Interpreting via VRI in the Medical Setting

1. InterpretingviaVRI intheMedicalSetting 1 Presenter:VanessaJ.NiñoMPA,CMI

2. Objectives • UnderstandkeyareasintheNewpatient- centeredcommunicationstandardsbyTheJoint Commission • Becomefamiliarwithnewrequirements • PrepareforInterpretingVRIintheMedical • Setting

3. NewHospitalRequirementsfor PatientCenteredCommunication

4. TheJointCommission • Anindependent,not-for-profitorganization,whichaccreditsandcertifiesmorethan19,000 healthcareorganizationsandprogramsintheUnitedStates. • JointCommissionaccreditationandcertification isrecognizednationwideasasymbolofqualitythatreflectsanorganization’scommitmenttomeetingcertainperformancestandards. http://www.jointcommission.org/about_us/about_the_joint_commission_main.aspx

5. JointCommission’sNewStandardsfor Patient-CenteredCommunication • HealthCareisdependentonaccurate • communicationbetweenpatientandprovider • Communicationhasbeenidentifiedasaroot causeforSentinelEventsreportedtoTheJointCommission • –TheJoint CommissionSentinelEventdatabaseshowsthatcommunicationis cited asarootcausein nearly70 percent ofreported sentinelevents,surpassingother commonlyidentifiedissuessuch asstafforientationandtraining,patientassessmentandstaffing. • http://www.jcrinc.com/Products-and-Services/Conferences-and-Seminars/Robert-Wood-Johnson-Foundation- 5 Communication/

6. Admission) • Informpatientsoftheirrights. • Identifythepatient’spreferredlanguagefor • discussinghealthcare. • Identifywhetherthepatienthasa sensoryorcommunicationneed. • Determinewhetherthepatientneedsassistancecompleting • admissionforms. • Collectpatientraceandethnicitydatainthemedicalrecord. • Identifyifthepatientusesany assistive devices. • Askthepatientifthereareanyadditionalneedsthatmay • affecthisorhercare. • Communicateinformationaboutuniquepatientneedstothe careteam.

7. Assessment) • Identifyandaddresspatientcommunicationneeds • duringassessment. • Beginthepatient–providerrelationshipwithanintroduction. • Supportthepatient’sabilitytounderstandandactonhealth • information. • Identifyandaddresspatientmobilityneedsduring • assessment. • Identifypatientcultural,religious,orspiritualbeliefs orpractices thatinfluencecare. • Identifypatientdietaryneedsorrestrictionsthataffectcare. • Askthepatienttoidentifyasupportperson. • Communicateinformationaboutuniquepatientneedstothe careteam.

8. Treatment) • Addresspatientcommunicationneedsduringtreatment. • Monitorchangesinthepatient’scommunicationstatus. • Involvepatientsandfamiliesinthecareprocess. • Tailortheinformedconsentprocesstomeetpatientneeds. • Providepatienteducationthatmeetspatientneeds. • Addresspatientmobilityneedsduringtreatment. • Accommodatepatientcultural,religious,orspiritual • beliefsandpractices. • Monitorchangesin dietaryneedsorrestrictionsthatmayimpactthe • patient’scare. • Askthepatienttochooseasupportpersonif oneisnotalready • identified. • Communicateinformationaboutuniquepatientneedstothecare team.

9. EndofLifeCare) • Addresspatientcommunicationneedsduring • end-of-lifecare. • Monitorchangesin thepatient’scommunication • statusduringend-of-lifecare. • Involvethe patient’ssurrogatedecisionmaker • andfamilyin end-of-lifecare. • Address patientmobilityneedsduring end-of-life care. • Identify patientcultural,religious,or spiritualbeliefs • andpracticesat the end of life. • Makesurethe patienthasaccessto his or herchosensupport person. 9

10. DischargeandTransfer • Addresspatientcommunicationneeds • duringdischargeandtransfer. • Engagepatientsandfamiliesindischargeandtransferplanningandinstruction. • Providedischargeinstructionthatmeetspatient • needs. • Identifyfollow-upprovidersthatcanmeetunique • patientneeds. 10

11. How itpertainsto VRI)

12. NewJointCommissionHR Requirement) • HR.01.02.01 • Requireshospitalstodefinequalifications(staff • oragency)specifictojobresponsibilities. • Requireshospitalstospecificallyensurethat individualswhoprovideinterpretingservicesinthehospitalhavedefinedqualificationsand competencies • –Forcontracted services,thehospitalcontractincludes informationabouthowtheserviceproviderdefinescompetenciesconsistentwith eachhospital’sdefinedexpectations.

13. NewJointCommissionRI Requirements) • RI.01.01.03 • Thehospitalrespectsthepatient’srighttoreceive • informationinamannerheorsheunderstands. • EP2Thehospitalprovideslanguageinterpretingandtranslation services,asnecessary. • Languageinterpretingoptionsmayinclude • hospital-employedlanguageinterpreters,contractinterpreting • services,ortrainedbilingualstaff. • Theseoptionsmaybeprovidedinpersonorviatelephoneorvideo. • EP3Thehospitalprovidesinformationtocommunicatewiththepatientwhohasvision,speech,hearing,orcognitiveimpairmentsinamannerthatmeetsthepatient’sneeds.

14. HowthisAffectsVRI) • VRIInterpreterswhoarenotCertifiedmaybe • unabletoprovidemedicalInterpretation • Mosthospitalsaroundthecountryareupdating theirpoliciesregardingInterpreterqualification • For SignLanguageCertificationwillberequired • ForSpokenLanguageMedical/HealthcareCertificationor Qualification(basedon Language)will be required.

15. ChallengeswhileInterpreting intheMedicalSetting WhatEvery InterpreterNeedstoKnow

16. DifficultSituations) • UnfamiliarwithMedicalTerminologybeingused • DifficultyunderstandingthePatient/Provider • Inappropriatelighting • Culturaldifferences • HealthLiteracy

17. EncounteringSituations InappropriateforVRI • Situations suchas • Patientswithcognitive,psychiatricorlinguisticdifficulties; • Patientsincertainphysicalpositions(e.g.,whilelying down); • Patientswhoareundertheinfluenceofmedicationorwho • aretired; • Patientsusingregionalsignlanguagedialects,which requiretheuseofalocalinterpreter; • Equipmentortechnicaldifficulties; • Theneedtomatchupspecificinterpretersorcommunicationstyleswithcertaindeafpatients. 17 www.nad.org/2008VRIadvocacystatement.