CLAS Standard 6
Where language barriers exist, accurate and effective communication cannot exist. Relying on staff not fully bilingual or who lack interpreter training leads to misunderstanding, dissatisfaction, omission of vital information, misdiagnosis, inappropriate treatment and lack of compliance with treatment.
Standard 6's intent is to ensure accurate and effective communication between the patient/consumer and the clinicians and administrative staff.
Competent Language Assistance: Professional interpreters or staff acting in the role of an interpreter must demonstrate a level of bilingual proficiency. This includes knowledge and facility with the terms and concepts relevant to the type of encounter. Their training and competency of all interpreters must be verified and documented. (The National Council on Interpretation in Healthcare has recommended a minimum of 40 hours of specific training).
Family or friends should not be required, suggested or used as interpreters. Minor children are never to be used as interpreters, nor be allowed to interpret for their parents when they are the patient.
It is only after the staff has offered free interpreter services and the patient has declined the services that a family member or friend can be used as an interpreter. When the patient chooses the option of using a family member or friend as their interpreter, the staff should suggest a professional interpreter be present during the initial encounter to ensure accurate interpretation. Staff then should document the patient's decline of the offer in the patient's medical record.
Consider the following example:
A Hispanic woman had to sign an informed consent for a hysterectomy. She was not offered an interpreter by her bilingual son was willing to serve as the interpreter. When he described the procedure to his mother, he appeared to be translating accurately and indicating the appropriate body parts. His mother signed willingly. The next day, however, when she learned her uterus had been removed and that she could no longer bear children, she became angry, upset and threatened to sue the hospital.
What went wrong? It is inappropriate for a Hispanic male to discuss his mother's private parts with his mother. The son was embarrassed and explained that a tumor would be removed from her abdomen and pointed to the general area. When the patient learned her uterus had been removed, she became quite angry and upset. Her status as a Hispanic woman, which was partially determined by her ability to bear children and the number that she produced, was now compromised.