Interpreter Services at BWH
Yilu Ma, MS, MA, CMI
Director, Interpreter Services Department
Interpreter Services has grown from a one-person show over 33 years ago to what is now one of the largest hospital-based interpreter services in Boston. In the late 1970s, there was one Spanish interpreter in the hospital, Pedro Sanchez, MD, presently of the Phyllis Jen Center. A medical student at that time, he was hired by coordinator Eileen Amy, RN, a staff nurse in the Department of Obstetrics and Gynecology. Interpreting service was sporadic at best, available only during the day and limited by the small staff’s availability and other responsibilities.
In the years that followed, the needs increased as the patient population became more diverse. The service expanded, adding another four to five Spanish interpreters. It began to formalize into a department in 1995 when my predecessor, Ileana Jimenez-Garcia, came on board. From then on, interpreters and languages were added, resources secured and allocated, and office spaces sprawled in different buildings and locations.
Today, the department has 23 part- and full-time staff interpreters and 70 per-diems, providing interpretation and translation service in over 40 languages, 24 hours per day, seven days per week. In addition to face-to-face interpreting, which accounts for over 75 percent of the total requests, telephonic interpreting was added and has seen an upsurge in the past few years. This latter modality, mostly via a vendor, rose to more than 1,300 calls a month and is capable of providing interpretation in over 200 languages. In 2013, the department provided over 68,000 interpretations, and we anticipate an increase this year. Unlike the ad hoc interpreters in the early days, interpreters are now members of the International Medical Interpreters Association and are certified by the National Board for Medical Interpreters.
To be more effective and expand language coverage to the increasingly distributed institution, Interpreter Services is also leveraging technology to provide remote interpreting via video conferencing. As of late 2012, over 10 service areas have installed video devices that are fully tested and ready to use. This innovative interpreting modality will eliminate interpreters’ travel time and patient/caregiver wait time, allowing our interpreters to provide remote interpretation from their offices. In addition, Interpreter Services has teamed up with Information Technology (IT) to develop a daily operation management system that enables us to develop quality benchmarks on patient wait time, interpretation time and statistics updating and compilation, to effectively deploy our resources in a timely fashion. Technology is transforming the service into a customer service-oriented and rapid response program. Since 2013, the department has been working with IT and a vendor to develop the web-based tracking system to improve transparency, inter- and intra-departmental communication and quality control. It’s currently being tested and will be in use soon.
Despite the incredible expansion of staff and resources, the core of the service has never changed. Interpreters are deeply committed to providing professional, competent and timely responsive interpretation services to patients with limited English proficiency and/or hearing impairment. As part of the care team, interpreters proudly play the crucial role of language conduit, bridging the linguistic gap between patients and providers. They also offer inter-cultural advice, clarify information, facilitate communication and advocate for patients. They work closely with doctors, physician assistants, nurses, social workers, occupational/physical therapists, dieticians and nutritionists, to name a few. They are in ambulatory clinics, inpatient bedsides, family meetings, consults, emergency rooms, operating rooms, at discharges and at registrations. Their contribution to patient care is omnipresent throughout the gamut of care, from diagnosis to treatment delivery, from establishing physician-patient rapport to facilitating conflict resolution. Our interpreters are invaluable. As they put it themselves: “We are the mouths of the patients and their families.