NEW SPECIAL INTERPRETER-CONFERENCING PHONES ON INPATIENT UNITS

At a February 8, 2007 special staff meeting, Pat Rowell, Director of Volunteer, Interpreter, Information Ambassador, and General Store Services, Karin Hobrecker, Translation Specialist, and Lulu Sanchez, Manager, Interpreter Service explained and demonstrated the new tool for medical interpretation services by phone which are being rolled out to all inpatient floors. These hands-free speaker-type phones are on wheeled poles and enable all parties in the conversation to hear each other clearly.

Pat Rowell explained that medical interpretation services by phone have been available for some time, but that the recent JCAHO visit underscored the need for greater staff accessibility to the service and awareness of it. Interpreter Services is placing 50 of these phones throughout the hospital – one on each inpatient unit. Each phone is mounted on a special IV pole set at the ideal height for transmitting conversation from a hospital bed. The units roll easily into rooms and out again for storage. The poles are equipped with written instructions and a basket that holds hospital-approved disinfectant wipes to clean the equipment after use.

Interpreter Service is working to enable use of this equipment in outpatient settings in the future, once some technical issues are worked out because these phones require analog phone lines. Currently the patient bed-side phones use analog technology, but most outpatient lines are digital.

These phones are to supplement in-person interpretation NOT to replace it. Interpreter Services has a staff of trained, full-time interpreters but although staffing increases with need, they are always looking for new ways to improve quality and efficiency to make services readily available when needed.

When to Use the Phones

• Whenever you want to communicate with a patient. Use them to keep your patients in the loop. They are ideal for on the spot interactions for which you have not had lead time to schedule an interpreter to meet you on the unit.
• To get you started with the patient in cases in which the interpreter will be arriving later, maybe from outside the hospital. You might even use the tool to have a phone interpreter help you inform a patient that you will be meeting with them at a time scheduled with an MGH interpreter
• Off hours – service is available 24/7.
• When the required language is not available through MGH Interpreter Services.

About the System

• The phone connects you to a vendor who has a staff of professional medical interpreters in most languages. The vendor screens and recruits interpreters throughout the country for this service (which incidentally was started by a social worker).
• There is no charge to patients, the patient care unit or social service for use of the system. Costs of the interpretation service are absorbed by the Interpreter Service budget.
• To use: roll the unit in, plug it in to a power source and the unused phone jack at bedside, talk, wipe it down (with Super Sani wipe- hospital approved disinfectant), roll it out and store.

Tips

Detailed instructions, including the phone number to access the service, are attached to the unit. Staff can make the best use of the new tool in their professional work following these tips for communicating with patients with remote phone interpreting services:

• For best sound keep the phone within 7 feet of you and the patient.
• If you know that the needed language is uncommon and may require extra time to find an interpreter, you can call MGH Interpreter Service and ask them to set up an interview time in advance to save time waiting on the phone in the presence of the patient/family.
• Very Important: Give Context to Interpreter. The phone interpreter has no visual cues .
• You must orient the interpreter:
• Briefly paint a picture of the setting: describe where you are, what you do, what the goal of your conversation is.
• Remember the phone interpreter works from a remote location.
• He or she is not familiar with MGH.
• Clarity is important.
• Avoid MGH jargon: “Go to my office at the WANG ACC”. Instead say “My office is in one of the buildings here at MGH. The name of my office building is WANG. It is also called the ACC”.
• Avoid professional & local jargon: instead of DSS say the name first, then the acronym.
• Follow your interview protocol closely:
• Introduce yourself and your role: “I am Mary Jones. I am the Social Worker for this patient unit.”
• State the goal of the encounter: initial assessment, daily session, discharge plan
• Encourage both the interpreter and the patient to request clarification from you or from each other: “It is very important for each of us to say right away if we do not understand each other or if we can’t hear each other well.”

Working With ALL Medical Interpreters

Tips for BEST Communication & Dialogue:

1. Speak directly to the patient – do not say: “Can you please ask the patient if…”

2. Pace your speech for the interpreter.

3. Ask one question at a time

4. Define medical terms or jargon

5. Avoid idioms, sayings and other culturally bound expressions

6. Listen - before redirecting

7. Check for understanding

8. Ask patient to teach back

• Restate agreed / recommended next steps

Document your interaction!

Staff are required to document whenever an interpreter is used. If this is not documented, of course, there is no evidence that an interpreter was used and it appears as if the patient/family did not have access to language-appropriate services. Staff should indicate whether this was in-person interpretation using staff from MGH Interpreter Services or if a telephone interpreter was used. For Quality Assurance purposes, staff should document the ID number of the remote phone medical interpreter , or the name of the MGH Medical Interpreter when the interpretation is face to face.

Questions? Comments? E-mail: Mghphoneinterpreting@partners.org

2/07