Interpretative Services
Computer-Based Learning Module
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Communication Barriers
Cultural and language differences create
unique communication barriers.
Legally speaking, both Federal Law and Joint
Commission require hospitals to provide
services to those with limited abilities to
communicate – this can include abilities
related to sight, hearing, or the inability to
speak a common language (like English).
Patients have the right to appropriate
assistance with these barriers.
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To stress the importance for hospital staff to respect the right
and need of patients for effective communication:
Provided information is to be both age-appropriate and
language appropriate
Provided interpretation must address the needs of those with
vision, speech, hearing, language and cognitive impairments
To enable the user to arrange interpretation for hearing
impairment or language 24 hours a day.
To enable the user to understand the Children’s Hospital
telephone system conference calling option via the
TRANSFER button.
To enable the user to connect Incoming & Outbound
patient/family calls to the appropriate interpretive service.
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What is “appropriate
Children’s Hospital has a procedure in place
for dealing with communication barriers.
This may include: live interpreters, telephone
interpretive services, printed materials, Braille
on internal signage, and steps for
documenting the barriers and teaching
All language services are still subject to
HIPAA guidelines and a patient’s right to
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The Procedure
Our procedure states …
“It is the philosophy of Children’s Hospital that all
patients and families be provided with an equal
opportunity for communication during hospitalization.
Should a patient and/or family member be deaf or
non-English speaking, the Social Work department
assumes responsibility for the arrangement of
Interpretive Services for inpatient, ambulatory care
clinics, and the Emergency Department Services.”
The procedure can be found by using ETCHNet and
going to Administration documents. Then look for the
Interpretation Services Procedure.
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Flow Chart
There is also a flow chart to help you decided
which kind of Interpretive service is needed.
Follow this flow chart and work with Social
Work to determine appropriate interventions.
Live interpreters are available at this time for
Spanish speaking families.
The Flow Chart can be found using
ETCHNet. Go to Nursing documents, and
look for the Interpretation Services procedure.
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Hearing Impaired Population
ETCH contracts with KCD (Knoxville Center for the Deaf)
Every state is required to use certified Signing Interpreters when
sharing Legal or Medical information
The interpreters are arranged through Social Work during the
day, and through the Nursing Coordinator when the Social Work
office is closed.
Give the social work department as much notice as possible.
With emergencies, KCD has a 30 minute response time.
ETCH does have 3 TDD/TTY (Telecommunications Device for
the Deaf/Teletypewriter) devices. One is in the ER, and two are
available to lend to patients/families. Information Systems
keeps this one and it is available 24hours a day.
Limited English Proficiency
Definition:Inability to speak, read,
write, or understand English at a level
that permits effective interaction with
health care providers.
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Limited English Proficiency (LEP) Population
Federal Law requires Medical facilities to provide
Interpretive services to every patient / family free of
Language interpretation may be provided In Person
or by telephone.
More than 97% of ETCH’s LEP population is Spanish
speaking. The Social Work department has 3 FT
Spanish Interpreters to meet In Person requests.
Patients/families may have the right to bring their own
interpreter; ETCH policy requires any Interpreter to
be at least 18 years of age.
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Limited English Proficiency
Have a right to the same quality of care as
any English speaking family.
Have a right to be involved in any program or
activity related to the family member’s care
just as any English speaking family would.
Have a right to know they can have
interpretive services free of charge, or
provide their own interpreter.
(Hospitals will lose federal support if they do not
follow these rights…)
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What we do at ETCH…
Over 80 Sharing Information brochures are
available in Spanish.
Hospital, Home Health and Rehabilitation
Center documents and consents are also
translated into Spanish.
Audio recordings (Spanish and English) of
the ETCH Parent Information Sheet are
available in Admitting and Social Work
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In-Person Interpretation
Sessions at ETCH…
45 0 0
40 0 0
350 0
30 0 0
250 0
'0 4-'0 5
'0 5 -'0 6
'0 6 -'0 7
'0 7-'0 8
20 0 0
15 0 0
10 0 0
50 0
Fiscal Year
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If I have a Spanish speaking
and I need In Person
(I need to discuss a complex diagnosis, have a patient care
conference, teach a class etc.)
Contact Social Work Interpreter on Wave Ware
Monday-Friday 7:30am-9:30pm
Saturday and Sunday 1:00pm-9:30pm
During night shift (after 9:30pm) and Saturday
and Sunday mornings, contact Light House
Interpreters, Inc. at 748-7354 or 335-2246
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Tips for Working with an Interpreter
In-Person Session
Speak directly to patient or family member.
Communicate directly with each other as if the interpreter is not
there. Interpreters will relay information and communicate patient
response directly back to you. Speak naturally, not louder and at
normal pace, not slower.
Speak in one sentence or two short sentences at a time. Avoid
breaking up a thought. Express the whole thought at one time if
possible. This will help the interpreter. Interpreters will ask you to
slow down or repeat if necessary. Pause to give interpreter enough
time to deliver your message.
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Tips for Working with an Interpreter
In-Person Session
Ask if the patient or family member understands.
Do not assume understanding. Some cultures may say ‘yes’ as
you explain, but not necessarily understand its meaning. Also
understand that lack of English does not automatically mean lack of
Avoid jargon and technical terms.
To help the patient and interpreter better understand you, don’t use
industry jargon, slang, abbreviations or technical terms. Explain
any words unique to the situation, and give examples if needed to
explain a term.
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If I have a Spanish speaking
And I need telephone
Contact Social Work
Interpreter by Wave
Ware Pager.
When Staff Interpreter is
not available, contact
Optimal Phone
Interpreters at
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If I have a family speaking any
other language…?
Call for assistance!
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use of Optimal Phone Interpreters
Phone # 1-877-746-4674
Organization Name –
East Tennessee Children’s Hospital
Callers Name
Department –
Department to which the call is to be
billed, ie., “Nursing 2East,” “Emergency
Department,” etc.
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Start with Using Optimal Phone
Call Optimal Phone
Choose option for
Specify language
Provide your dept. name
Brief interpreter
Pass handset back & forth
between yourself and the
Non-English speaker
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How long does it take to reach
an Interpreter?
On average, we connect
you to an Interpreter
within 60 seconds.
However, occasionally
the connection time for a
less commonly requested
language or dialect may
be a bit longer.
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Can I reach an Interpreter at
night or on weekends?
Yes. We operate 24
hours a day, 7 days a
week, 365 days a year.
On rare occasions all
Interpreters for a
particular language may
be busy. When this
happens we’ll ask that
you call back in a few
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Can I just transfer a call to OPI
No. The Interpreter serves as
a communication conduit
between you and your nonEnglish customer and is
dependent on you for direction
during the call. You take the
lead and provide the subject
matter expertise; the
Interpreter relays the
information back and forth.
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How do we identify the language
that a caller is speaking?
Our Operations/Communication
Center (CC) is trained to help you with
language identification. If you are
unsure of the language, ask the CC
for help. Often it is as simple as
asking (in English) a caller what
language he or she speaks. If you are
face-to-face, use the Language ID
Card to pinpoint the language needed.
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What happened if we have a problem
hearing one another on a call?
If the Communications
Center (CC) is still on
the line, ask him or her
to re-dial the Interpreter.
If the CC has left the
line, call us back,
explain the problem and
ask the CC to stay on
the line to check for
sound quality.
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What should I do when the
Interpreter joins the conversations?
Start by briefing the Interpreter.
Summarize what you wish to
accomplish and give any special
instructions. Take the lead in the
conversation. Give the Interpreter
specific questions to relay. Group
your thoughts or questions to help
the conversation flow naturally and
quickly. For example, ask for
someone’s address and phone
number as one question.
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Why do the non-English conversations
seem longer than the English?
We require that our Interpreters be
accurate and to the point. It is important
to recognize that they interpret not only
across language, but also across
culture. You can help facilitate the
interpretation by making your message
easy for the non-English speaker to
understand. Clarification and/or
elaboration is sometimes needed to
explain concepts that do not have an
equivalent in other languages or
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What guarantee of
confidentiality do I have?
All of our personnel
are bound by a strict
code of conduct,
ensuring that all
information pertaining
to the work we do for
you remains strictly
Interpreters routinely
destroy all notes.
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Are calls recorded?
No. Neither Optimal
Phone Interpreters or
Children’s Hospital
records calls.
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Important Tips In Summary
When you need interpretive services, review the policy and
procedure on your unit.
OPI needs your information. You must provide the
language needed, your first name and department,
Organization Name, to be connected to an Interpreter. The
Communication Center will assist with language
identification if necessary.
Working with an Interpreter. Give the Interpreter specific
questions to relay. Group your thoughts or questions to
help conversation flow quickly.
Interpreter Identification. OPI Interpreters identify
themselves by first name and number only. For reason of
confidentiality, they do not divulge either their full names or
phone numbers.
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Important Tips In Summary
Length of call. Expect interpreted comments to run a bit
longer than English phrases. Interpreters convey meaningfor-meaning, not word-for-word. Concepts familiar to us
often require explanation or elaboration in other languages
and cultures.
Line quality problems. If you experience problems with the
sound quality and the CC is still on the line, ask him or her
to re-dial the Interpreter. If the CC has left the line, call us
back, explain the problem and ask the Answer point to stay
on the line to check for sound quality.
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Take Test
Please click the TAKE TEST button on
the left side of your screen to proceed.
You must score 80% or better on the
following T/F, multiple choice test to
transfer credit to your transcript.
If you have any questions about the
content. please contact your
Thank You and Good Luck!

AT&T Language Line - Tennessee Wesleyan College