1.2.12 Translation service Estimated reading: 12 minutes 654 views Authors 1 Aim and purpose Rules for communicating with foreign-language patients. Commissioning and utilisation of foreign-language services beyond the patient's reference. Foreign-language patients have the same rights to information and education as German-speaking patients. This also includes their need for dialogue with the diagnosing and treating staff. The cases in which an interpreter/translator must be called in must be regulated. The process of ordering, scheduling, execution, documentation and financing must be regulated. The most important patient information should be available in translation for the hospital's widely spoken foreign languages. The patient's reading ability must be taken into account. 1.1 Ensuring communication To ensure communication between hospital staff and foreign-language patients, professionally qualified interpreters must be called in in the following cases:- Declarations of consent for treatments and therapies- Surgery information and consent- Anaesthesia information and consentSimilarly, in problematic cases, professionally qualified interpreters should also be called in, e.g. for the following communication situations:- Medical history- Diagnostic messages- Therapy suggestions- Dismissal interviews 1.2 Legal justification The burden of proof for the effectiveness of the information provided and the patient's consent to a surgical procedure lies with the doctor. In the case of a foreign-language patient, the doctor must consult a linguist for the informed consent discussion if it is not immediately certain that the patient has a good enough command of German to understand the doctor's explanations. It must be ensured that misunderstandings are ruled out. The doctor also bears the burden of proof in this respect. The person called in must therefore be demonstrably capable of interpreting and be able to use this according to the state of the art.As a rule, the latter does not apply to hospital staff, and even less so to relatives or persons accompanying the patient. The involvement of this group of people can therefore not be invoked as evidence.In less problematic situations, communication can be ensured by bilingual hospital staff. The involvement of relatives should be avoided, as this places a burden on both the relatives and the patient. Otherwise, neutral language mediation is not guaranteed. 1.3 Transcultural justification Culturally specific taboo areas are touched upon in clinical anamnesis, diagnostics and therapy, which are weighted very differently by patients and treating staff. Without specific knowledge of these behaviours and idiosyncrasies, it is not possible to take a complete medical history. On the other hand, it is necessary for foreign-language patients not only to have the staff's instructions interpreted, but also to understand them.Both mean that people who interpret doctor-patient communication must not only be interpreters, but also mediators between two cultural systems. As a rule, only native-speaker interpreters will be able to strike the right note and address taboo areas at the same time, thanks to their in-depth knowledge of the concepts of body and illness and the traditions of their culture.The use of an interpreter also ensures quality assurance in intercultural communication. This gives the patient the feeling of being well looked after. 2 Scope of application Interpreting and translation services can be requested for any official purpose, although this does not have to be fulfilled in the HOSPITAL. The application for a service is decided by a defined group of persons (cf. Section 3.1.2). 3 Description of the procedure 3.1 Request procedure 3.1.1 Contractor The hospital management must appoint a service provider (translation service for short) for the provision of interpreting and translation services. They are responsible for commissioning the qualified interpreters. Other interpreting and translation services cannot be invoiced. 3.1.2 Authorised personnel The assignment of an interpreter or translator is ordered by a doctor, the management or shift management (nursing) of a ward or the management of a unit. The directors of the clinics, departments and institutes are at liberty to extend or restrict the group of staff authorised to request interpreters or translators according to their specific needs. 3.2 Interpreting 3.2.1 Interpreting form In order to be able to arrange an interpreting assignment, the translation service's placement centre requires the data specified on the interpreting form (see Section 9, Appendix 3). This data must be provided prior to the assignment; the date or time of the meeting must be specified in advance.ßß=== 3.2.2 Time of assignment === It is recommended to request an interpreting assignment immediately after becoming aware of the need, if possible no later than 24 hours before the planned meeting.The business hours of the switchboard and the telephone number of the hotline as well as the availability outside business hours are listed in Section 9, Annex 6. Please note that orders placed outside of business hours will not be processed until the following working day. In the event of urgent interpreting requirements outside the working hours of the translation service, interpreters may be commissioned directly by the hospital staff following prior agreement with the interpreter. The documentation obligation remains in place in accordance with Section 5.1. 3.2.3 Languages offered The available languages and the countries in which they are spoken are attached as Annex 2 in Section 9. It should be noted that interpreters for less common languages may not be available for every day. 3.2.4 Form of commissioning The contractor is usually commissioned verbally by telephone. Alternatively, the interpreting form (Annex 3) can be completed and sent by fax. Orders can also be sent by e-mail. In this case, a printout must be attached to the patient files for documentation purposes. Telephone and fax numbers and the contractor's e-mail address can be found in Appendix 6.An order is deemed to have been accepted when the translation service has confirmed the deadline in writing, usually by fax. 3.2.5 Cancellation of an order If an assignment has to be cancelled, this must be done immediately. Cancellations must be made in writing by fax using the form Interpreting (Annex 3). 3.2.6 Duty of confidentiality All interpreters are bound to confidentiality. Patients must be informed of this by the interpreter before the start of the consultation (Appendix 8). 3.2.7 Data protection The patient must provide a written declaration of consent in German and the respective national language for the use of an interpreter. This should be obtained by the hospital staff at the latest before the start of the consultation. The form in Appendix 8 should be used for this purpose. If a patient is unable to read or understand the consent form, it will be read out and explained by the interpreter before the consultation begins.It must be ensured that only the patient-related data that is really necessary for a successful dialogue is given to the translation service. However, the interpreter must also be given the opportunity to prepare for the specific terminology of a speciality or symptoms. 3.2.8 Confirmation of use When the interpreter arrives at the agreed location at the specified time, a member of hospital staff confirms the interpreter's arrival on the interpreter's order form. At the end of the assignment, the interpreter receives confirmation from the authorised staff that the service has been provided.In order to avoid confusion when assigning patients or to be able to correct the spelling of the name transmitted verbally, the confirmed interpreting order is provided with an ISM label; if not available, the patient's name must be legibly stated in block letters on the interpreting order. 3.2.9 Waiting time of the interpreter If the conversation with the patient does not take place at the agreed time but is delayed, the interpreter's waiting time counts as the time of the assignment. In order to avoid unnecessary costs, the times specified by the hospital staff for the interview must be adhered to. 3.2.10 Invoicing and processing of invoices, budget utilisation Invoices with corresponding proof of services are issued monthly to the purchasing department and are allocated from there to the ordering or patient-managing clinics, departments or institutes. 3.3 Procedure of an interpreted conversation 3.3.1 Preliminary discussion with the interpreter In a brief preliminary discussion, the interpreter should be informed about the patient's situation and the objective of the conversation. At this point, arrangements should be made regarding the type of interpreting (consecutive or simultaneous) or the interpreter's "stop sign". 3.3.2 Introduction of the interpreter by hospital staff The interpreter should not meet the patient before the conversation begins. Experience has shown that in such cases, patients provide information that the interpreter does not repeat in the subsequent doctor-patient communication and assumes that they know it.The interpreter is introduced to the patient; the patient's consent to the use of an interpreter must be obtained and documented at this point at the latest (Annex 8). 3.3.3 Interpreted doctor-patient dialogue As usual, the conversation is addressed directly to the patient, not to the interpreter. The intervention of relatives of the patient who speak more or less good German is a hindrance and should be avoided. If relatives are involved in the conversation in German, the interpreter must interpret these sections of the conversation for the patient. 3.3.4 Arrangement of a follow-up appointment with patient and interpreter, documentation In order to simplify the procedure for requesting a follow-up appointment, a follow-up appointment is arranged together with the interpreter and the patient if required. For coordination with the placement centre, it is sufficient to indicate the follow-up appointment on the interpreter's form. The interpreter is responsible for forwarding the appointment. 3.3.5 Joint farewell to the patient and follow-up discussion Hospital staff and interpreter say goodbye to the patient together. This is to ensure that all necessary information is given by the hospital staff and does not have to be supplemented or explained by the interpreter afterwards.Time should be planned for a brief follow-up of the conversation with the interpreter. If necessary, the interpreter can provide helpful explanations or observations that were not appropriate to share during the interview. 3.4 Translations 3.4.1 Commissioning The patient must provide written consent in German and the respective national language for the translation of their documents. This must be documented by the hospital staff before a translation is commissioned. The form (Appendix 8) must be used for this purpose.Translation orders are submitted directly to the translation service. The document is sent by e-mail if possible, alternatively by post and only in urgent cases by fax. Information should be obtained in advance as to whether the foreign language is offered. 3.4.2 Translations form The information required by the client for a translation must be sent to the translation service with the document in accordance with the translation form (Appendix 4). The translation service shall confirm receipt and inform the client in writing of the time required for completion and the cost estimate.Only 1:1 translations are possible; summaries of text excerpts are not permitted. 3.4.3 Cancellation of a translation order If the date for completion and/or the cost estimate is not agreed, the translation order shall be deemed cancelled free of charge. If a cancellation is made at a later date, fees (Annex 7.3) will be charged. 3.4.4 Delivery of the translation The translation is delivered by the translation service by e-mail and only in exceptional cases by post or fax.It must be checked beforehand whether the character sets of foreign languages can be printed on the hospital printers. 3.4.5 Languages offered The languages available are not identical to the languages specified for interpreting orders. Whether a translation is possible must first be enquired about when placing the order, but can only be decided by the translation service once the document has been submitted. 3.5 Telephone interpreting In order to obtain brief information from patients or to pass on information to them (with the exception of the communication content listed in Section 1.1), interpreting by telephone can be requested. The main purpose of using a telephone interpreter is to ensure, simplify and speed up the flow of information in doctor-patient communication in outpatient clinics and polyclinics. 3.5.1 Required technology The technical prerequisite is a telephone with a loudspeaker or monitoring device.The establishment of this form of telephone interpreting service and the modalities of utilisation have yet to be determined. 4 Responsibility, qualification 4.1 Qualification of interpreters The interpreters to be commissioned either have a certificate from the University of Hamburg or have already been sworn in at court or have diplomas or state-recognised qualifications. All interpreters are trained in medical-social interpreting. As a rule, they are native speaker interpreters.The services are provided in accordance with the ethical guidelines for interpreting and translation.If hospital employees are included in this group of interpreters and are placed, the fee conditions of the translation service also apply to these persons. However, the interpreting services must be provided outside office hours. Interpreting services provided during working hours cannot be invoiced. An application must be made for authorisation for ancillary services. These interpreters can identify themselves with an interpreter's pass from the translation service and wear this pass visibly on their clothing in the hospital.Interpreters may not be entrusted with medical or nursing tasks or provide assistance in these areas. 5 Documentation 5.1 Interpreting assignments The original of a patient's consent to the involvement of an interpreter (Annex 8) is added to the patient file. A copy is attached to the consultation notes. The use of an interpreter is documented in the patient file, on consultation notes or other documents by the staff responsible for conducting the consultation as a note "with interpreter".In the case of documents as per Section 1.1, documentation shall be provided by the interpreter's signature. The service provided shall be documented by authorised personnel (Section 3.1.2) on the order submitted by entering the time of arrival of the interpreter and the time at the end of the service.If possible, a patient sticker is affixed to the order. \\The interpreter submits the confirmed service to the contractor. 5.2 Translations Translations are documented as follows: - By making a copy of the document to be kept at the hospital- Through the copy of the written order- By confirming the service provided to the purchasing department 6 Notes and comments If hospital staff are called in to interpret after consideration of Clause 1.2, these staff are prohibited from accepting a fee or gifts from patients for the service provided. 7 Applicable documents Contract of the hospital with the translation serviceContract with the interpretersBDÜ Ethics GuidelineVA "Information and consent before medical interventions"Basic Law, Article 3 8 Terms Interpreting Oral communication between people of different languages Translate Reproduce a text in writing in another languageSource language Language from which interpretation or translation is providedTarget language Language to be taught to a non-native speakerConsecutive interpreting Interpreting at different times (delayed)Simultaneous interpreting Simultaneous interpreting during the ongoing conversation 9 Systems Appendix 1: Mediation procedure, flow chartAppendix 2: Languages offeredAppendix 3: Interpreting formAppendix 4: Translation formAppendix 5: Telephone interpreting formAppendix 6: Translation service, communication dataAnnex 7: Billing basisAppendix 8: Patient's declaration of consent to the use of an interpreter Appendix 9: Survey on language skillsDownload Appendix 10: GQMG work aid Interpreting for patientsDownload 1.2 Patient orientation - Previous 1.2.11 Involvement of relatives Next - 1.2 Patient orientation 1.2.13 Protection of patient property