[Brian Pacheco]

Yes, Executive Order 13166 applies in the state of Massachusetts, helping to improve access to services for persons with limited English Proficiency (LEP). Since nearly all hospitals and most community health centers in Massachusetts receive federal funding, Executive Order 13166 applies directly to them. Massachusetts also has its own state-level laws that reinforce federal requirements. Massachusetts General Law, Chapter 111, Section 25J, requires acute-care hospitals and clinics to provide interpreter services for non-English-speaking patients. DPH (The department of public health) also monitors Massachusetts compliance with this making sure it is implemented and can/will take action if hospitals fail to provide necessary requirements of the law.

I feel that the present day legislation is there, but could quickly fall short. I’ve read that enforcement is limited because many hospitals are unaware of, or don’t comply with federal requirements. Funding is limited, smaller rural hospitals may struggle to be able to afford/employ Professional interpreters and may just rely on family or no one at all. Overall quality control is lacking as there are no universal national standards for interpreter certification across all languages or settings. The lack of professional interpreters sounds very scary, I feel that it is very unfair to all patients who cannot communicate or express themselves in the English language. The lack of resources would highly impact that patient in so many ways potentially causing many problems due to the lack of communication services available. I feel like the legislation is there, but could definitely use improvements.

[Brian Pacheco]

Nicely explained

[Brian Pacheco]

Great explanation!

[Brian Pacheco]

Great job at explaining Shannelys!

[Brian Pacheco]

Great job at explaining Emily

[Brian Pacheco]

Makes sense quickly stating that to the patient in an emergent situation.

[Brian Pacheco]

I agree, it will definitely help knowing why we are there!

[Brian Pacheco]

Hi Alejandra, Yes I agree! Doing a pre-session will definitely make things go smoother!

• This reply was modified 1 month, 1 week ago by Brian Pacheco.

[Brian Pacheco]

1.) Message Conveyor or Conduit- “In the message converter role interpreters listen to both speakers, observe body language, and convert the meaning of all messages from one language to another, without unnecessary additions, deletions, or changes in meaning.” (Interpreter Associates, chapter 2, pg 6)
* It is important to listen to all information being given from both patient and provider and also watch non verbal communication/cues.

2.) Message Clarifier- “When we talk with patients, we need to take into consideration their register so as to communicate with them efficiently and effectively”.(Interpreter Associates, chapter 2, pg 8)
* We as interpreters need to be able to recognize different levels of understanding.This could be due to a number of things including educational or cultural background. This could also include words not being understood by both the patient or provider, it is important to allow both the patient and provider the opportunity to communicate without intervening and then if needed to make sure the information is interpreted correctly without adding or removing information.

3.) Cultural Broker/Clarifier- “Cultural beliefs about health and illness around the world vary significantly from the biomedical perspective”. (Interpreter Associates, chapter 2, pg 8)
* Cultural backgrounds can/will definitely determine how some patients view certain parts of a visit including medications and treatments. Body language and non verbal actions may also differ.

4.) Patient Advocate- “Limited English speakers can face major cultural and linguistic barriers in accessing and utilizing services at all levels of the healthcare system”. (Interpreter Associates, chapter 2, pg 10)
* prior to intervening as a patient advocate it is important to consider many things including options that may be available to the patient as well as if patient is in agreement with the changes.

[Brian Pacheco]

I feel like there would be multiple benefits of doing a pre-session with myself, the patient and the provider. I feel like it sets clear expectations right from the start explaining what my role is/will be as well as provide all involved with a clear picture of what to expect. Benefits may include eliminating fear, worry of information presented/needed to be spoken about by the patient as well as eliminate any questions of my role with the provider. It provides the information prior to the visit leaving room for questions to be asked ahead of time to clear up any unclear thoughts or ideas of what the visit may be going to entail.

The possible scenarios that could be avoided could include eliminating confusion about who I am and what my role is/what I am there to do.It could possibly eliminate the patient thinking that i am there to speak for them within the given information of the situation (more as a friend or family member who knows them personally) or take their side on what needs to be said. It could also prevent both the provider and the patient from talking too long or giving too much information all at once without pausing not allowing me enough time to correctly interpret what is being said.

I feel like it would be best to always do a pre-session when/if allowed. Letting the provider know who I am and what my role is, I feel would be preferred and ideal. However, I also believe that in an emergent situation, we should be able to accurately and professionally interpret the information needed without having had a pre-session.

[Brian Pacheco]

Hi Judith! Nice to “meet you”. Columbia is definitely on our radar of places to visit. I have friends that live in Cali and Bogota that I would love to see.

[Brian Pacheco]

Hi Emily, Yes, I also love being helpful when it comes to getting rid of the communication barriers!

[Brian Pacheco]

Totally agree with you!

[Brian Pacheco]

Yes, I agree! They definitely each face their own challenges!

[Brian Pacheco]

hmmmm, I would say you need to closely pay attention to body languages, cues and tone of voice while interpreting the ‘I’m fine”. Depending upon the issue, the atmosphere or the situation you are in, I would think that that may give me a little more insight on what they are feeling or trying to say. For instance, going back to what you said about the doctor typing looking down at the computer, lets say you have a homeless person who hasn’t eaten in days. They answer “I’m fine” but at the same time it sounds sad and weak, also I can hear their stomach rumbling, and see them shaking. I feel that knowing they are homeless and haven’t ate in days would give me more info to the fact that they actually may be hungry. Or like when one of the kids would fall off the bike and say “i’m fine” because they wanted to continue with their friends but really they weren’t fine. I’m probably going way off here lol but you get it….have compassion.

• This reply was modified 1 month, 2 weeks ago by Brian Pacheco.
• This reply was modified 1 month, 2 weeks ago by Brian Pacheco.

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