Need for Interpreter

Introduction

Interpreter services can assist in ensuring quality communication in a range of settings,
and may be required when:

• providing direct care to people of low English fluency


• providing health promotion and health education; or


• Undertaking community consultation for service planning and evaluation.

Whenever working with CALD clients the services of an interpreter may be required.
Agencies providing direct care require some means of determining which clients need an interpreter, and when these clients will need them.

Definition and Quality Standards

When is an interpreter needed?

Depending on their proficiency in English, CALD clients may not seek or require interpreter services on every occasion of contact with a primary health care service. At the same time primary health care agencies may need to prioritise the provision of interpreter services within funding and resource constraints. A “critical points” approach is one way of developing agency policy for prioritising the provision of interpreter services. This approach can provide consistency in determining when an interpreter “must, should or could” be provided.

When must an interpreter be provided?

The “critical points” when an interpreter “must” or “should” be provided may vary across
agencies and programs, but in general will include some or all of the following:-

• A life-threatening situation when a client is not proficient in English.


• When obtaining information from the client for the purposes of assessment or diagnosis to inform treatment and service provision decision-making.


• Communicating important information to the client to enable him/her to make informed decisions about his/her treatment and care. For example:-
  o When providing clients with information about entitlements, rights and responsibilities, such as privacy and confidentiality.
  o Communicating assessment outcomes, test results, or diagnosis,
  o When discussing treatment and referral options
  o When explaining procedures, treatments, prescribed medications or other interventions included in care plans.
  
  
• When obtaining client consent to treatment or release of information.


• Interviews related to the following:-
  
  o Refusal of treatment
  o Freedom of information requests
  o Client/carer complaints
  o When discussing residential care applications, resident agreements
  o Power of attorney and guardianship matters.

Which clients need an interpreter?

The engagement of a professional interpreter is particularly important when dealing with CALD clients who do not speak any English or display only limited capacity to communicate in English. For example:

• The client exhibits no understanding or effective use of English.


• The client is able to communicate in English, but in a limited capacity.


• The client is reliant on friends or family to communicate on their behalf in English.


• The client is able to communicate in English, but is more comfortable to communicate in his/her own language.


• The client is under stress, which may affect his/her, ability to communicate effectively in English.

Tools to assist services in assessing language proficiency and identification of the need for an interpreter have been tested through pilot projects and are designed to support the Department of Human Services (DHS) Service Coordination Tool Templates (SCTT).
Resources available include:

• Form 1 – Initial Contact Procedure Checklist


• Language Chart (Appendix C))


• Form 2 – Communication Assessment Tool
  
  o Language Proficiency Test and
  o Cultural Information form


• Form 3 – Interpreter Booking Checklist

When to complete the Initial Contact Procedure Checklist

The Initial Contact Procedure Checklist should be completed when a client who speaks little or no English presents at a Primary Health Care agency. Completion of the checklist can be prompted by the SCTT Consumer Information form, which requires the service provider to record if an interpreter is required. If the client presents a Victorian Interpreter Card the need for an interpreter should be recognised and be recorded on file as well.

When to complete the Communication Assessment Tool

Ideally the Communication Assessment Tool shown should be completed in conjunction with the SCTT Consumer Information form, which requires information in relation to the requirement for an interpreter. If completed in conjunction with the Scott forms, agencies at the same time obtain permission from the consumer to pass on this relevant information to any other agency involved in the care for the client. This tool can also be used to assess whether the client should be issued with the Victorian Interpreter Card.

Form 1 - Initial Contact Procedure Checklist

This checklist identifies the steps to be taken when a person who speaks some English or no English presents to a Primary Health Care agency.



If the Client Speaks Some English	Completed
1. If the client speaks some English proceed with the language proficiency test and fill in the Communication Assessment Tool and place it in the file.
2. Advise the client about the purpose of the tool and what will be done with the information.
3. If an interpreter is required, ring your language service provider and ask for an interpreter in the relevant language to assist with completion of the interview.
Following the interview:
1. Mark the file with a colour coded Alert Sticker identifying the need for an interpreter, so that at each subsequent visit staff know to book an interpreter for the client.
2. Ensure that this information is provided to the next service provider caring for the client.
3. Record the following data in the patient/client file: • If an interpreter was used, note the name and the accreditation level of the interpreter • If an interpreter was offered but refused by the client note this • If a family member or a person other than a professional interpreter was engaged for language assistance note this • Record at each subsequent consultation/interview that an interpreter was used or declined by the client
If the Client Speaks No English at All	Completed
If the client speaks no English at all, show them the “Language Chart” attached in Appendix D so they can identify their preferred language. This list contains most languages currently spoken in Australia.
Advise the client in English that you will:
1. Ring your language service provider and ask for an interpreter in the relevant language to assist with completion of the Communication Assessment Tool and Initial Contact and/or Needs Identification interview. It is most likely that telephone interpreting will be required in this instance.
2. Once the telephone interpreter is available, through the interpreter, advise the client about the purpose of the tool and what will be done with the information.
3. Fill in the Communication Assessment Tool and place it in the client file.
Proceed with the client interview and completion of SCOTT forms using the interpreter.
If the client presents with the Victorian interpreter card, follow steps 1 – 3 above.
Following the interview:
Mark the file with a colour coded Alert Sticker so that at each subsequent visit of the client staff know to book an interpreter.
Ensure that this information is provided to the next service provider caring for the client.
Record the following data in the clients file: • If an interpreter was used, note the name and the accreditation level of the interpreter • If an interpreter was offered but refused by the client • If a family member or a person other than a professional interpreter was engaged for language assistance • Record at each subsequent consultation/interview that an interpreter was used or declined by the client

Communication Assessment Tool

As part of the Quality Language Services in Rural Primary Care Settings best practice
project, a Seamless Care pilot was undertaken to trial the effectiveness of a
Communication Assessment Tool. The pilot aimed to assess the communication needs of
CALD clients and communicate the respective findings from pre-admission, to acute care
and subsequent post acute discharge services. The Kyabram and District Memorial
Hospital was chosen to undertake the pilot as the hospital was trialling the Statewide
Service Coordination Tool Templates at the time, in conjunction with Campaspe PCP, and
the Communication Assessment Tool was to form part of the Service Coordination Tool
Templates and Initial Needs Identification process.

Communication Assessment Tool: Assessment of Cultural and Linguistic Needs

This Communication Assessment Tool is to be completed in conjunction with the Service Coordination Tool Templates (SCTT) forms

Original versions of the SCTT forms are available on the DHS Primary Health Knowledge Base www.health.vic.gov.au/pcps/coordination/sctt2006.htm#forms

The Communication Assessment Tool (Form 2) has been provided for use by agencies who wish to add the form to those used by their Service Providers.

Form 2: Communication Assessment Tool

Language Proficiency Test	Record Agency Assigned Consumer Identifier (initial contact agency)
	Or affix label here

Language Proficiency Test:	Form 2
LEVEL OF ENGLISH	Please tick
Level 1: Fluent (similar to native speaker)
Able to think in a second language and does not have to translate from the first
Understands slang and jokes
Level 2: Limited (limited English language skills at basic level)
Can understand and hold very simple conversation
Can answer simple questions
Cannot follow conversations between native speakers
Cannot follow discussions
Has difficulty in expressing a broad range of feelings and thoughts
Level 3: Cannot speak or understand
Unable to speak and understand the English language
Knows formulaic greetings and some vocabulary
Cannot construct simple sentences
Interpreter Need
Use the Language Proficiency Test before answering this question.
1. Fluent, similar to native speaker of English
2. Limited, demonstrates limited English language skills at a basic level
3. Cannot speak or understand English

Interpreter is required if 2 or 3 above is ticked
Language of Required Interpreter (See Language Chart):
Preferred Gender of Interpreter:	No Preference	Male	Female
Advocate/representative if required:		Yes	No
Literacy in preferred language (can the client read or write in their preferred language:

Go to Cultural Information

Office Use Only
Name:	Designation/Agency:
Sign:	Contact No: Date:
If information becomes superseded, indicate below and record updated information on new form
The information on this form has been superseded Date: Name:	Sign:

Cultural Information	Record Agency Assigned Consumer Identifier (initial contact agency)
	Or affix label here

Cultural Information When a client is recorded as a level 2 or 3 in the English Proficiency Test this information may be obtained through the interpreter.

Ask the client if there are any important things the service needs to understand about their:

Health beliefs:

Ask the client if there are any important things the service needs to understand about their:

Health practices:

Ask the client if there are any important things the service needs to understand about their:

Values:

Ask the client if there are any important things the service needs to understand about their:

Expectations:

Complete Language Proficiency Test BEFORE
completing this form

Office Use Only
Name:	Designation/Agency:
Sign:	Contact No: Date:
If information becomes superseded, indicate below and record updated information on new form
The information on this form has been superseded Date: Name:	Sign: