Keeping Up With Language Interpretation Demand

Aug 15, 2019

In Nevada, there's a growing need for medical interpretation and translation services from English to Spanish in local hospitals and clinics. So, how are we keeping up? KUNR’s Jazmin Orozco-Rodriguez reports.

Imagine being a young child and interpreting for your mom or dad at their doctor’s appointment. Hearing confusing medical terms that are hard to translate, and perhaps having a limited vocabulary, make this a uniquely challenging experience, not to mention responsibility, for a child.

Jerry Trigueros is the director of patient services at Northern Nevada Hopes. He says the clinic receives diverse language requests for interpretation services, but Spanish is the most requested language.
Credit Jazmin Orozco-Rodriguez

Jerry Trigueros remembers stepping in to interpret for his mom when he was younger because his mom struggled to communicate with her doctor.

“6 years old I was when my mom, she had a migraine for about two to three days, and my dad was working two jobs and my mom was like, 'You’re gonna go with me and let them know what I’m feeling,” said Trigueros.

“Emotionally, it’s one of those things; you want to help your family member. But I don’t think we realize, sometimes, how much pressure we put on the kids. Messaging can go wrong in a matter of one or two words and, next thing you know, they’re not getting the full picture of what's going on with the patient,” he said.

For Trigueros, this is an important issue as he is the Director of Patient Services at Northern Nevada Hopes, a non-profit medical clinic in downtown Reno.

28 percent of Northern Nevada Hopes’ patients in the past year were Spanish-speaking, making it the most-requested language at the clinic. To meet this demand, Northern Nevada Hopes has established a diverse workforce, having about 65 Spanish-English bilingual employees, ranging from front desk staff to medical assistants to behavioral health providers, so patients can feel comfortable at any point in their visit.

Credit Lauren Bain

Nearby, Renown Health has 40 in-person interpreters and the majority of St. Mary’s interpretations happen via a telephone system. Down in South Lake Tahoe, Barton Memorial Hospital actually has an entire department dedicated solely to language access services.

Barton has 16 medical interpreters on staff and is working to double that number. Twice a week in the evenings, Tracy Young teaches a class for employees who are training to become nationally certified.

Young explains that for English speakers visiting the hospital, there is a complete understanding of the posters and signs on the walls, of what’s being said in the hallways, and what your provider is telling you.

“And when you have, let’s just say, a Spanish speaker, they are in a new world, nothing is making sense to them, so if you have bilingual signs on the wall, it lowers their anxiety [and] they know more of what’s going on. If you provide an interpreter, that interpreter will interpret everything, so they are truly getting equal language access; they are hearing and understanding everything that is being said around them,” said Young.

Aside from in-person interpreters, Barton Memorial Hospital uses a technology interpretation service, LanguageLine InSight Video Interpreting, that provides interpretation for nearly 60 different languages via video.
Credit Jazmin Orozco-Rodriguez

A medical interpreter’s job, according to Young, is to facilitate the relationship and connection between a patient and their provider, establishing trust and understanding. Many hospitals rely on video and telephone interpretation technologies, but she says in-person services are generally better.

Young says these services provide greater patient care, and not only that, they are actually required by federal law.

The Civil Rights Act of 1964 established that federally-funded institutions, like hospitals, cannot discriminate based on national origin, providing the basis for modern language access laws.

Melody Schiaffino is an assistant professor in public health at San Diego State University and studies disparities in how healthcare is delivered. In 2016, she led a study that found that nearly one-third of U.S. hospitals fail to offer interpreters to patients who need them.

“I always thought if there was a law, everybody followed it. It turns out that’s not necessarily the case,” said Schiaffino.

Schiaffino’s study discovered that many hospitals that offered language access services were located in areas that did not necessarily have a high level of language assistance needs.

“We saw that there was a significant mismatch to who was offering services and where they were needed. Again, the need was based on whether there was a significant population with language barriers, so there are definitely places that have people with language needs and no hospitals that offer them,” said Schiaffino.

She also said that failing to provide language access services could have economic consequences for hospitals because a limited English-speaking patient can be subjected to more invasive diagnostic procedures due to communication challenges, ultimately increasing the cost of care.

This story was produced in partnership with Noticiero Móvil, a bilingual multimedia outlet run by the Reynolds School of Journalism.