The National Council on Interpreting in Health Care (NCIHC) has developed the first set of national standards for medical interpreting professionals in the United States. The 32 standards provide guidance on the qualifications and proper role of the interpreter and define what constitutes good practice. They are designed to promote better communication between patients and health professionals who do not share a language and improve the quality of care for these patients.
The Issue: Although in recent years, health care facilities and agencies across the United States have made strides in providing linguistically appropriate services, there has been little clarity about what constitutes appropriate training, qualifications, and performance for bilingual health care interpreters, who facilitate communication between patients and providers. As a result, health care interpreting across the country is uneven and inconsistent, leaving many patients with limited English proficiency at risk of having incomplete and inaccurate communication with their health care professionals, which studies suggest can result in higher costs and poorer outcomes. In 2004, the NCIHC published the National Code of Ethics for Interpreters in Health Care. Building on that code of ethics, these standards of practice define the characteristics and competencies of medical interpreters. They also describe what is considered "best practice" by the profession, helping to ensure consistency and quality across medical settings.
Organization: The NCIHC Standards, Training and Certification committee, with funding from The Commonwealth Fund and The California Endowment
Target Populations: Health care interpreters and those who train, employ, and work with interpreters
The Intervention: After commissioning an international environmental scan of current practices and existing published standards, the NCIHC Standards, Training, and Certification committee conducted a series of seven targeted focus groups across the country. Once they analyzed the focus group and environmental scan results, the committee drafted an initial standards document. The draft standards were presented to the health care community for feedback through a national survey of interpreters and those who work with them. The final document incorporates changes made by the committee after careful consideration of all the input from survey respondents. The 32 standards—which are grouped into nine categories that are each associated with a corresponding ethical principle—are expected to be used in training, hiring, performance monitoring, and as a basis for discussion on the merits of a certification process to assess the qualifications of interpreters working or preparing to work in health care settings. The new national standards provide guidelines on the following nine issues:
- Accuracy: To enable other parties to know precisely what each speaker has said.
- Confidentiality: To honor the private and personal nature of the health care interaction and maintain trust among all parties.
- Impartiality: To eliminate the effect of interpreter bias or preference.
- Respect: To acknowledge the inherent dignity of all parties in the interpreted encounter.
- Cultural Awareness: To facilitate communication across cultural differences.
- Role Boundaries: To clarify the scope and limits of the interpreting role, in order to avoid conflicts of interest.
- Professionalism: To uphold the public's trust in the interpreting profession.
- Professional Development: To attain the highest possible level of competence and service.
- Advocacy: To prevent harm to parties whom the interpreter serves.