In my previous posting, I mentioned how one of the new Standards for Patient-Centered Communication by The Joint Commission will expect hospitals across the nation to define and confirm staff qualifications in what pertains to individuals’ language proficiency. Within this expectation, interpreters in general, contract or staff, as well as anyone called to facilitate any communication between patients and medical providers, will have to demonstrate their language competency via an assessment.

Typically, both staff and contract interpreters are assessed on their language of expertise before working as interpreters. These are best case scenarios. Interestingly, bilingual staff, who when called to interpret, perform the same job, yet are rarely tested on their ability to offer quality interpreting services.

Taking the above into consideration, and come July 2012, it would not be surprising if, out of the comprehensive list of markers set in place by The Joint Commission, the language competency requirement becomes one of the surveyors’ main focal points when determining hospitals’ compliance to the new standards. This concept is not really farfetched if we keep in mind that these new guidelines are Patient-Centered Communication Standards. Theoretically speaking, in today’s clinical settings, every encounter with a non-English speaking person is handled either through a staff interpreter, a contract interpreter, bilingual staff, or in the worst cases, via family members. But, we’ve all heard it, and according to JACHO, research literature demonstrates it, “relying on untrained individuals as interpreters is more likely to result in misinterpretation , lower quality of care, or even contribute to an adverse event*. Untrained individuals—including family members, friends, other patients, or untrained bilingual staff—should not be used to provide language access services during medical encounters.” [HR.01.02.01: page 58, Explanation of Revision]

Okay, so this part of the message is clear, and as we know, effective July 2012, only those individuals with documented language qualifications should assist the LEP in communicating with their healthcare providers. The expectation, however, goes beyond the task of testing and documenting interpreters’ and bilingual personnel’s linguistic skills. In fact, as part of the explanatory note under the specific Element of Performance for requirement HR.01.02.01, it is clearly stated that these qualifications for language interpreters and translators may be met, in addition to language proficiency assessments, through education, training, and experience. In other words, the commitment sought for by JACHO calls for three more pieces, which like in a puzzle, are key to get the full picture. It is precisely in this process of capturing this mandatory “full picture” that hospitals need to consider the exploration of more effective ways to accomplish their goals faster and smarter.

*An event that causes an injury to a patient as the result of a medical intervention rather than the underlying medical condition. It represents an unintentional harm to a patient arising from any aspect of healthcare management. [AAOS]

[on to part 2]