Health to Human International Medical Center (Healthuma)

Interpreter Services: Policy and Procedures

Last Updated: 04/09/2025
Policy Owner: Office of Patient Experience & Diversity, Equity, and Inclusion

1.0 Policy Statement

Health to Human International Medical Center (Healthuma) is committed to providing equitable, high-quality healthcare to all patients, regardless of their primary language, cultural background, or communication abilities. Effective communication is a critical component of safe, effective, and patient-centered care.

It is the policy of Healthuma to provide timely, qualified, and no-cost interpreter services to patients and their companions who:

• Are Deaf or Hard of Hearing.

• Are Blind or have low vision.

• Have Limited English Proficiency (LEP).

• Require assistance due to other communication disabilities.

The use of qualified interpreters is mandatory for all significant medical conversations. The use of family members, friends, or untrained staff as interpreters is strongly discouraged and, in many clinical situations, prohibited to ensure confidentiality, accuracy, and patient safety.

2.0 Scope and Compliance

This policy applies to all Healthuma staff, physicians, trainees, volunteers, and contractors interacting with patients and their families across all inpatient, outpatient, and emergency settings.

This policy is in compliance with:

• Title VI of the Civil Rights Act of 1964

• Americans with Disabilities Act (ADA)

• Section 1557 of the Affordable Care Act

• The Joint Commission Standards (PC.02.01.01, RI.01.01.01)

• State and local regulations

3.0 Definitions

• Limited English Proficiency (LEP): A person who does not speak English as their primary language and who has a limited ability to read, speak, write, or understand English.

• Qualified Interpreter: A professional who has met all required competencies, including proficiency in both English and the target language, knowledge of medical terminology, and adherence to ethical standards (e.g., confidentiality, impartiality, cultural sensitivity). This includes certified interpreters.

• American Sign Language (ASL) Interpreter: A qualified interpreter skilled in translating between spoken English and American Sign Language.

• Video Remote Interpreting (VRI): A technology-based service that provides real-time, face-to-face interpreting through a secure video connection.

• Over-the-Phone Interpreting (OPI): A service that provides immediate interpreter assistance via a telephone handset or dual-handset phone.

• Companion: A family member, friend, or other individual associated with the patient.

4.0 Types of Interpreter Services Available

Healthuma provides a tiered approach to ensure the right mode of interpretation is available for every situation.

4.1 In-Person Interpreters

• Best For: Complex medical discussions (e.g., informed consent, diagnosis disclosure, surgery pre-op, mental health evaluations), lengthy appointments, and for patients who prefer a human presence.

• Process: Requires scheduling in advance through the Interpreter Services Department.

4.2 Video Remote Interpreting (VRI)

• Best For: Immediate needs or for languages of lesser diffusion where an in-person interpreter is not readily available. Provides the benefit of seeing the interpreter's face and gestures.

• Process: Available 24/7 on demand. Utilizes secure tablets and mobile carts that can be wheeled to the patient's bedside or exam room.

4.3 Over-the-Phone Interpreting (OPI)

• Best For: Quick, straightforward conversations (e.g., simple instructions, scheduling, registration), or as a backup when VRI is unavailable.

• Process: Available 24/7 via a dedicated hotline. Dual-handset phones are available in key areas.

4.4 Qualified Sign Language Interpreters & Certified Deaf Interpreters (CDI)

• Best For: Patients and companions who are Deaf or Hard of Hearing. A CDI may be used in complex situations where a highly specialized interpretation is needed.

• Process: Can be scheduled in-person or deployed via VRI.

4.5 Additional Tools for Blind/Low Vision Patients

• Qualified Readers, Braille materials, and large-print documents are available upon request.

5.0 Procedures for Requesting an Interpreter

5.1 Identification of Need:

• Staff must identify the need for an interpreter at the first point of contact (e.g., scheduling, registration, triage).

• Key questions to ask: “What is your preferred language for discussing your healthcare?” and “Do you need an interpreter?”

• Do not rely on a family member or companion to assess the need. Ask the patient directly.

5.2 How to Request:

• For Scheduled Appointments/Admissions: The department scheduling the appointment is responsible for placing the request with Interpreter Services as far in advance as possible (ideally >48 hours).

• For Immediate/Unscheduled Needs (Inpatient & ED): Staff must immediately contact Interpreter Services for VRI or OPI.

• Emergency Situations: While awaiting a qualified interpreter, staff may use a phone interpreter to gain critical, immediate information necessary for stabilization. A qualified interpreter must be engaged for full consent and discussions as soon as possible.

5.3 Required Information for Request:
When requesting, have the following ready:

• Patient name and MRN

• Location (department, room/bed number)

• Language/Dialect required (e.g., Spanish, Mandarin, Farsi)

• Type of appointment/procedure (e.g., Cardiology consult, surgical consent)

• Date and time of need

• Estimated duration

• Preferred modality (if known)

6.0 Staff Responsibilities and Best Practices

• Plan Ahead: Schedule interpreters for known LEP patients well in advance of procedures and key family meetings.

• Speak Directly to the Patient: Always maintain eye contact and speak directly to the patient in the first person (e.g., "How are you feeling today?"), not to the interpreter. The interpreter will interpret everything you say.

• Use Short Sentences: Pause frequently to allow for accurate interpretation. Avoid jargon, slang, and complex medical terms without explanation.

• Allow Time: Conversations requiring an interpreter will take approximately twice as long. Plan your schedule accordingly.

• Document Usage: The use of an interpreter must be documented in the patient's medical record. Note the language, the mode of interpretation (e.g., "In-person Spanish interpreter," "VRI for ASL"), and the name/ID of the interpreter if available.

7.0 Prohibition of Use of Unqualified Interpreters

• Minors under the age of 18 are strictly prohibited from acting as interpreters for any medical situation.

• Family members, friends, or untrained staff should not be used due to risks of:

  • Inaccurate interpretation of critical medical information.

  • Breach of patient confidentiality.

  • Filtering or editorializing information based on their own emotions.

  • Potential for ethical violations.

• Exceptions may be made only in a life-threatening emergency where a qualified interpreter is not immediately available, and only for the minimum amount of communication necessary to secure the patient's immediate welfare.

8.0 Patient Notification & Accessibility

Patients and the public will be informed of the availability of these services through:

• Signage: Notices in multiple languages and the International Symbol of Access for Hearing Loss in all reception areas.

• Admission Packets: Information included in patient materials.

• Website: Detailed information on the Healthuma website.

• Verbal Notification: Staff will verbally offer the service at points of contact.