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School of Medicine
INTERPRETERS HELP CAREGIVERS OVERCOME LANGUAGE BARRIERS.
When Mary Ann Wood got the call from Howard County General Hospital requesting her assistance in its labor and delivery unit, she never guessed it would turn into a life-and-death ordeal. Nurses and the attending physician needed to stabilize a county resident who had arrived earlier that June morning experiencing pre-delivery complications. But the patient only spoke Spanish and none of the care team could communicate in her native tongue. Wood is a Spanish interpreter from Hopkins' International Patient Services (IPS) call center. She stayed with the patient, explaining everything the caregivers were doing to achieve a successful natural childbirth. But by early evening, the unborn child's and mother's heartbeats were diminishing, and the doctor decided an emergency Cesarean was necessary to save both lives. Wood remained with the patient until the doctor delivered a healthy baby girl.
Wood is one of 35 staff interpreters used by International's call center, a two-year-old program that now offers translation and cultural assistance for Hopkins Medicine's three hospitals, home care group and community clinics. The service resulted from increased requests for interpreters for non-English-speaking patients, many of whom are U.S. citizens or permanent residents. But it also satisfies new regulatory requirements under Title VI of the U.S. Civil Rights Act and by the Joint Commission on Accreditation of Healthcare Organizations (JCAHO).
The number of requests for interpreters now averages 350 per month, according to Harris Benny, director of International Patient Services, nearly double the number since the center's inception. This increase is partially due to the program's expansion, last year, to include all of Hopkins Medicine. Currently, 25 percent of requests come from locations outside the East Baltimore campus. Additionally, they have grown because of an increase in non-English- speaking residents, particularly among the Korean community in Howard County and recent Russian emigres to Baltimore City and County. Although Spanish continues to be the language most often requested for translation, 20 percent of calls are now for Korean interpreters and 15 percent are for Russian.
The 24-hour call center gives any caregiver telephonic or on-site interpreting. Protocols require that an interpreter respond by phone within two to four minutes of the request, or appear on site within two hours for the mostly commonly spoken languages (Spanish, Russian and Korean). For this, International Patient Services provides staff interpreters. IPS also has contracted with Bowne (formerly Berlitz), an international language service, as a back-up for translations over the phone in more than 300 languages.
Benny says, initially, around 90 percent of requests were for on-site interpreters, but as caregivers have become more experienced with the service, the percentage of those requests has fallen to 75. "I think that doctors and nurses have discovered that most situations involve about a 10-minute conversation, and it's faster to achieve that over the phone," Benny says.
And although the call center is a break-even operation, it has saved the Institution money. "Last fiscal year, our operation cost about $130,000," Benny says, "but had we gone outside, it would have been close to $300,000."
The call center's success has inspired organizations such as the National Institutes of Health, Baltimore's Union Memorial Hospital and a North Carolina medical center to approach International Patient Services for advice on setting up similar programs. Benny says IPS plans to put a representative on the national Council for Interpretive Services to offer recommendations on interpretive standards, code of ethics, and mechanisms to help hospitals deal with limited English proficiency issues. "We aim to be the leader," he says, "in medical interpreting and cultural competency."
The call center number: 410-614-4685