Recommended Standards
During the past few decades, the number of immigrants and
refugees in the United States has been steadily increasing, resulting in a
larger limited-English-speaking population in this country. Providing medical and mental health care to
this population requires providing quality medical and mental health
interpreters to assure accurate communication between patient and
clinician. However, studies have shown
that thousands of people receive improper medical and mental health care
because high quality interpretation services are missing. To improve the
quality of medical interpretation, recommended standards have been developed by
a number of organizations. Expert groups
have also examined best practices for providing language interpretation services
in health care settings. Because this field is still in its infancy, more work needs to be done in researching
what elements contribute to effective interpretation and developing standards
and guidelines for interpreters based on that research.
National Standards of Practice for Interpreters in Health Care [pdf]
- These
standards were developed 2004 by the National Council on Interpreting in
Health Care (NCIHC) as a set of guidelines that define what an interpreter
does in the performance of his/her role.
These are skills the interpreter should be able to demonstrate in
the course of fulfilling the duties of the profession.
- The
NCIHC is a multidisciplinary organization whose goal is to promote equal
access to health care for limited English-proficient individuals. The project was staffed by the
Standards, Training and Certification Committee, a group of medical
interpreter experts, formed by the NCIHC.
The committee conducted a literature review of current practices
and existing published standards, both nationally and internationally. The
staff of the committee developed the draft standards and submitted them
for feedback to 632 interpreters and 141 medical professionals whom the
interpreters work with. The final standards were reviewed and
approved by the NCIHC board of directors.
- The
document includes 32 standards of practice under 9 group headings:
- Accuracy
- Confidentiality
- Impartiality
- Respect
- Cultural Awareness
- Role Boundaries
- Professionalism
- Professional Development
- Advocacy
National Standards on Culturally and Linguistically Appropriate Services (CLAS) [pdf]
- These fourteen standards,
developed in 2000, took over three years using a two-stage process. During stage one, a draft of the
standards were developed after a review of reports on research studies,
philosophical and disciplinary papers, and policy literature, such as
legal reports and reports on cultural competency standards or measures. This information was then analyzed
through qualitative and quantitative methods. Stage two consisted of a national
process of public comment, input from stakeholders, and a final review by
the National Project Advisory Committee, directed by Carlos Rodriguez,
PhD, the principal research scientist at the American Institutes for
Research. For additional details on
the development process refer to page 122 of the document.
- These standards were
developed as a guideline for health organizations to provide culturally
and linguistically appropriate services (CLAS). The goal of these standards is to correct
the inequities that currently exist within health services in the United
States and to make these services more responsive to the individual needs
of all patients.
- The
following one-page summary lists the 14 Standards for Health Organizations: http://www.omhrc.gov/templates/browse.aspx?lvl=2&lvlID=15
Best Practices
Providing Language Interpretation Services in Health Care Settings: Examples from the Field [pdf]
- In 2002, the National
Health Law Program (NHeLP) developed a short survey to obtain information
about interpreter access programs in communities. These surveys were
delivered electronically, through the NHeLP listserv, and by mail to
interested organizations, as well as the National Council of Interpretation
in Health Care’s Policy and Research Committee, National Limited English Proficiency Task Force, and the listserv
of the National Immigration Law Center. From the completed surveys,
fourteen programs were selected for more in-depth assessment, which included
key interviews and research. These programs were selected to reflect a
range of interpreter services in different health care settings, funding
sources, and costs of implementation. Programs profiled in this report
include those sponsored by state and local governments, managed care
organizations, hospitals, community-based organizations, and educators.
- The NHeLP, funded by The
Commonwealth Fund, assessed the fourteen programs whose aim is to improve
access to interpreter services in health care settings. This report examines several different methods of
providing oral interpretation, including using bilingual providers/staff,
hiring staff interpreters, contracting with qualified interpreters, and
creating interpreter pools.
- The findings of this report demonstrate the need for a range of interpreter
access approaches tailored to the needs of specific communities and
patient populations, and they show that such approaches are meeting with
success.
