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Found in Translation

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It may be low-tech, but it works. That's the consensus on a telephone-based translation service that San Diego-based Scripps Health system has used for seven years. The telephonic system has helped Scripps tackle a growing communication problem: patients with limited English skills seeking treatment at the system's five Southern California hospitals. During 2006, Scripps used the system to translate clinical dialogues into nearly 70 languages, from well-known tongues such as Spanish to more exotic ones like Punjabi, says Debra Lambert, hospital facilitator and chairperson of a diversity team that tracks the health system's "cultural competence" with its growing audience of foreign patients.Using the system from CyraCom International is simple, says John Boucher, R.N., a patient care manager in the cardiac care unit at Scripps Memorial Hospital La Jolla. The bright blue CyraCom phones feature two receivers: one for the clinician, the other for the patient. To reach a translator, hospital staff members enter a speed-dial code that connects them to CyraCom's central switchboard. Translators fluent in some 150 languages are available-usually within two minutes. The vendor vouches for the translators' fluency in medical terminology. The fee is based on usage, but averages about $20 per call, according to a CyraCom spokesperson. For Boucher, the system is a major improvement over using family members as translators. For one thing, nonclinical people may do a poor job of translating medical vocabulary, he says. In addition, family members may serve as biased translators, Lambert adds. "If the patient is consenting to have a heart procedure, the family member may not want it, or is fearful," Lambert says. "The family member could make something up and we would not know the difference."Scripps' five hospitals average roughly 700 total calls each month, with 60 percent of them in Spanish, Lambert says. Usage reports help the hospital understand its market, she adds. For example, Somalian and Chaldean are among the top emerging languages spoken by patients.To ensure access, Scripps stocks scores of the phones in highly visible bags. Once patients use the service, a phone is kept in their room throughout their visit. "We used to unplug it and take it out, but that was cumbersome," Lambert says. "So we doubled the number of phones." For Boucher, picking up the blue phone beats tracking down a bilingual staff member or leaning on a relative. "If we couldn't find a translator, we would draw a picture and point," he says. "It was extremely primitive compared to the phone." -Gary Baldwin