How to use interpreters in general practice: the development of a New Zealand toolkit

Abstract

BACKGROUND AND CONTEXT: New Zealand is becoming more ethnically diverse, with more limited English proficiency (LEP) people. Consequently there are more primary care consultations where patients have insufficient English to communicate adequately. Because effective communication is essential for good care, interpreters are needed in such cases. ASSESSMENT OF PROBLEM: The literature on the use of interpreters in health care includes the benefits of using both trained interpreters (accuracy, confidentiality, ethical behaviour) and untrained interpreters (continuity, trust, patient resistance to interpreter). There is little research on the actual pattern of use of interpreters. RESULTS: Our research documented a low use of trained interpreters, despite knowledge of the risks of untrained interpreters and a significant use of untrained interpreters where clinicians felt that the communication was acceptable. A review of currently available guidelines and toolkits showed that most insist on always using a trained interpreter, without addressing the cost or availability. None were suitable for direct use in New Zealand general practice. STRATEGIES FOR IMPROVEMENT: We produced a toolkit consisting of flowcharts, scenarios and information boxes to guide New Zealand practices through the structure, processes and outcomes of their practice to improve communication with LEP patients. This paper describes this toolkit and the links to the evidence, and argues that every consultation with LEP patients requires clinical judgement as to the type of interpreting needed. LESSONS: Primary care practitioners need understanding about when trained interpreters are required. KEYWORDS: Communication barriers; primary health care; New Zealand; quality of health care; professional–patient relations; cultural competency

Arabic-speaking migrants’ experiences of the use of interpreters in healthcare: a qualitative explorative study

“…Patient-centred communication and provider/interpreter collaboration has often been missing, with communication tending to be partial and healthcare-staff-centred, with healthcare staff directed their communication towards interpreters, spoke in long turns and asked several questions at once [38]. Some guidelines recommended that healthcare staff speak directly to patients, talk slowly in moderated sequences in order to create good communication for the interpreter so that they may translate clearly all that is said [36,39]. Previously, the role of interpreter has been described as that of a translation machine providing accurate and neutral communication [40] and the role has been questioned because the interaction between the interpreter, patient and healthcare staff is symbiotic and not dyadic in the interpretation situation [41].…”

‘There’s a letter called ef’ on Challenges and Repair in Interpreter-Mediated Tests of Cognitive Functioning in Dementia Evaluations: A Case Study

“…The primary concerns of such research are the potential effect of interpretation on the clinical outcome of the healthcare event, for example in terms of diagnosis and prescriptions (e.g., Dodd 1984), clinician and patient satisfaction (e.g., Kuo and Fagan 1999), rates of clinically significant errors (e.g., Flores et al 2003), and lack of linguistic and cultural understanding (e.g., Brooks 1992). Whereas some research is prescriptive, i.e., provides advice on how clinicians most effectively work with interpreters (Gray et al 2012;Phelan and Parkman 1995;Poss Je Rangell 1995), other investigations are descriptive, dealing with the prospects and consequences of the interpreter-mediated clinical encounter (e.g., Karliner et al 2007, for a review; Rudvin 2006) and the interpreter's role and positioning (e.g., Angelelli 2003Angelelli , 2004Llewellyn-Jones and Lee 2014). The use of interpreters in clinical interaction has also been in focus in research on medical education, e.g., in practising the communication skills of medical students (Lau et al 2001).…”

Attitudes and concerns of doctors and nurses about using a translation application for in-hospital brief interactions with Korean patients

“…Seven participants indicated the boundary between the app's purpose and the purpose of interpreters, saying In order to acknowledge how social influence can indirectly be exerted on IT use, we asked how direct and indirect social norm may influence how the participant uses the app. 6. Do you think that support from hospital and management will influence how you use this app?…”

“…3 Patient satisfaction, quality of care and health outcomes are poorer when a person with limited English proficiency (LEP) needs but does not get a trained interpreter. 4, 5 Trained interpreters are preferred when communicating with LEP patients, 6 resulting in better communication, patient satisfaction, quality of care and health outcomes than using untrained family members or bilingual staff members. 4,5 Although trained interpreters or accompanying family members can be called upon in situations such as taking a full history or obtaining informed consent, they may not be readily available for day-to-day communication, at night or in unplanned encounters.…”