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Arkansas has one of the fastest growing Hispanic populations in the country with an increase of 59 percent from 2000 to 2006, according to U.S. Census data. The increase in the Spanish-speaking population has resulted in hospitals, the Arkansas Department of Health and other healthcare providers instituting special programs to help assure good communication that includes providing interpreters with special medical training.

The University of Arkansas for Medical Sciences (UAMS) Regional Programs’ Bridging the Gap is a 48-hour course for interpreters of any non-English language. While not a language course, it does require a mandatory working languages assessment and a proof of medical terminology mastery. “The goal of this course is to master the art of medical interpreting,” said Angelina Levitskaya, UAMS director of medical interpreting training programs. “It hones the ability to listen, understand and convey the verbal message accurately and completely. Participants learn different modes of interpretation, and learn to manage the flow of communication and the dynamics of the three-way medical interview.”

Levitskaya said the purpose of the course is to contribute to better health outcomes. This is accomplished by training and certifying medical interpreters to help eliminate health disparities by building linguistic and cultural capacity, enhancing communication between providers and their diverse patients, improving organizational support for linguistic and culturally appropriate medical services, increasing providers’ and patients’ satisfaction and reducing legal risks.

Trained medical interpreters are used at the UAMS Area Health Education Center clinics throughout the state and at the hospital in Little Rock. While at times a family member or friend can be used to help interpret, there are advantages to using a skilled medical interpreter. Using trained and certified interpreters rather than family members and friends insures confidentiality, prevents conflict of interest and assures the correct interpretation of medical terms.
“While many problems can result from using adult family members and friends as interpreters, additional problems arise when the interpreter is a minor,” Levitskaya said. “There is a greater potential for harm when providers use children to interpret in highly sensitive medical settings.”

A unique aspect of this course is its treatment of culture as an integral part of communication, and therefore, an important aspect of the interpreter’s work. The interpreter’s cultural competency is a crucial part of communication in a health care.

Iliana Rivera, language service coordinator at Washington Regional in Fayetteville, one of the areas of the state with the highest population of Hispanics, said they provide several resources for communication, anything from assisting limited English-speaking patients to patients who might need a sign language interpreter to someone who needs communication resources for medical reasons. They might have had a stroke or communications problem caused by being on breathing support.

“So what we do is provide those services for those patients, as well, as part of our language program,” Rivera said. “We’ve grown because of the need of our community and our staff. There are definitely federal guidelines out there that any health clinic should follow regarding language services. But here at our hospital we have gone further than that and developed an education program for our staff, and our communities, as well.”

Classes are held for staff and members of the community to gain proficiency with medical Spanish. If someone is bilingual but needs help with medical terminology, those classes are available.

“As well as educating medical interpreters, we are also educating the community at the same time,” Rivera said. “We provide them with information on how to contact us when they need services, especially when coming in for outpatient services. We also have plans to teach English as a Second Language (ESL) curriculum for our community that will teach the community how to access our facility and services.”

Mark Lowman, vice president of strategic development for Baptist Health in Little Rock, said to ensure that limited-English proficient patients are able to communicate effectively with healthcare providers, Baptist Health developed a Limited English Proficiency Task Force to continually monitor the language needs of patients and employees within the system.

Baptist provides access to the Certified Languages International Language Line that provides interpreter services for most international languages by phone and can be accessed 24 hours a day at no charge to the patient. Baptist Health Medical Centers in Little Rock and North Little Rock have specially trained medical interpreters with plans to train additional employees in the near future. The health information library on the Baptist Health website is available in Spanish to help fulfill the needs of this demographic population.
Baptist Health HealthLine has the capabilities of accessing language interpreters when patients with limited English proficiency call for health information, classes and physician referrals and appointments. A three-way call is initiated to meet the customers’ needs.

Baptist Health Community Outreach, in partnership with Immanuel-Brookwood Baptist Church, offers free preschool physicals immunizations, and back-to-school supplies for the Hispanic community. And Baptist Health Community Outreach offers free ESL classes within the community.

Community Outreach programs targeting the Hispanic community have been advertised in both print (El Latino) and broadcast (KPZA Hispanic radio station) media. Baptist Health routinely advertises for employment in the El Latino & Hola Arkansas. Human resource policies are translated in Spanish including the Code of Ethical Conduct. The system also periodically offers on-site ESL classes for employees.

Baptist Health has established communications and ongoing relationships with the Mexican Consulate’s office in order to create on-going dialogue. Also, as a resource for the Spanish-speaking employees, Baptist Health has a full-time bilingual Employee Relations Specialist in the main Human Resources Department.
Arkansas Department of Health provides services dependant on the size of the Spanish-speaking population. In Sevier County, 49 percent of the health department caseload is Hispanic while there are other areas of the state with few Hispanics.

“It has quite a range in Arkansas,” said Ed Barham, public information officer, Arkansas Department of Health. “Understandably, we use different solutions from one place to another. In Sevier County we have been working on those problems for 15 years to make sure we have translator services when they are needed. Some districts have full-time interpreters and others part-time interpreters. In some places we have a volunteer on call.”



March 2008

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