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Delivering Services to Multilingual Communities

Delivering Services to Multilingual Communities. Shiva Bidar-Sielaff, M.A. Director of Community Partnerships UW Health. Demographics (2006 Census Data). Foreign born residents US: 1 in 8 WI: 1 in 22 Residents speaking a language other than English at home

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Delivering Services to Multilingual Communities

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  1. Delivering Services to Multilingual Communities Shiva Bidar-Sielaff, M.A. Director of Community Partnerships UW Health

  2. Demographics (2006 Census Data) • Foreign born residents • US: 1 in 8 • WI: 1 in 22 • Residents speaking a language other than English at home • US: 19.7% of total population) • WI: 4.4% of total population speaks language other than English at home (2006 Census)

  3. Limited English Proficient (LEP) Individual “An LEP individual is a person who is unable to speak, read, write or understand the English language at a level that permits him or her to interact effectively with health and social agencies and providers.” Office for Civil Rights

  4. Who Is a Qualified Interpreter? • Fluent in two languages • Trained as an interpreter • ability to accurately transfer information between 2 languages • familiar with medical concepts & terminology • familiar with Western biomedical culture and LEP patient’s culture • understands and adheres to the Interpreter’s Code of Ethics • Not a family member • In one study family members mistranslated or did not translate 23-44% of the questions asked by physicians • Never a minor child

  5. Unqualified “Interpreter” Bloopers... • Gallbladder as vagina/ bladder • Seizures as loss of consciousness/ cramps/stitches • Cervix as neck/cervical vertebrae/hip/uterus • IUD as catheter

  6. The Role of a Medical Interpreter • The role of the interpreter is to facilitate communication between a provider and a patient/family who are speaking a different language • How? • Interpreting accurately everything that is being said • Asking for clarification, in a transparent way, if there is confusion • Providing a cultural framework if there is a misunderstanding between provider and patient based on a cultural reference

  7. Working Effectively Through an Interpreter • Have a brief pre-session with the interpreter • Make sure everybody is positioned appropriately • Speak directly directly to the patient, not the interpreter • Use the first person and active voice, i.e. ”I will be listening to your heart.” • Look at the patient • Speak at an even pace in relatively short segments • Use normal tone of voice (not louder!) • Stop after 3-4 short sentences or one long one

  8. What Should You Avoid... • Highly technical speech/jargon • Idiomatic expressions/similes/metaphors • Comments that you do not want interpreted. • Asking the interpreter about the patient’s history or state of mind

  9. Un Poquito de Español: Know Your Limits • Language acquisition is a very long process • Due to Latino cultural norms of politeness and respect for those in authority, patients will not tell a provider directly that they don't understand the providers' Spanish • Communication with limited fluency prevents accurate/complex communication. Nuances are often missed. • Spanish is a highly variable language, with tremendous variations in accent, vocabulary, syntax depending on the region of origin (country, urban/rural, etc.).

  10. When to Use a Phone Interpreter (OPI) Service? • When face to face interpreter not available • OPI Services available in 140 languages, 24/7 • OPI Services available on demand • When both parties are already communicating on the phone (i.e. confirming an appointment, checking in with a patient)

  11. Written Translations • A qualified interpreter is not necessarily a qualified translator • Interpreting: facilitating oral or sign language communication between two or more speakers who do not speaking, or signing, the same language. • Translation: transferring the meaning of a text (written message) from one language in another language • Use trustworthy sources (i.e. Medlineplus, AAFP) • Make sure it is reviewed by a native speaker • Never use free translation websites

  12. Remember • The interpreter is there to support the development of your relationship with the patient. • You are in control: you need to ensure that there is appropriate communication. • Be patient: it may take longer but, accurate communication is key to a good outcome. • Language is the tip of the iceberg

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