Scl communication with non english speaking patients
Working with Interpreters toImprove Access to Care for theLimited Proficient Patients. Julia Sosa, MS, RD Office of Minority Health November 10, 2011
Why Cultural and LinguisticCompetence?• Changing Demographics• Health Disparities• ADPH provides the preventive and primary care services that are essential to decreasing health disparities• Improving access to services of the Health Department improves the health of our community
Civil Rights Title VI• Title Vi of the Civil Rights Act • 1964 • Prohibits discrimination “No person in the US shall, on ground of race, color, or national origin, be excluded from participation in, be denied the benefits of, or be subjected to discrimination under any program or activity receiving Federal financial assistance
CLAS 1 Culturally Competent 6 Care 11 Qualifications for Bilingual Collection of Data and Interpreter Services on Communities 2 Staff Diversity 7 12 Translated Materials Community Partnerships for CLAS 3 Staff Education and Training 8 Organizational Framework for Cultural Competence 13 Complaint and Grievance 4 Resolution Qualified Language 9 Assistance Services Organizational Self-Assessment 14 Information for 5 the PublicNotices to Patients of the 10 Right to Language Collection of Data Assistance Services on Individual Patients
Communication• Communication is more than just words. Cultures have a variety of norms that influence the non verbal aspects of getting the message across.• The purpose of communication is culturally defined.• Facial expression and eye contact are learned behaviors and are unconscious.• Whom and how we touch is culturally prescribed.• Not talking is also culturally prescribed.Manging Diversity by LeeGardenswart and Anita
Ways of Communication When Language Barriers• Non Verbal communication • Facial expressions • Voice intonation • Emotional responses • Eye Contact • Touching • Smile
Tips for Working With People Who SpeakAnother Language• Do not think that people who are struggling with English are stupid• Learn greetings, titles of respect, and attitude toward touching• Write numbers down when giving instructions• Ask questions in several different ways• Be friendly, accepting and approaching “ Everybody relates to a smile”
How should a provider offer oral interpretation services?• Various options for language assistance • Use of bilingual staff • Staff interpreters • Contracting for interpreters • Telephone interpreter lines • Community volunteers
Modes of Interpretation• Simultaneous • Is real time interpreting. Speaker talks and interpreter listens and reproduces in another language. All this occurs at the same time.• Consecutive • Involves a pause between language conversations: interpreter listens to the entire original phrase or passage, then the interpreter says it in another language.
Working Effectively with Interpreters• Speak directly to the patient• Consider interpreter positioning• Be attentive to the pace of your interpreter• Avoid medical jargon• Check for understanding
Speak directly to the patient• Due to language barrier, it is easy to feel like you are carrying on a conversation with the interpreter• Look at the patient/parent when you speak and when they speak• Address the patient/parent directly as “You”, not “Tell her that…”
Use of Body LanguageYour care for the patient and their family transcends language barriers.• Eye contact• Pat on the shoulder• Smile• Show of concernIf you are not sure what is appropriate, ask.
Risks of Not UsingLanguage Services No way of knowing quality of interpretation provided by children, family members, friends, Internet translators