HIN Values and Principles

HIN members have the responsibility to facilitate clear and accurate communication between patients and providers in a multi-lingual, multi-cultural and multi-ethnic health care environment.

Why is interpretation important?

There are four compelling reasons for organizations and governments to spend the time and resources needed to provide high quality interpretation for patients who need it:

1. Research indicates that language barriers affect health outcomes for patients because of:
   
   • Misdiagnosis
   • Wrong referrals
   • Wrong treatment


2. Poor communication due to language barriers can leave providers and organizations open to legal challenges;


3. While interpretation services cost money, a lack of appropriate interpretation can lead to inefficient use of resources and increased cost to the health care system. This translates in:
   • Unnecessary medical tests
   • Repeat appointments, poor compliance with follow-ups, no shows


4. Language barriers may result in failure to protect patient confidentiality, to obtain consent, or properly comprehend the nature of the ailment.

The Role of the Interpreter

Members of the HIN define the role of health care interpreter as the person who, "delivers, as faithfully as possible, messages transmitted between the provider and the patient who do not share a common language" (based on the Roles and Responsibilities of an Interpreter Associated with the Violence Against Women Prevention Initiatives, Ontario Ministry of Citizenship and Immigration 2006).

Standards for Interpreters

The use of untrained interpreters poses risks for both the patient and the provider. There should be a set of skills and knowledge requirements for those providing interpretation in health care settings.

Basic components that set the groundwork for quality interpretation:

1. An excellent knowledge of the passive and active working languages.


2. Knowledge and adherence to the Code of Conduct for interpreters (Accuracy and completeness, confidentiality, impartiality and conflict of interest, limitation of practice and accountability).


3. Sufficient knowledge of the subject.


4. Knowledge and mastery of interpretation practices, techniques, skills and strategies including but not limited to problem solving, decision making, note taking, sight translation, short term memory, active listening, turn taking, terminology research, vocabulary acquisition /preparation of glossaries, use of silence and space, concept of time, awareness of non-verbal communication.


5. Professional Development.

HIN Recommendations

• All people who need interpretation should be guaranteed this right through legislation with clear guidelines for enforcement and accountability.


• The Federal Government recognizes the importance of interpretation in order to ensure the principle of access as defined in the Canada Health Act and explore ways to ensure this principle is upheld by provincial governments.


• The Ontario Hospital Association and the bodies that regulate health care professionals should play a leadership role in advocating that the Provincial Government should designate appropriate funding to those responsible for the delivery of health care to be used specifically for interpretation services for immigrants and refugees who have a limited proficiency in either official language, deaf people, First Nations people, and French speakers (where French language services are not available).


• The funds provided by the Ministry of Health to health care organizations should be related to the size of the organization and the diversity of the community served by the organization.


• Health care organizations should set aside funds for interpretation services and create a distinct budget for these services.


• Members of the HIN define the role of health care interpreter as the person who ”Delivers, as faithfully as possible, messages transmitted between the provider and the patient who do not share a common language” (HIN Manual)


• There has to be common standards for health care interpreters across Ontario to ensure that the public will receive interpretation services of a consistent quality in the health care system.


• Standards should be monitored through a common test or tool. Any tools should test to ensure the following:
  • Language proficiency in both languages being used in interpretation;
  • Knowledge of health care terminology;
  • Knowledge and adherence to the Code of Conduct for interpreters.


• The HIN pursues funds to further review and adapt existing tools so they can be adopted as the screening mechanism for interpreters used by all HIN members.


• The HIN works together with the Ministry of Education and Training in the development and implementation of interpreter’s training.



All interpreters in the health care setting should be appropriately trained and possess the necessary skills.

• When resources and logistics permit, hospitals and health care organizations should seek to work with interpreters whose skills have been assessed and who have been trained based on the above described standards for interpreters.


• That hospitals and health care organizations set aside specific budgets for interpretation programs.