC is a multidisciplinary organization whose mission is to promote and enhance language access in health care in the United States.
Great resource for information about local interpreter associations, policy information, interpreter ethics, federal and state policy for equal access to communication, workshops, seminars and more.
OBJECTIVE: To enable other parties to know precisely what each speaker has said.
Interpreters strive to render the message accurately, conveying the content and spirit of the original message, taking into consideration the cultural context.
1. The interpreter renders all messages accurately and completely, without adding, omitting, or substituting.
For example, an interpreter repeats all that is said, even if it seems redundant, irrelevant, or rude.
2. The interpreter replicates the register, style, and tone of the speaker.
For example, unless there is no equivalent in the patient's language, an interpreter does not substitute simpler explanations for medical terms a provider uses, but may ask the speaker to re-express themselves in language more easily understood by the other party.
3. The interpreter advises parties that everything said will be interpreted.
For example, an interpreter may explain the interpreting process to a provider by saying "everything you say will be repeated to the patient."
4. The interpreter manages the flow of communication.
For example, an interpreter may ask a speaker to pause or slow down.
5. The interpreter corrects errors in interpretation.
For example, an interpreter who has omitted an important word corrects the mistake as soon as possible.
6. The interpreter maintains transparency.
For example, when asking for clarification, an interpreter says to all parties, "I, the interpreter, did not understand, so I am going to ask for an explanation."
OBJECTIVE: To honor the private and personal nature of the health care interaction and maintain trust among all parties.
Interpreters treat as confidential, within the treating team, all information learned in the performance of their professional duties, while observing relevant requirements regarding disclosure.
7. The interpreter maintains confidentiality and does not disclose information outside the treating team, except with the patient's consent or if required by law.
For example, an interpreter does not discuss a patient’s case with family or community members without the patient’s consent.
8. The interpreter protects written patient information in his or her possession.
For example, an interpreter does not leave notes on an interpreting session in public view.
Health Insurance Portability and Accountability Act (HIPPA) was endorsed by US Congress in 1996
Patients control how “Covered entities” use individually-identifiable health information
Covered entities include healthcare provider, insurance company, medical team, etc…
OBJECTIVE: To eliminate the effect of interpreter bias or preference.
Interpreters strive to maintain
impartiality and refrain
from counseling, advising,
or projecting personal biases
9. The interpreter does not allow personal judgments or cultural values to influence objectivity.
For example, an interpreter does not reveal personal feelings through words, tone of voice, or body language.
10. The interpreter discloses potential conflicts of interest, withdrawing from assignments if necessary.
For example, an interpreter avoids interpreting for a family member or close friend.
To acknowledge the inherent dignity of all parties in the interpreted encounter.
Interpreters treat all parties
11. The interpreter uses professional, culturally appropriate ways of showing respect.
For example, in greetings, an interpreter uses appropriate titles for both patient and provider.
12. The interpreter promotes direct communication among all parties in the encounter.
For example, an interpreter may tell the patient and provider to address each other, rather than the interpreter.
13. The interpreter promotes patient autonomy.
For example, an interpreter directs a patient who asks him or her for a ride home to appropriate resources within the institution.
To facilitate communication across cultural differences.
Interpreters strive to develop
awareness of the cultures
encountered in the performance
of interpreting duties.
14. The interpreter strives to understand the cultures associated with
the languages he or she interprets, including biomedical culture.
For example, an interpreter learns about the traditional remedies some patients may use
15. The interpreter alerts all parties to any significant cultural misunderstanding that arises.
For example, if a provider asks a patient who is fasting for religious reasons to take an oral medication, an interpreter may call attention to the potential conflict.
To clarify the scope and limits of the interpreting role, in order to avoid conflicts of interest.
The interpreter maintains
the boundaries of the professional
from personal involvement.
16. The interpreter limits personal involvement with all parties during the interpreting assignment
For example, an interpreter does not share or elicit overly personal information in conversations with a patient
17. The interpreter limits his or her professional activity to interpreting within an encounter
For example, an interpreter never advises a patient on health care questions, but redirects the patient to ask the provider
18. The interpreter with an additional role adheres to all interpreting standards of practice while interpreting
For example, an interpreter who is also a nurse does not, at any time, offer any medical advice, to the patient or any health care provider
To uphold the public’s trust in the interpreting profession.
Interpreters at all times act in a professional and ethical manner.
19. The interpreter is honest and ethical in all business practices
For example, an interpreter accurately represents his or her credentials. An interpreter never claims to have medical certification, for example, if they are not actually a certified interpreter.
20. The interpreter discloses skill limitations with respect to particular assignments
For example, an interpreter asks about the nature of the assignment, and reviews relevant terminology. Additionally, if an interpreter arrives at an assignment and finds they are over their head, they are to bring it to the attention of the medical staff, and Ad Astra as soon as possible, so Ad Astra may find a replacement.
21. The interpreter is prepared for all assignments
For example, an interpreter who is unfamiliar with a highly technical medical term asks for an explanation before continuing to interpret
22. The interpreter avoids sight translations
For example, interpreters tell medical staff to explain all charts and forms, and then will interpret the explanation.
Legally, according to our contract with the client, contract interpreters are not allowed to perform sight translations.
Situation 1: the patient needs directions written down for exercises at home (IE: physical therapy)
Situation 2: the patient needs to read and understand a consent form for a surgery
Situation 3: the patient is bringing documents from past medical professionals, however they are not in English
Situation 4: the patient is required to fill out forms, such as contact information, medical history, etc, however the patient doesn’t read or write English.
23. The interpreter is accountable for professional performance
For example, an interpreter does not blame others for his or her interpreting errors.
24. The interpreter advocates for working conditions that support quality interpreting
For example, an interpreter, on a lengthy assignment, indicates when fatigue might compromise interpreting accuracy.
25. The interpreter shows respect for professionals with whom he or she works
For example, an interpreter does not spread rumors that would discredit another interpreter.
26. The interpreter acts in a manner befitting the dignity of the profession and appropriate to the setting.
For example, an interpreter dresses appropriately and arrives on time for all appointments.
To attain the highest possible level of competence and service.
Interpreters strive to further
their knowledge and skills,
through independent study,
continuing education, and
actual interpreting practice.
27. The interpreter continues to develop language and cultural knowledge and interpreting skills.
For example, an interpreter stays up to date on changes in medical terminology or regional slang.
28. The interpreter seeks feedback to improve his or her performance.
For example, an interpreter consults with colleagues about a challenging assignment.
29. The interpreter supports the professional development of fellow interpreters.
For example, an experienced interpreter mentors novice interpreters.
30. The interpreter participates in organizations and activities that contribute to the development of the profession.
For example, an interpreter attends professional workshops and conferences.
Question: How can I further my knowledge and skills as an interpreter?
Answer: Ad Astra offers free training, online resources, and complimentary workshops at no cost to our medical interpreter team. To download self-study information at any time: http :// ad-astrainc.com/interpreters-info/ Password: adastrainterpreter
Ad Astra recommends that interpreters get involved in the following linguistic organizations for further professional development:
The National Council of Interpreters in Health Care – www.ncihc.org
The American Translators Association – www.atanet.org
Registry of Interpreters for the Deaf, Inc. – www.rid.org
National Association for the Deaf – www.nad.org
To prevent harm
to parties that
the interpreter serves.
When the patient’s health,
well-being or dignity is at
risk, an interpreter may be
justified in acting as an
31. The interpreter may speak out to protect an individual from serious harm.
For example, an interpreter may intervene on behalf of a patient with a life-threatening allergy, if the condition has been overlooked.
32. The interpreter may advocate on behalf of a party or group to correct mistreatment or abuse.
For example, an interpreter may alert his or her supervisor to patterns of disrespect towards patients.
Resources for self employed
Interpreters should be attired professionally and comply with OSHA guidelines for working in a patient care area
For women: Non-provocative business suites, career dresses, dress pants and blazers/jackets/sweaters are appropriate.
For men: Professional suit and tie or dress pants with shirt and tie are appropriate attire. During the winter months, a sweater with a shirt and tie are acceptable.
If an interpreter is called for an emergency assignment and are not in professional attire, they are to let Ad Astra Staff know, so that Staff Member may request permission from the hospital.
Sometimes, for an emergency, a hospital will allow Ad Astra to send an interpreter who is dressed in jeans for example, but this is not always the case, so interpreters must inform Ad Astra before accepting the assignment.
This dress code is Johns Hopkins’ staff dress code. Our contract interpreters are held to the same level of professionalism
The following slides discuss many of the items which are strictly prohibited. Please consult your folder for the full Male and Female dress codes.
Contact Ad Astra Staff to inform them of delay and ETA.
If an interpreter is more than 10 minutes late, without calling to inform Ad Astra at least 15 minutes prior to the start of the assignment , the interpreter will not be paid for the assignment. Additionally, this interpreter will be placed on probation. A second, unannounced late arrival will result in that interpreter being placed on a “Do-Not-Use” list for that hospital.
Any interpreter who misses an assignment, without prior notification to Ad Astra, will be placed on a “Do-Not-Call” list for that location.
The only instance in which Ad Astra would continue to use an interpreter who missed an assignment, is if they produce appropriate documentation of a legitimate, extenuating circumstance within 7 business days following the assignment.
Additionally, If an interpreter habitually calls out of assignments at the last minute, they may also be placed on a “Do-Not-Use” list.
At no time, is an interpreter to accept gifts, monetary or otherwise from a patient, family or friend of patient, or hospital personnel.
Interpreters are strictly forbidden to have any friend or family member accompany them to an assignment. The interpreter is to arrive alone. Failure to do so is not only a breach of this Code of Professional Conduct, but also a breach of the patient’s right to confidentiality. Any friend or family member giving interpreters a ride are to not allowed to come into the hospital with the interpreter.
Before entering a patient room, the interpreter should check in with the nurse caring for the patient to ensure compliance with standard precautions.
Any billing or procedural questions and concerns are to be addressed only to Ad Astra staff. Interpreters are encouraged to bring bilingual dictionaries to assignments.
Interpreters are to be honest about linguistic limitations.
ALL Interpreters are bound by the National Council on Interpreting in Health Care's (NCIHC) National Standards of Practice.
Interpreters found in violation of any of Ad Astra’s policies or procedures will be subject to non-payment, suspension, and/or termination at the discretion of management.
All interpreters are required to have a timesheet signed at every assignment, INCLUDING patient no-shows/cancelations, etc…
If it is an emergency assignment, and no timesheet is available, the interpreter must have a receptionist, doctor or nurse print, sign, date and timestamp a blank piece of paper, with an extension or phone number for verification.
Interpreters have 72 hours, from the date of the assignment, to turn in both the timesheet and invoice to Ad Astra.
Failure to turn in paperwork within 72 hours may result in non-payment, at the discretion of management.
Call and speak with an Ad Astra team member if your timesheet and invoice will be late.
Call after your assignment, and speak with a project manager to give them the start and finish time of your assignment. Also give them an indication of when the timesheet/invoice is expected to arrive.
Date and Time of start and finish Phone extension and printed name of person signing interpreter in and out Completed rating from the nurse, doctor or receptionist who signed the interpreter out. Filled out by Ad Astra. This is all of the information the interpreter needs for the job. Normal business hour’s contact phone number and EMERGENCY afterhours/weekend/holiday contact phone number
All assignments are to be billed for a minimum of two hours. Any additional time over the two hours will be billed in 15 minute increments.
Invoices will NOT be accepted without the accompanying, properly signed timesheet.
Invoices that are billed for the wrong amount will be changed by our accounting department.
Ad Astra does not pay for, nor reimburse Mileage, travel time, cabs, public transportation, or parking.
All billing related issues are between the interpreter and Ad Astra. Interpreters are not to discuss billing with any member of the hospital staff.
To be filled out by interpreter each time Must be filled out the first time, and each time afterwards, you may write “ON FILE” Number of hours worked, in .25 (15 minute) increments To be filled out by the interpreter
Question - What do I do about parking fees, train, metro, or bus fairs or automobile gas or tolls related to commuting to and from assignments? What do I do about my home office expenses like cell phone and fax/printer?
Answer – As a self-employed worker you may be able to deduct your business expenses – please discuss the resources below with your tax advisor or financial planner:
Articles published with free information about deducting business expenses:
Ad Astra does not provide tax advice or financial planning information and recommends that all independent contractors seek the advice of their tax adviser or financial planner.
When working at the hospital, please keep Ad Astra Staff updated on all changes:
Appointment running longer than 3 hours
Another patient in the same location also needs an interpreter
Patient didn’t show up for their assignment
A member of the medical team is asking that you perform sight translations, make a phone call, asks you to perform any service OTHER than interpreting, or anything else that may be a breach of your contract and outside of the scope of your duties.
Please be prepared for any situation: ER, Inpatient Procedure, Out Patient Procedure, Medical Appointments, Psych Appointments, etc…
Ad Astra does not pay for or reimburse parking, travel time or mileage.
Parking is the responsibility of the interpreter; please leave time for finding parking. Not being able to find a parking space is not an acceptable excuse for being late for an assignment.