The evolution of a healthcare interpreting service mapped against the bilingual health communication model: a historical qualitative case study

Abstract

Background: Twenty-five years ago, the need for health care interpreting in Switzerland increased due to the sharp influx of asylum seekers from war zones and countries of political unrest. Due to complex health needs, there was a need to move away from using volunteers as interpreters towards qualified interpreter services. Methods: A historical qualitative case study design was used to describe the evolution of the language assistance programmes at Geneva University Hospitals, between 1992 and 2017. The aim was to map the evolution of the interpreter services against the Bilingual Health Communication Model with the constructs-Communicative Goals, Individual Agency, System Norms and Quality and Equality of Care-while identifying key factors to optimise interpreter service and patient care. Results and discussion: Five phases were identified during the 25 years of service evolution studied: (1) Service initiation-the interpreter services were first used in a small service that cared for refugees and asylum seekers. (2) Growth and formalisation-due to the arrival of high numbers of Albanian-speaking asylum seekers, Albanian-speaking interpreters were provided to all departments of the Geneva University Hospitals. This helped roll out the use of interpreters among doctors and nurses. (3) Ensuring quality-the care for all patients, whether foreign-language speaking or not, became an issue and led to research into the quality of patient-provider communication. (4) Institutionalisation-this phase dealt with challenges including the lack of interpreter financing regulation and the clarification of interpreter roles. (5) Equity-healthcare interpreter services were put in an overall framework of equity standards. The Bilingual Health Communication Model was applied and showed that some items were not implemented: clear shifts (i) towards a culturally sensitive focus, (ii) towards community interpreting, (iii) towards triadic communication, (iv) towards spelling out the right to have an interpreter and (v) towards the involvement of insurance companies. Finally, the inclusion of healthcare interpreting as an essential ingredient in healthcare provision, including chronic disease management, is incomplete or missing.

Healthcare Interpreting in Emergency Departments: Importance of Healthcare Interpreters in the Communicational Process of Foreign Patients and Physicians

“…In this context, it can be said that communicating with foreign patients has become a part of the daily routines of physicians working in EDs. This result is consistent with the findings of the studies in the literature (Bischoff, 2020;Bischoff et al, 2003;Chae -Park, 2019;Saeki et al, 2022). All these studies have underlined the large population of foreign patients suffering from language barriers in their countries, and our study has presented similar data for Türkiye.…”

“…Healthcare providers are the main agents communicating with foreign patients; therefore, their opinions, expectations, and evaluations on the availability and quality of interpreting services play a significant role in understanding the function and importance of healthcare interpreting and creating a professional framework for interpreters. For this reason, numerous studies have been carried out by the medical staff to underline the importance of communication between foreign patients and physicians in medical settings (Bischoff, 2020;Angelelli -Ross, 2021;Álvaro Aranda -Lázaro Gutiérrez, 2022;Bruno Echauri Galván, 2020;Delizée -Michaux, 2022;Gavioli -Wadensjö, 2021;Merlini -Gatti, 2015;Clifford, 2006).…”

“…Bischoff carried out a qualitative study on "the evolution of the language assistance programs at Geneva University Hospitals, between 1992 and 2017" (Bischoff, 2020, 4). In this research, he found that interpreting services became more professional due to the increasing population of the migrants and continuous need for such services (Bischoff, 2020). Angellelli and Ross investigated the challenges experienced by healthcare interpreters while working through telephones, and they concluded that interpreting through telephones caused important losses in communication in medical settings (Angelelli -Ross, 2021).…”

Interpreter services and effect on healthcare - a systematic review of the impact of different types of interpreters on patient outcome

“…A recent review of the literature on costs of medical interpretation showed that providing interpretation are both associated with lower and increased costs. However existing studies only look at the short term, and the pay off in the investment of high quality of care is measurable in the long term ( Brandl et al., 2020 ), indicating the investment is worth it as supported by others ( Bischoff, 2020 ). In addition, modern technological solutions of better and more accessible audio and video technology can alleviate some of the costs, while also providing the professional interpreter services associated with best overall quality of care for those who need it.…”

Interpreters as Translation Machines: Telephone Interpreting Challenges as Awareness Problems

“…Since a free Emergency Telephone Interpreting Service was first established to assist non-English-speaking migrants to handle emergency situations, telephone interpreting has evolved to cover a wide range of areas relating to daily life, with healthcare as one of the key service domains ( Department of Home Affairs, n.d. ). Currently, the Translating and Interpreting Service (TIS) operating under the Department of Home Affairs offers free interpreting across the nation, and the availability of a nationwide free interpreter service has helped Australia to be recognised as a global leader in terms of interpreting services ( Bischoff, 2020 ).…”