Clinical Care Access to Care Quality of Care Search Policies & Programs

hints
Display All Policies & Programs

Professionally trained medical interpreters

Health Factors: Quality of Care
Decision Makers: State Government Federal Government Healthcare Professionals & Advocates Public Health Professionals & Advocates
Evidence Rating: Some Evidence
Population Reach: 20-49% of WI's population
Impact on Disparities: Likely to decrease disparities

Is this program or policy in use in your community? Tell us about it.

Description

Professionally trained medical interpreters provide interpretation services for limited English proficiency (LEP) patients in outpatient and inpatient health care settings, and sometimes also serve informally as cultural liaisons or patient advocates. Interpreters are taught to interpret spoken words in the correct context via at least 40 hours of training, which often includes on-the-job training and courses in health care interpretation (CCHI). Interpreter services are mandated by Title VI of the Civil Rights Act for LEP patients who receive federal financial assistance. Availability of professional interpreters is limited in most states, often due to budgetary limitations; ad-hoc or telephone interpretation services are often used. Professional interpreters are certified by the Certification Commission for Healthcare Interpreters or the National Board of Certification for Medical Interpreters (Juckett 2014).

Expected Beneficial Outcomes

Improved patient-provider communication
Increased patient satisfaction
Improved health outcomes

Evidence of Effectiveness

There is some evidence that professionally trained medical interpreters improve patient-provider communication (Campbell-Wollscheid 2015, Flores 2005), increase satisfaction (Campbell-Wollscheid 2015, Karliner 2007, Flores 2005, Bagchi 2011, Giordano 2007), and improve health outcomes (Flores 2005, Giordano 2007) for patients with limited English proficiency (LEP). Additional evidence is needed to confirm effects.

LEP patients who receive interpretation services from professionally trained medical interpreters are more likely to have preventive screenings, fill prescriptions, and successfully manage conditions such as diabetes than patients with ad-hoc interpreters such as family, friends, or health care staff untrained in interpretation (Flores 2005). In two New Jersey emergency departments, patients and providers report higher levels of satisfaction and better communication with trained interpreters than with ad-hoc or telephone interpreters (Bagchi 2011).

Professionally trained medical interpreters have been shown to make fewer clinically significant interpretation errors than untrained interpreters (Flores 2005, Karliner 2007, Flores 2012). Interpreters with 100 or more hours of training are less likely to make errors than interpreters with fewer hours of training (Flores 2012). Professionally trained medical interpreters are associated with improved quality of care for LEP patients (Campbell-Wollscheid 2015, Flores 2005, Karliner 2007, Flores 2012, Rosenberg 2008). Remote, real-time telephone interpretation may also reduce errors and increase patient satisfaction (CWF-Cooper 2004).

A Boston-based study suggests that patients may prefer family members or friends serving as ad-hoc interpreters rather than engaging professionally trained interpreters (Ginde 2010). 

Implementation

United States

Professionally trained medical interpreters are available in many health care settings, especially in non-profit hospitals in large, diverse urban areas (Schiaffino 2014). Memorial Sloan Kettering Cancer Center, for example, offers a medical interpreting training program along with cultural responsiveness training (MSKCC-Medical interpreting). The University of Texas MD Anderson Cancer Center’s international center provides professional medical interpretation services in Arabic, French, Mandarin, Spanish, Russian, Turkish, Vietnamese, and American Sign Language (UTMDACC-International center). The University of California Davis Medical Center’s Department of Interpreting and Translation Services provides in-person, over-the-phone, and video conference interpretation in 18 languages as well as health care interpreter training courses (UCDMC-Interpreting).

The Continuing Education Accreditation Program (CEAP) maintains a database of all professional medical interpretation programs certified by the Certification Commission for Healthcare Interpreters (CCHI). Programs can be viewed by location, language, cost, and in-person or online training; program costs range from under $100 to $500 (CEAP-CCHI providers).

Wisconsin

The Wisconsin Department of Children and Families provides medical interpreter trainings, particularly in the languages of refugees relocating to Wisconsin, through three area vendors and maintains a roster of all trained medical interpreters in the state (WI DCF-Medical interpreter). 

Implementation Resources

CCHI - Certification Commission for Healthcare Interpreters (CCHI). Eligibility Criteria. Accessed on March 20, 2017
Think cultural health - US Department of Health and Human Services (US DHHS), Office of Minority Health (OMH). Think cultural health: Guide to providing effective communication and language assistance services. Accessed on March 20, 2017

Citations - Description

CCHI - Certification Commission for Healthcare Interpreters (CCHI). Eligibility Criteria. Accessed on March 20, 2017
Juckett 2014 - Juckett G, Unger K. Appropriate use of medical interpreters. American Family Physician. 2014;90(7):476–480. Accessed on March 20, 2017

Citations - Evidence

Bagchi 2011* - Bagchi AD, Dale S, Verbitsky-Savitz N, et al. Examining effectiveness of medical interpreters in emergency departments for Spanish-speaking patients with limited English proficiency: Results of a randomized controlled trial. Annals of Emergency Medicine. 2011;57(3):248–256.e4. Accessed on March 20, 2017
Campbell-Wollscheid 2015 - Wollscheid S, Munthe-Kaas HM, Hammerstrøm KT, Noonan E. Effect of interventions to facilitate communication between families or single young people with minority language background and public services: A systematic review. Campbell Systematic Reviews. 2015:7. Accessed on March 20, 2017
CWF-Cooper 2004 - Cooper LA, Powe NR. Disparities in patient experiences, health care processes, and outcomes: The role of patient-provider racial, ethnic, and language concordance. New York: The Commonwealth Fund (CWF); 2004. Accessed on March 20, 2017
Flores 2005* - Flores G. The impact of medical interpreter services on the quality of care: A systematic review. Medical Care Research and Review. 2005;62(3):255-299. Accessed on March 20, 2017
Flores 2012* - Flores G, Abreu M, Barone CP, Bachur R, Lin H. Errors of medical interpretation and their potential clinical consequences: A comparison of professional versus ad hoc versus no interpreters. Annals of Emergency Medicine. 2012;60(5):545–553. Accessed on March 20, 2017
Ginde 2010* - Ginde AA, Sullivan AF, Corel B, Caceres JA, Camargo CA. Reevaluation of the effect of mandatory interpreter legislation on use of professional interpreters for ED patients with language barriers. Patient Education and Counseling. 2010;81(2):204–206. Accessed on March 20, 2017
Giordano 2007* - Giordano S. Overview of the advantages and disadvantages of professional and child interpreters for limited English proficiency patients in general health care situations. Journal of Radiology Nursing. 2007;26(4):126–131. Accessed on March 20, 2017
Karliner 2007 - Karliner LS, Jacobs EA, Chen AH, Mutha S. Do professional interpreters improve clinical care for patients with limited English proficiency? A systematic review of the literature. Health Services Research. 2007;42(2):727-54. Accessed on March 20, 2017
Rosenberg 2008* - Rosenberg E, Seller R, Leanza Y. Through interpreters’ eyes: Comparing roles of professional and family interpreters. Patient Education and Counseling. 2008;70(1):87–93. Accessed on March 20, 2017

Citations - Implementation

CEAP-CCHI providers - Continuing Education Accreditation Program (CEAP). Certification Commission for Healthcare Interpreters (CCHI). Find a health care interpretation provider. Accessed on March 20, 2017
MSKCC-Medical interpreting - Memorial Sloan Kettering Cancer Center (MSKCC). Immigrant Health & Cancer Disparities Service. Medical interpreting training program. Accessed on March 20, 2017
Schiaffino 2014 - Schiaffino MK, Al-Amin M, Schumacher JR. Predictors of language service availability in U.S. hospitals. International Journal of Health Policy and Management. 2014;3(5):259–268. Accessed on March 20, 2017
UCDMC-Interpreting - University of California Davis Medical Center (UCDMC). Department of Interpreting and Translation Services. Accessed on March 20, 2017
UTMDACC-International center - The University of Texas MD Anderson Cancer Center (UTMDACC). International center. Certified medical interpreters. Accessed on March 20, 2017
WI DCF-Medical interpreter - Wisconsin Department of Children and Families (WI DCF). Medical interpreter training. Accessed on September 27, 2016

Page Last Updated

September 29, 2016

* Journal subscription may be required for access.