Not lost in translation: Hospital interpreters open lines of communication

The name of Dr. Abdul Mazin has been corrected.

From broken bones to burns, rashes, accidents, coughs, colds and fevers, kids of all ages, shapes and sizes cause parents endless worry when health is in question.

"A trip to the hospital or an outpatient specialty clinic can be a scary experience for any parent with a sick or injured child," says Paola Velasquez, manager of communication and translation services at Advocate Sherman Hospital Elgin. "Imagine what it's like if you don't speak English and aren't certain you'll be able to understand the doctors and nurses."

Velasquez's concerns are on target according to numerous studies which have found that if language barriers between doctor and patient are not overcome, misdiagnosis and inappropriate treatment are among negative consequences that are more likely to occur.

Across the country, hospital interpreters help bridge the communication gap for an estimated 24 million Americans who do not speak enough English to communicate effectively with their health care provider. In fact, federal law requires hospitals that receive Medicare, Medicaid and other government funds to provide free interpretation services.

"Problems associated with poor communication between doctor and patient are compounded when the patient is a child," says Velasquez, who notes that 34 percent of the Kane County area population is Hispanic and calls for Spanish interpretation are common.

"It can be a challenge with the many dialects within Spanish-speaking countries or ways of communicating specific concepts," she says.

Many hospitals, like Advocate Sherman Hospital, offer in-house Spanish language interpreting, with medical interpreters carrying phones or pagers and being available around the clock to assist families with the admission process, pre-op and prenatal visits, doctor-patient communication, ER and specialty clinic visits.

According to Velasquez, a special language line service can be accessed to help with more than 300 other languages. A new and developing wireless video interpretation service using Skype or FaceTime technology also now allows some patients to opt for the gender of the interpreter and visually see their interpreter.

"This video capability is especially important when time is of the essence and a patient is deaf or hard of hearing and relies on sign language or lip reading," says Velasquez, who notes it may take a dedicated sign language interpreter valuable minutes to arrive on the scene, even in an emergency situation.

"It's also very helpful in challenging interpretation situations when, for example, an individual of Hispanic descent says the word for foot and is actually pointing to a calf, thigh or another part of their leg. The words are interchangeable and having that visual is good."

While ad hoc interpreters, including family members, occasionally are tapped to interpret for children, experts say family dynamics and even the psychological health of children are at risk when they are asked to translate for the adults.

"At Advocate, we don't use family members and child interpreters," says Velasquez, who notes the experience can be traumatic for a child who may not understand the technical issues or have the educational background to understand what is being explained.

"Lots can be lost in translation. The best care comes when doctors and nurses can speak directly with the patient to understand concerns, symptoms, and needs."

In addition to initial access challenges, studies show a lack of English fluency among a young patient's parents often results in longer hospital stays for kids.

A nine-year study of patients in Children's Mercy Hospitals and clinics in Kansas City found that children whose parents have limited English proficiency spend more time in the hospital than those whose parents are fluent in English.

The retrospective study found that pediatric inpatients spend an average of 60 percent longer in the hospital when their parents don't speak English well.

"Medical interpreters can help the health care team develop a better understanding of the patient's cultural background and how it may influence health care decisions," says Gabriela Osorio, a certified translator at Alexian Brothers Women and Children's Hospital in Hoffman Estates.

Osorio says it isn't unusual for immigrants to attempt to heal problems with their own folk treatments before turning to Western medicine and interpreters can be especially helpful to the medical team and bridge the cultural divide if they are able to understand remedies that may have been used before the child was brought to the hospital.

"Parents of Hispanic ancestry often have a difficult time understanding the concept of developmental delay," says Osorio, who shares a similar background and who works in the Center for Pediatric Brain at Alexian Brothers Women & Children's Hospital. "They often need clarification to best understand delays or the different aspects and levels of autism, something for which little information is available in many parts of Latin America."

Velasquez concurs and recalls a time when a child who had suffered a minor burn was brought to the Advocate Sherman emergency room covered in potato peels.

"Mom had put the potato skins on the burn to help draw out the sting, a Central American natural home remedy," says Velasquez, who adds that the emergency room doctors had not seen this before and were curious about the potato skins.

Experts say this form of social integration and cultural understanding increases the chances that patients, especially children, will correctly follow treatments recommended by health care providers.

  Dr. Abdul Mazin checks out Reily, 1, being held by his dad, Raul Rocha, at Alexian Brothers Women and Children's Hospital. Reily's parents were able to communicate with the doctor with the help of an on-staff Spanish interpreter who is a medical assistant. George LeClaire/
  Gabriela Osorio, a medical assistant and Spanish interpreter at Alexian Brothers Women and Children's Hospital, talks with Dr. Abdul Mazin as he works with Ereida Aguilar and Raul Rocha of Lombard about their 1-year-old son, Reily, left; in the middle is their daughter Evelyn, 8. George LeClaire/
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