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Standards for general practices (4th edition)

including Interpretive guide for Aboriginal and Torres Strait Islander health services

Standard 1.2 Information about the practice

Our practice provides sufficient information to enable our patients to make informed decisions regarding their care.

Criterion 1.2.3

Interpreter and other communication services

Our practice provides for the communication needs of patients who are not proficient in the primary language of our clinical team and/or who have a communication impairment.

Indicators

► A. Our clinical team can describe how they communicate with patients who do not speak the primary language of our staff or who have a communication impairment.

► B. Our practice has a list of contact details for interpreter and other communication services including the Translating and Interpreter Service.

Explanation

Key points

  • GPs have a professional obligation to understand their patients’ problems
  • Patients have a right to understand the information provided by GPs and their recommendations
  • Practices need to know how to access interpreter services.

Interpreting services for GPs

The Department of Social Services provides free telephone interpreting services for GPs when providing Medicare-rebateable consults in private practice:

  • Doctors Priority Line (available 24 hours a day, seven days a week)
  • Delivered by the Translating and Interpreting Service (TIS National)
  • On site interpreting service (subject to interpreter availability).

Information on these services is available at www.dss.gov.au/free-interpreting or by calling 1300 575 847.

Friends and relatives as Interpreters

Qualified medical interpreters should be the interpretation medium of choice.

The use of patients’ relatives and friends as interpreters is common. This is acceptable if it is an expressed wish of the patient and the problem is minor. However, further consideration should be given to the following:

  • whether friends and relatives will put their own interpretation into the translated communication
  • the use of friends and relatives in sensitive clinical situations or where serious decisions have to be made may be hazardous
  • the use of children as interpreters is not encouraged.

Translating services

The HealthInsite website at www.healthinsite.gov.au provides helpful educational material for patients on a range of clinical conditions in a variety of languages.

Some websites offer free translation of brief information. To protect patient confidentiality, practices should ensure that no identifying information is revealed.

A list of websites providing translation services is available at www.word2word.com/free.html.

Patients with special needs

A free AUSLAN service for patients who are deaf is available at www.nabs.org.au. Information about communicating with a person with impaired communication is available at www.betterhealth.vic.gov.au.

Information about communicating with a person with an intellectual disability is available at www.cddh.monash.org/assets/documents/working-with-people-with-intellectual-disabilities-in-health-care.pdf.

Standard 1.2 Information about the practice

Our practice provides sufficient information to enable our patients to make informed decisions regarding their care.

Criterion 1.2.3

Interpreter and other communication services

Our practice provides for the communication needs of patients who are not proficient in the primary language of our clinical team and/or who have a communication impairment.

In a nutshell

Clinical staff at your health service know how to use an interpreter service, how to work with a cultural broker or how to use other communication processes when interacting with patients who do not speak the same language as staff or who have a communication or hearing impairment. Clinical staff have an obligation to understand patients’ problems. Patients have a right to understand the information and recommendations provided by clinical staff.

Key team members

  • Practice manager
  • Clinical staff
  • Cultural brokers
  • Interpreters

Key organisational functions

  • Interpreting service manual/protocol
  • Clinical resources
  • Cultural resources

Indicators and what they mean

Table 1.7 explains each of the indicators for this criterion. Refer to Criterion 1.2.3 Interpreter and other communication services of the Standards for general practices for explanations of some of the concepts referred to in this criterion. 

Table 1.7 Criterion 1.2.3 Interpreter and other communication services
IndicatorsWhat this means and handy hints
 A. Our clinical team can describe how they communicate with patients who do not speak the primary language of our staff or who have a communication impairment.  Your clinical staff can describe how they engage the translating and interpreter service and/or service-based cultural brokers or interpreters in communicating with patients who do not speak the staff member’s primary language. Your staff can also access services and information to help them communicate effectively with patients who have a communication impairment.

It is recommended that your health service establish a policy for situations where patients express a wish to use relatives and friends to interpret. In establishing the policy, it is recommended it state that:
  • documented patient consent is required for any third party, including an interpreter, to be present in a consultation
  • an independent interpreter is preferable
  • it is acceptable that family or friends interpret where the problem is relatively minor
  • there may be a risk that the family or friend could put their own interpretation into the communication
  • there can be risks if family or friends are used in sensitive clinical situations
  • it is not appropriate to use children as interpreters.
 B. Our practice has a list of contact details for interpreter and other communication services including the translating and interpreter service. See Criterion 1.2.3 Interpreter and other communication services for information on interpreting services for GPs.

Case study

Below is a description of the ways in which an Aboriginal community controlled health service can ensure it provides interpreter and other communication services for its patients and community. Not all of these good practices are required by the Standards, but they illustrate the many practical and creative things that ACCHSs can do to ensure they deliver services of high safety and quality to their community.

The health service’s patient records identify if patients have a communication impairment or do not speak the main language used at the service, and need an interpreter. The service’s electronic appointment system will flag that an interpreter of any kind is required. Patient health files have records of when interpreter services have been used.

The reception and consultation rooms have a list of interpreter contact details, which includes staff members and other people who provide interpreter services, including in Auslan. The policy and procedure manual contains details of when to use the interpreter service and how to document in patient health files when these services are used.

When interviewed, staff members can describe how they contact and book interpreter services, including Auslan services, if required. All staff who need to use an interpreter know how to work with them. This includes knowing:

  • 
how to determine whether an interpreter is needed
  • 
how to prepare the interpreter before the consultation
  • 
how to conduct the patient consultation with the interpreter.

Showing how you meet Criterion 1.2.3

Below are some of the ways in which an Aboriginal community controlled health service might choose to demonstrate how it meets the requirements of this criterion for accreditation against the Standards. Please use the following as examples only, because your service may choose other, better-suited, forms of evidence to show how it meets the criterion.

Ensure and show that staff know how to contact and use the translating and interpreter service as well as Auslan services for patients who are deaf.

Provide staff a list of contact details for interpreter and other communication services.

Ensure contact details for interpreter and other communication services are kept both in reception and in consultation rooms.

Ensure staff members can describe when it is appropriate to use family and friends to interpret, and how they do this.

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