Health Care Interpreters : A Profession in the Making

1. Health Care Interpreters : A Profession in the Making Shiva Bidar-Sielaff, MA Manager of Interpreter Services & Minority Community Relations- University of Wisconsin Hospital & Clinics Board Member, NCIHC Child Heath Services Research Meeting June 2005

2. The National Council on Interpreting in Health Care (NCIHC) • 1994 - informal working group • 1998 - formally established • Multidisciplinary membership: • medical interpreters • interpreter service coordinators and trainers • clinicians • policymakers • advocates • researchers • Mission: to promote culturally competent professional health care interpreting as a means to support equal access to health services for individuals with limited English proficiency • Website: www.ncihc.org

3. Building a Profession • Create and build support for a single Code of Ethics that will guide the practice of interpreters working in health care venues • Develop a nationally accepted, unified set of Standards of Practice based on the Code of Ethics that will define competent practice in the field • Develop standards for health care interpreter training • Possibly create a national certification process that will set a standard for qualification as a professional health care interpreter (needs to be further discussed by profession and NCIHC)

4. The National Code of Ethics for Interpreters in Health Care (published in 2004) • Code of ethics based on a national consensus building process (focus groups/survey) • Final draft was also reviewed by a select number of health care providers and medical ethicists • Companion document was created that offers a more thorough discussion of the issues raised • places the code in the context of ethical behavior in general • provides an elaboration and discussion of each principle and the interrelationships among them, acknowledging that controversies still exist while offering the working interpreter a way to think about these controversies

5. National Code of Ethics for Interpreters in Health Care “The role of interpreter is a‘tightrope’ balancing act: A code of ethics is a good guide for the ‘bar’ carried on such a walk on the tightrope. It offers balance, some security and especially is a comfortable way to face the unknown risks faced on the interpreter’s path.” Anonymous Respondent to Code of Ethics Survey

6. Core Values • Support health and well-being of patient and do no harm • Remain faithful to original message • Take into consideration culture and cultural differences to ensure understanding

7. National Standards of Practice for Interpreters in Health Care Project • Co-funded by The Commonwealth Fund and The California Endowment • Project Directors: Shiva Bidar-Sielaff & Karin Ruschke • Project Committee: NCIHC Standards, Training & Certification Committee • Target date of completion – June 2005

8. Goal • To define competent practices in the field • To lead to more professional interpreting, resulting in clearer communication and better outcomes in health care • To lead to standards for health care interpreter training • To lay the foundation for a possible national certification process that will set a standard for qualification as a professional health care interpreter

9. Initial Efforts in This Area • The Massachusetts Medical Interpreter Association, 1995. Reflected initial thinking; included feedback from national leaders in the field at the time it was created. • Minnesota, 1999. Standards developed by a committee without much input from the field; not widely acknowledged. • The California Healthcare Interpreter Association, 2001. Most recent document; only includes thinking of California. = > Learnings from these efforts are an integral part of the NCIHC Project

10. Creating National Standards of Practice for Interpreters in Health Care • Conducted an environmental scan • Conducted a series of seven targeted focus groups across the country • Analyzed the focus group and environmental scan results and draft the standards document • Presented draft standards document for national feedback • Finalize, publish and distribute the standards document(in progress)

11. Over 23 regional interpreter association in the US • Increasing number of hospital/clinics with staff interpreters and coordinated language access programs • Increasing number of agencies/companies offering medical interpreter services • Increased availability of interpreter training programs

12. Resources • NCIHC www.ncihc.org • Resources for Cross Cultural Health Care www.diversityrx.org • Massachusetts Medical Interpreters Association www.mmia.org