Translation Services in the Hospital Setting

Since July 2016, Section 1557 of Obama Care also known as the Affordable Care Act has been in place to provide translation services for a Limited English Proficient (LEP) person as well as those with a hearing disability in the healthcare setting. An overview of the act, video translation machines and in-person translators, fines imposed by the federal government for being non-compliant, and some scenarios to prove just how important it is in today’s hectic world of nursing are discussed. Nurses Announcements Archive

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When accidents happen or unexpected hospitalizations occur, not everyone is on equal footing. The federal government under the Affordable Care Act (ACA) has passed Section 1557 to ensure that everyone in the United States is able to have access to healthcare information on a timely basis.1 Just think about it? You or your loved one is admitted to the hospital after a car accident or comes through the emergency room for chest pain or an excruciating headache. As nurses, most of us have had patients who speak a language none of us can translate or relied on sign language.

SCENARIOS REQUIRING TRANSLATION

Most of us have been in a hospital setting unexpectedly. Just imagine if speaking English was a problem. What if the person is deaf or hard of hearing? What would that be like in a life or death situation? This scenario would be for a Limited English Proficient (LEP) person as well as those with a hearing disability.1 In the past, people would rely on a family member, a fellow patient, visitor or a non-clinically trained hospital staff member (think housekeeping) to convey the information. The result many times was biased or inaccurate information about life and death decisions or even ordinary knowledge the patient needed to survive in the hospital setting.2

A HISTORY LESSON

The history surrounding translation services is lengthy. Title VI in 1964, referred to national origin as an indicator for this necessary part of health care.3 That was under President Lyndon Johnson's term. Years later President Clinton issued Executive Order 13166 to compel those facilities receiving Medicare or Medicaid funding to provide "meaningful language access."3 Otherwise, money earmarked for hospital programs would be for forfeited.

HARD FACTS

In so far as the hard of hearing or deaf population, there are 56.7 or 19 percent of the population with a disability.3 This means that about 56.7 million Americans are disabled. This includes all disabilities, not just the hearing impaired. If you want to drill down deeper, we find that 13 percent or 30 million people which translates to one in eight individuals have some type of hearing loss.4 Therefore, translation services are more than necessary. If you project that figure to mean that out of the eight patients that you see in one or two days, one of them will have a hearing loss. That becomes a staggering figure.

SECTION 1557

How will you provide services to inform them about their medication, x-rays, or IVs if they cannot understand you? This is where a video translation machine or in person translator becomes a necessity. Since July 2016, Section 1557 of the Affordable Care Act has been in effect to safeguard the rights of these individuals.2 This covers all providers that receive federal monies from HHS, the Department of Health and Human Services. This pertains to the non-discriminatory section of the ACA. This also covers all Federal Marketplace providers under existing Obama Care plans.

This provision provides trained translators as well as machine translation. It covers the best known 15 languages in any given state in the country.1 A video translator can be provided via computer. The screen is literally turned toward the patient so the translator can see the individual and chat in real time about the health care provider's immediate concern. This can range from a need for an intravenous line to administer fluids to an imaging exam such as an X-ray or a social worker's assessment of a patient's safety at home.

SHOW ME THE MONEY

There are penalties under ACA for not providing an interpreter in the health care setting to the tune of $70,000 each time the service is not given.2 Multiply that for an average hospital visit and the cost as you can see goes up exponentially. That is why it becomes cheaper to employ an interpreter or have the technology available for video interpreters than not using this service.

This is 2018. You are reading this on a computer device. The technology is there for us to help our patients. Think of ways translation services can help your patients in today's multi-ethnic hospital culture. The list is endless and the time saved to the RN is priceless. This provision will continue to be of vital importance to the healthcare industry and ultimately save lives.


REFERENCES

1. ACA's Section 1557 Strengthens Requirements for Language Resources | Sponsored by CyraCom | Hospital & Health Networks Published October 21, 2016. Accessed July 10, 2018.

2. It's Illegal for Hospitals to Not Provide Translation Services. So Why Is Proper Translation Still Scarce? Published December 27, 2017. Accessed July 12, 2018.

3. The Trump Administration May Have Made It Even Harder for People With Disabilities to Access Health Care - Rewire.News Robyn Powell Published May 2, 2018. Accessed July 12, 2018.

4. Quick Statistics About Hearing | NIDCD National Institute on Deafness and Other Communication Disorders, Published December 15, 2016. Accessed July 12, 2018.

Daisy4RN

2,221 Posts

Specializes in Travel, Home Health, Med-Surg.

While I agree that patients should have the required info I do not see how translation services save time for nurses, it does just the opposite, it takes much more time.

Debi Fischer

6 Articles; 78 Posts

Specializes in Orthopedics and Neurology.

Thank you for your comment. I agree, it does take time. Nevertheless, it removes any posssible frustration the patient may feel. This is a time saver for the nurse in the end. The patient then knows what is going on with their care. Also, watching the video translation machine with the translator talking in a language you've never heard is pretty amazing.

smf0903

845 Posts

I think the translation services are amazing. We used to have to do translation services over the phone. It was awkward, to say the least. Now we have iPads and can simply hold them up so that both we and the patient can see/hear the translator. It makes interactions with the patient much smoother, and I love having this service available.

Debi Fischer

6 Articles; 78 Posts

Specializes in Orthopedics and Neurology.

I agree! Thank you for reading.

Neats, BSN

682 Posts

Specializes in Case Manager/Administrator.

I work Case Management at an Insurance Company and I use our translation line all the time with exception of the German Language (I speak that). I would rather use the translator line than have the patients family speak for them...this article is spot on for not only compliance but for accurate communication directly with the patient.

Debi Fischer

6 Articles; 78 Posts

Specializes in Orthopedics and Neurology.

Thank you.

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