NCIHC National Standards of Practice PDF
NCIHC National Standards of Practice PDF
NCIHC National Standards of Practice PDF
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•••• NATIONAL STANDARDS
•••• OF PRACTICE
•••• for
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N AT I O N A L C O U N C I L O N I N T E R P R E T I N G
COMMITTEE ..............................................................................................................................ii
BOARD ......................................................................................................................................ii
ACKNOWLEDGEMENTS ............................................................................................................iii
INTRODUCTION ........................................................................................................................1
STANDARDS OF PRACTICE ......................................................................................................5
Accuracy ............................................................................................................................5
Confidentiality ....................................................................................................................6
Impartiality ........................................................................................................................6
Respect ..............................................................................................................................7
Cultural Awareness ............................................................................................................7
Role Boundaries ................................................................................................................8
Professionalism..................................................................................................................9
Professional Development ..............................................................................................10
Advocacy ..........................................................................................................................10
GLOSSARY ..............................................................................................................................11
© 2005 National Council on Interpreting in Health Care, Inc., All Rights Reserved.
The NCIHC National Standards of Practice for Interpreters in Health Care is in the public domain and may be reproduced as is in its current
format under the copyright law of fair use. No changes may be made to the document except by the National Council on Interpreting in
Health Care. Persons seeking to use this document should contact NCIHC. i
COMMITTEE
Co-Chairs
Karin Ruschke, MA
President, International Language Services, Inc.
Interpreter Trainer, Program Development Consultant
Shiva Bidar-Sielaff, MA
Manager of Interpreter Services/Minority Community Relations
University of Wisconsin Hospital and Clinics
Members
Maria-Paz Beltran Avery, PhD
Strategic Director, Education Development Center, Inc.
Member, Certification Committee of the Massachusetts Medical Interpreters Association
Carola E. Green
Interpreter, Translator, Interpreting Trainer
Project Coordinator, Vista Community Clinic
Linda Haffner
Freelance Consultant, Trainer, and Spanish Interpreter/Translator
BOARD
REVIEWED AND APPROVED BY THE NCIHC BOARD OF DIRECTORS
© 2005 National Council on Interpreting in Health Care, Inc., All Rights Reserved.
The NCIHC National Standards of Practice for Interpreters in Health Care is in the public domain and may be reproduced as is in its current
format under the copyright law of fair use. No changes may be made to the document except by the National Council on Interpreting in
ii Health Care. Persons seeking to use this document should contact NCIHC.
ACKNOWLEDGEMENTS
This work was generously funded by The Commonwealth Fund and The California Endowment. We
would like to thank the project coordinators, Esther Diaz and Patricia Ohmans/Health Advocates, for
their commitment to this project and Marjory Bancroft for her work on the Environmental Scan. We
would like to specially recognize the many interpreters and other individuals who participated in
our focus groups and responded to our survey, and the expert consultants who provided us with
valuable input.
© 2005 National Council on Interpreting in Health Care, Inc., All Rights Reserved.
The NCIHC National Standards of Practice for Interpreters in Health Care is in the public domain and may be reproduced as is in its current
format under the copyright law of fair use. No changes may be made to the document except by the National Council on Interpreting in
Health Care. Persons seeking to use this document should contact NCIHC. iii
INTRODUCTION
This introduction to the National Standards of Practice for Interpreters in Health Care explains the
context in which the standards were developed, describes the process of development, and sug-
gests ways in which the standards can be used.
In 2004, the National Council on Interpreting in Health Care1 (NCIHC) published the National Code
of Ethics for Interpreters in Health Care. Development of the code of ethics followed an extensive
period of gathering input and counsel from working interpreters and their colleagues. Through a
similar consensus-building process, the NCIHC has now developed a set of standards of practice
for interpreters working in health care settings. This project built on the work in standards devel-
opment at the individual state level, specifically on the pioneering work of the Massachusetts
Medical Interpreters Association (MMIA)2 and the California Healthcare Interpreting Association
(CHIA)3. While we reviewed the Registry of Interpreters for the Deaf (RID) standards of practice4
and received input from American Sign Language interpreters, our focus and expertise lies in spo-
ken language interpreting and therefore these standards represent a consensus on standards for
spoken language interpreters.
As in all professions, the field of interpreting is guided by ethical principles. These standards for
health care interpreters show how professional interpreters respond to ethical and other consider-
ations in the performance of their duties. Standards of practice are concerned with the “hows” of
performance as compared with codes of ethics that focus on the “shoulds.” A code of ethics
provides “a set of principles or values that govern the conduct of members of a profession while
they are engaged in the enactment of that profession.”5 In other words, codes of ethics provide
“guidelines for making judgments about what is acceptable and desirable behavior in a given
context or in a particular relationship”6 while standards focus on the practical concerns of what
the interpreter does in the performance of his or her role, offering “best practice” strategies for
observing the principles of the code of ethics in day-to-day practice.
1
A National Code of Ethics for Interpreters in Health Care. National Council on Interpreting in Health Care, 2004.
2
Massachusetts Medical Interpreters Association and Education Development Center, Inc. Medical Interpreting Standards of
Practice. Newton: EDC, 1996.
3
California Standards for Healthcare Interpreters: Ethical Principles, Protocols, and Guidance on Roles & Intervention; California
Healthcare Interpreting Association, 2002.
4
Registry of Interpreters for the Deaf; www.rid.org.
5
A National Code of Ethics for Interpreters in Health Care, National Council on Interpreting in Health Care, 2004.
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6
See Footnote 5. ••••
© 2005 National Council on Interpreting in Health Care, Inc., All Rights Reserved.
The NCIHC National Standards of Practice for Interpreters in Health Care is in the public domain and may be reproduced as is in its current
format under the copyright law of fair use. No changes may be made to the document except by the National Council on Interpreting in
Health Care. Persons seeking to use this document should contact NCIHC. 1
WHY ARE PROFESSIONAL STANDARDS OF PRACTICE FOR INTERPRETERS IN HEALTH CARE NEEDED ?
Health care interpreting is a distinctive and specialized area of practice. Interpreters working in health
care facilitate communication between providers and patients or families who do not share a language.
Although in recent years health care facilities and agencies across the United States have made strides
in providing linguistically appropriate services, the lack of qualified interpreters continues to be a
barrier to health care for limited English proficient (LEP) patients. There has been a lack of clarity and
consistency at the national level in defining the characteristics and competencies of a qualified health
care interpreter, leaving interpreters and health care facilities, as well as other stakeholders, with little
or no guidance in identifying the performance requirements of the interpreter role. As a result, the
quality of health care interpreting across the country is uneven and inconsistent, leading to a danger-
ous potential for incomplete and inaccurate communication. The clinical and financial ramifications are
documented in the research literature.
Nationally recognized standards of practice provide the necessary guideposts for improving the train-
ing of health care interpreters, helping to raise the quality and consistency of interpreting in health
care. Just like medical protocols for physicians, these standards will provide guidance to interpreters
as to what is expected of them and what constitutes good practice.
In the survey, the question “Should this standard be included (in the professional standards of practice
for health care interpreters)?” was asked about each of the proposed standards. Each was approved for
inclusion by a large majority of respondents, both interpreters and non-interpreters; almost all were
approved by over 90% of respondents. This final document incorporates changes made by the STC
committee after careful consideration of all the input from survey respondents.
7
Bancroft, Marjory. The Interpreter’s World Tour: An Environmental Scan of Standards of Practice for Interpreters. Prepared for
the National Council on Interpreting in Health Care. Woodland Hills: The California Endowment, March 2005
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© 2005 National Council on Interpreting in Health Care, Inc., All Rights Reserved.
The NCIHC National Standards of Practice for Interpreters in Health Care is in the public domain and may be reproduced as is in its current
format under the copyright law of fair use. No changes may be made to the document except by the National Council on Interpreting in
2 Health Care. Persons seeking to use this document should contact NCIHC.
The standards are numbered consecutively for ease of reference. Each standard is accompanied
by an example, intended to clarify the practical significance of the standard by illustrating one
possible application. The examples are not comprehensive and should not be confused with the
standards. They simply suggest ways in which the standards may be applied. To keep the document
brief, only one example is given for each standard. When the standards are discussed in interpreter
training, we expect many other examples will be provided.
The standards of practice in this document should be taken as a whole. While each standard has
merit and can stand on its own, the full implication of each standard is best understood when seen
in its connection and interdependence with the other standards. Therefore, each standard should
be understood and practiced in the context of the whole.
It should also be understood that in every profession statements of ethical principles and stan-
dards of practice are concise summary statements of expectations and skills that a competent
professional in that field should have. Having these documents does not eliminate the need for
training and education. In fact, training is central to the continued growth and development of the
profession of health care interpreting.
A. TRAINING .
Supervisors, trainers, and training organizations are encouraged to adopt and promote these
standards and to incorporate them into their training for health care interpreters. For the pur-
poses of training, the examples that accompany each standard should be discussed and many
other examples considered as further illustrations of good interpreting practice.
B. HIRING .
Hiring authorities can refer to these standards when interviewing or testing candidates for
employment as interpreters in health care settings.
C. PERFORMANCE MONITORING .
These standards can be used, with other criteria, as a basis for performance evaluation and
on-going quality assessment of interpreting services.
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© 2005 National Council on Interpreting in Health Care, Inc., All Rights Reserved.
The NCIHC National Standards of Practice for Interpreters in Health Care is in the public domain and may be reproduced as is in its current
format under the copyright law of fair use. No changes may be made to the document except by the National Council on Interpreting in
4 Health Care. Persons seeking to use this document should contact NCIHC.
STANDARDS OF PRACTICE
ACCURACY
OBJECTIVE:
To enable other parties to know precisely what each speaker has said.
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© 2005 National Council on Interpreting in Health Care, Inc., All Rights Reserved.
The NCIHC National Standards of Practice for Interpreters in Health Care is in the public domain and may be reproduced as is in its current
format under the copyright law of fair use. No changes may be made to the document except by the National Council on Interpreting in
Health Care. Persons seeking to use this document should contact NCIHC. 5
STANDARDS OF PRACTICE
CONFIDENTIALITY
OBJECTIVE:
To honor the private and personal nature of the health care interaction and maintain trust
among all parties.
Interpreters treat as confi- For example, an interpreter does not discuss a patient’s case with family
dential, within the treating or community members without the patient’s consent.
team, all information learned 8. The interpreter protects written patient information in his or her
in the performance of their possession.
professional duties, while For example, an interpreter does not leave notes on an interpreting session
observing relevant require- in public view.
ments regarding disclosure.
IMPARTIALITY
OBJECTIVE:
To eliminate the effect of interpreter bias or preference.
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© 2005 National Council on Interpreting in Health Care, Inc., All Rights Reserved.
The NCIHC National Standards of Practice for Interpreters in Health Care is in the public domain and may be reproduced as is in its current
format under the copyright law of fair use. No changes may be made to the document except by the National Council on Interpreting in
6 Health Care. Persons seeking to use this document should contact NCIHC.
STANDARDS OF PRACTICE
RESPECT
OBJECTIVE:
To acknowledge the inherent dignity of all parties in the interpreted encounter.
For example, an interpreter may tell the patient and provider to address
each other, rather than the interpreter.
For example, an interpreter directs a patient who asks him or her for
a ride home to appropriate resources within the institution.
CULTURAL AWARENESS
OBJECTIVE:
To facilitate communication across cultural differences.
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© 2005 National Council on Interpreting in Health Care, Inc., All Rights Reserved.
The NCIHC National Standards of Practice for Interpreters in Health Care is in the public domain and may be reproduced as is in its current
format under the copyright law of fair use. No changes may be made to the document except by the National Council on Interpreting in
Health Care. Persons seeking to use this document should contact NCIHC. 7
STANDARDS OF PRACTICE
ROLE BOUNDARIES
OBJECTIVE:
To clarify the scope and limits of the interpreting role, in order to avoid conflicts of interest.
16. The interpreter limits personal involvement with all parties during
Related ethical the interpreting assignment.
principle: For example, an interpreter does not share or elicit overly personal
The interpreter maintains information in conversations with a patient.
the boundaries of the pro- 17. The interpreter limits his or her professional activity to interpreting
fessional role, refraining within an encounter.
from personal involvement.
For example, an interpreter never advises a patient on health care
questions, but redirects the patient to ask the provider.
For example, an interpreter who is also a nurse does not confer with an-
other provider in the patient's presence, without reporting what is said.
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© 2005 National Council on Interpreting in Health Care, Inc., All Rights Reserved.
The NCIHC National Standards of Practice for Interpreters in Health Care is in the public domain and may be reproduced as is in its current
format under the copyright law of fair use. No changes may be made to the document except by the National Council on Interpreting in
8 Health Care. Persons seeking to use this document should contact NCIHC.
STANDARDS OF PRACTICE
PROFESSIONALISM
OBJECTIVE:
To uphold the public’s trust in the interpreting profession.
For example, an interpreter does not blame others for his or her
interpreting errors.
For example, an interpreter does not spread rumors that would discredit
another interpreter.
26. The interpreter acts in a manner befitting the dignity of the profession
and appropriate to the setting.
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© 2005 National Council on Interpreting in Health Care, Inc., All Rights Reserved.
The NCIHC National Standards of Practice for Interpreters in Health Care is in the public domain and may be reproduced as is in its current
format under the copyright law of fair use. No changes may be made to the document except by the National Council on Interpreting in
Health Care. Persons seeking to use this document should contact NCIHC. 9
STANDARDS OF PRACTICE
PROFESSIONAL DEVELOPMENT
OBJECTIVE:
To attain the highest possible level of competence and service.
ADVOCACY
OBJECTIVE:
To prevent harm to parties that the interpreter serves.
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© 2005 National Council on Interpreting in Health Care, Inc., All Rights Reserved.
The NCIHC National Standards of Practice for Interpreters in Health Care is in the public domain and may be reproduced as is in its current
format under the copyright law of fair use. No changes may be made to the document except by the National Council on Interpreting in
10 Health Care. Persons seeking to use this document should contact NCIHC.
APPENDIX A
GLOSSARY8
ADVOCACY: Advocacy is understood as an action taken on behalf of an individual that goes
beyond facilitating communication, with the intention of supporting good health outcomes. In
general, advocacy means that a third party (in this case, the interpreter) speaks for or pleads the
cause of another party, thereby departing from an impartial role.
HEALTH CARE INTERPRETING : Interpreting that takes place in health care settings of any sort,
including doctor’s offices, clinics, hospitals, home health visits, mental health clinics, and public
health presentations. Typically the interpretation occurs during an interview or encounter between
a health care provider (doctor, nurse, lab technician) and a patient (or the patient and one or more
family members).
INTERPRETER: A person who renders a message spoken or signed in one language into a second
language. (See Professional Interpreter)
INTERPRETING: The process of understanding and analyzing a spoken or signed message and
re-expressing that message faithfully, accurately, and objectively in another language, taking the
cultural and social context into account. [Within the language profession, the term translation is
restricted to the process of converting written messages.]
INTERPRETING ASSIGNMENT: A period of time during which an interpreter performs his or her
duties. An interpreting assignment may involve multiple encounters with patients and providers.
LIMITED ENGLISH PROFICIENCY (LEP): The inability to speak, read, write or understand the
English language at a level that permits an individual to interact effectively with health care
providers and social service agencies.9
8
These are selected definitions from Terminology of Health Care Interpreting: A Glossary of Terms. National Council on
Interpreting in Health Care, 2001, 2005.
9
US Department of Health and Human Services: Guidance to Federal Financial Assistance Recipients Regarding Title VI
Prohibition Against National Origin Discrimination Affecting Limited English Proficient Persons. Federal Register. August 8,
2003; Volume 68 (153):47311-47323.
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© 2005 National Council on Interpreting in Health Care, Inc., All Rights Reserved.
The NCIHC National Standards of Practice for Interpreters in Health Care is in the public domain and may be reproduced as is in its current
format under the copyright law of fair use. No changes may be made to the document except by the National Council on Interpreting in
Health Care. Persons seeking to use this document should contact NCIHC. 11
APPENDIX A
GLOSSARY
SIGHT TRANSLATION: Translation of a written document into spoken or signed language. An
interpreter reads a document written in one language and simultaneously interprets it into a
second language.
TRANSPARENCY: The principle that during the encounter the interpreter informs all parties of any
action he or she takes, including speaking for him- or herself, outside of direct interpreting.
TREATING TEAM: All health care providers involved in the care of a particular patient within a
single facility.
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© 2005 National Council on Interpreting in Health Care, Inc., All Rights Reserved.
The NCIHC National Standards of Practice for Interpreters in Health Care is in the public domain and may be reproduced as is in its current
format under the copyright law of fair use. No changes may be made to the document except by the National Council on Interpreting in
12 Health Care. Persons seeking to use this document should contact NCIHC.
NOTES
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© 2005 National Council on Interpreting in Health Care, Inc., All Rights Reserved.
The NCIHC National Standards of Practice for Interpreters in Health Care is in the public domain and may be reproduced as is in its current
format under the copyright law of fair use. No changes may be made to the document except by the National Council on Interpreting in
Health Care. Persons seeking to use this document should contact NCIHC. 13
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The National Standards of Practice for Interpreters in
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Health Care, produced by the National Council on
Interpreting in Health Care (NCIHC), Inc., is the result of a
systematic, deliberate, and reflective process. The NCIHC
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is confident that this document represents the standards
that working interpreters believe are important in the
practice of their profession. The document is designed as
a guide for both interpreters and the health care systems
in which they work, and is not meant to supplant or
expand policy or regulations pertinent to the provision of
competent interpreter services. The NCIHC regrets any
inadvertent result which may arise from the application
of these standards of practice.