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:

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.