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Interpreter Services Program
University Of Massachusetts Medical Center, Worcester, MA

The University of Massachusetts Medical Center (UMMC) recognizes the special needs and concerns of individuals who are members of linguistic and culturally diverse groups, have limited English proficiency (LEP), or are deaf or hard of hearing (DHH). Accordingly, it is UMMC policy to maintain a system whereby interpreter services are available 24 hours a day, 7 days per week to help UMMC providers communicate with persons of LEP or persons who are DHH, at no cost to the patient. Provision of professional trained interpreter services is mandated by the Commonwealth of Massachusetts to ensure proper and complete medical assessment of the patient, informed consent, treatment plans, patient education, conflict resolution, and other patient rights.

Appointment/Requests System

The Interpreter Services Office (ISO) provides interpreters for all requests scheduled through a computerized appointment system, as well as for non-scheduled appointments to all UMMC areas including emergency room and inpatient areas. In addition to person to person encounters, the ISO provides telephone services to patients who need to contact their providers to request prescription refills, arrange for a sick visit, or have any other request pertaining to their follow up care. Also, patients can call when they need to reschedule or to cancel appointments. The ISO makes phone calls to all scheduled patients to remind them of their appointments.

Services Provided

Bilingual Interpretation:

Interpreter services offered by UMMC are provided by:

1. Trained and qualified bilingual medical interpreters (FTE's and per diem) employed by the UMMC Interpreter Services Office (ISO).
2. "on call" trained and qualified bilingual medical interpreters primarily to serve on holidays, weekends, and Monday through Friday between the hours of 7:00 PM and 8:00 AM.
3. Students, employees, and volunteers at UMMC who have been trained and/or are qualified to provide bilingual medical interpretation and do so on a voluntary basis.
4. AT&T Language Line, primarily to serve emergencies in languages not common to the UMMC population and to the Worcester community.

Sign Language Interpretation:

Certified sign language interpreters are requested to and provided by the Massachusetts Commission for the Deaf and Hard of Hearing. The ISO is open Monday through Friday from 8:00 AM to 5:00 PM.

Communication:

A key element in the proper functioning if this ISO communication system is the bilingual (Spanish/English) dispatcher (76% of all telephone requests come from Spanish-speaking callers). The coordinator assigns the appropriate interpreter to resolve telephone requests. Interpreters regularly call to update the dispatcher about the status of the patients and providers with whom they are working. The dispatcher considers carefully before paging an interpreters so as not to interrupt an interpreting session in progress. The dispatcher utilizes the pager system only to inform interpreters when patients have arrived at a time other than when scheduled, to inform them when a provider is ready for an interpreter, or to dispatch them for an Emergency Room or inpatient request. All telephone requests are documented. All triadic interactions between patients, providers, and interpreters are documented on an encounter form which is part of the patient's medical record. Vietnamese is the second most requested language at UMMC, the ISO has established a separate Vietnamese telephone line. This line is answered by a Vietnamese interpreter when in the office, or by a Vietnamese voice mail message that instructs the patient to leave their name and phone number so that the Vietnamese interpreter may return the call upon returning to the office.

Staffing:

Director:

Oversees services, training of interpreters and providers. Establishes educational programs for interpreters, providers, students, faculty, patients and community regarding interpreter services and cross cultural issues. The core of the education and training programs consists of intercultural communication methods, how to work with professional interpreters and triadic interview techniques. Coordinates and develops the curriculum for the bilingual medical interpreter training program. This program trains potential interpreters in the methods of medical interpreting, the triadic interview, issues of accuracy, ethics, medical terminology, hospital systems, and critical health care areas such as death and dying, domestic violence, etc. It includes an overview of how the ISO fits in with all areas of the UMMC. Organizes workshops for the continuing education of medical interpreters. Participates in groups relating to cross cultural communication issues and education both within UMMC and the community at large. Participates, at state and national levels, in the development of policies supporting qualified interpreter training and services and supports the establishment of nationally recognized medical interpreters' standards of practice.

Coordinator:

1. Responsible for the overall operation of the interpreter services office and is the primary liaison person between the ISO, all UMMC providers and LEP/DHH patients. Assists in the development and management of the ISO budget, managing and delegating the work load of the ISO, meeting with department heads, physicians and nurse managers to provide a supportive network for interpreter services, anticipating and coordinating interpreting requests, keeping up to date on and informing other key UMMC staff about legislation and regulations for providing interpreter services, organizing regular and impromptu staff meetings, providing orientation for new UMMC employees on how ISO functions within UMMC, and providing on the spot education for the UMMC community at large regarding cross cultural communication issues and how to work with bilingual and sign language interpreters.
2. Interprets for patients and providers.

Bilingual Coordinator of Orientation and Training:

1. Acts as and selects senior staff members to act as mentors for bilingual medical interpreter trainees in the specific policies and procedures of UMMC and the ISO. The trainees participate in a practicum where they shadow and then are observed by the coordinator or other designated senior interpreters interpreting in a variety of medical settings. All trainees are evaluated prior to being accepted as UMMC ISO per diem or on call interpreter.
2. Interprets for patients and providers.

Bilingual Scheduling Coordinator:

1. Oversees the daily entering and extracting of information relating to ISO from IDX (including arrivals/no shows, scheduling functions, and weekly reports) Trains qualified staff members in the operation and updating of the IDX system. Develops contracts for staff, per diem, and on call interpreters, personnel action forms, purchase requisitions, and processing all invoices.
2. Interpreters for patients and providers (limited).

Interpreter:

1. Responsible for interpreting accurately and completely what is being said by patients and providers.
2. Assists in the clarification of concepts when communication is compromised.
3. Informs providers of resources available to support meeting patients' needs.
4. Abides by the Massachusetts Medical Interpreters Association's Standards of Practice.
5. Assists with clerical duties when possible.

Dispatcher:
responsible for handling telephone communications from patients of all languages, clinics and providers, and for insuring proper documentation of all telephone communications.

Secretary:

1. assists with training and education program (developing lists of candidates, admission procedures, classroom needs, exams, certificates, etc. Assists with the clerical needs of the ISO, including typing memoranda, filing, budget preparation, etc. Processes interpreter's invoices.
2. Interprets for patients and providers (limited)

Performance Measurement:
The coordinator of the ISO reviews encounter forms, telephone request forms, and on call interpreters forms. Documents, reviews, investigates and responds to any concerns registered by UMMC staff or patients. Documents performance reviews of all ISO staff. All staff, per diem and on call interpreters are asked to fill out self-evaluation, which they discuss with the coordinator of orientation and training. An assessment of the level of expertise of each individual interpreter is made to determine in which areas of UMMC they are qualified to work.

The director, the ISO coordinator and the coordinator of orientation and training are available to discuss specific questions, problem areas, or areas that need improvement with all interpreters. The ISO has a well developed and utilized mentor system. This system allows the more experienced interpreters to share their knowledge, expertise and experiences with newly arrived and junior interpreters, which establishes and reinforces the open lines of communication throughout the ISO.

The ISO updates its policies and procedures in accordance with the changes that occur throughout the UMMC and within the ISO and in relation to the needs of the community in accessing the UMMC system.

Standardization And Ongoing Monitoring:
The ISO follows the Massachusetts Medical Interpreter Association's Standards of Practice. The Director, the coordinator of ISO, and the coordinator of orientation and training have developed strategic plans, which are in place and continuously revised, to improve interpreter skills, techniques and expertise, and provide on the spot education, information and support for all members of the ISO.

Cost Of Program:
$480,000 for approximately 40,000 interpreted encounters/year, including 16,000 face to face encounters.

For more information contact:
Martha Benitez, coordinator of Interpreter Services
(508) 856- 5793
E-mail:Martha.Benitez@Banyan.ummed.edu

Bilingual Interpreter Services

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