STUDY ON THE MODEL IMPLEMENTATION OF PROFESSIONAL INTERPRETING

1. Designing a matrix for the implementation of interpreting

Based on preliminary work by the Bündnis für Sprachmittlung [Alliance for Interpreting] [1], the findings of the SIMPLE Future Conference ‘Sprache öffnet Türen’ [Language Opens Doors], and data from the SIMPLE project, we have developed a matrix for the modular implementation of interpreting. This is a modular framework that aims to meet the various challenges and demands of healthcare. The following questions are important to consider:

1. Which modular forms of interpreting are available/can be used?
2. Which medical discipline is providing the treatment?
3. In which setting (outpatient/inpatient) is the treatment taking place?
4. What infrastructure is in place in the workplace/treatment setting, e.g. tablets, contracts with interpreting providers etc.?
5. How predictable is the need for interpreting: can/should the service be scheduled, or should it be provided on an on-demand basis?
6. What level of sensitive communication is required during treatment: what topics and requirements are planned or should be communicated?

To answer the question of when which form of interpreting is appropriate and practicable to use in healthcare provision, the modular implementation matrix takes into account a) existing forms of interpreting, b) the medical discipline, c) the treatment setting, d) the infrastructural conditions of the work area, e) the predictability of the treatment, and f) the sensitivity of the topics to be communicated.

The matrix takes into account demands and challenges at the micro, meso, and macro levels. Funding models, legislation, qualifications for interpreters, and ongoing training for healthcare providers must all be developed in parallel with the implementation of interpreting in clinical practice.

Matrix for the implementation of interpreting, © SIMPLE

[1] Bündnis für Sprachmittlung (2022): Position paper: “Zur Aufnahme von; Sprachmittlung in den Leistungskatalog der Gesetzlichen Krankenkassen (GKV) bzw. ins SGB V.”, Position paper (long version, PDF); Position paper (short version, PDF)

2. Indication-based guidelines for the modular implementation of interpreting

Based on these considerations, we have adapted the modular implementation matrix into indication-based guidelines for the use of interpreting services in clinical practice, drawing on the three fields of oncology, psychiatry, and emergency medicine as examples. These are supported by the data and analytical results from the interview study with 36 practitioners from various professional fields (medical, nursing, psychological) and the accompanying field research conducted as part of the SIMPLE project.

The guidelines are based on the following indication criteria: the specific conditions of the discipline and setting (outpatient/inpatient), the predictability of use, and the importance of sensitive communication during treatment. The guidelines presented include four possible forms of interpreting: 1) digital/AI-supported, 2) via telephone, 3) via video, 4) in-person.

The key infrastructural requirements for the successful, indication-based implementation of interpreting are:

• The availability and reliability of end user devices, e.g. tablets for digital interpreting or telephones with a loudspeaker function.
• All specified forms of interpreting are implemented in parallel to enable indication-based and therefore cost-effective use.

If these conditions are met, practitioners can switch between different forms of interpreting depending on communication requirements – i.e. based on indications – if these requirements change during the course of treatment.

Guidance notes:
In a hospital with oncology (inpatient and outpatient), psychiatry (inpatient and outpatient), and emergency departments, interpreting is implemented in accordance with indication-based guidelines. Using this clinical example, we wish to illustrate how the appropriate form of interpreting can be selected depending on the indication.

In oncology, digital tools are especially useful for standardised processes such as scheduling appointments or collecting data from questionnaires. If unexpected questions or complaints arise during treatment, on-demand telephone or video remote interpreting allows for immediate clarification. Video appointments can be used for planned consultations, while particularly sensitive topics – such as discussions about prognoses or medical information – usually require in-person interpreting.

In psychiatry, there is a particularly great need for sensitive, ongoing communication. Digital forms of interpreting support administrative tasks, while emotional or crisis situations require the rapid availability of telephone remote interpreting. Planned therapy sessions can often be conducted via video. However, in-person interpreting is recommended (if available) for initial consultations or complex treatment situations and therapeutic processes.

In emergency medicine, the lack of predictability dictates which form of interpreting is used. Digital tools can help streamline initial admission procedures. However, on-demand telephone or video remote interpreting, which is available at all times, plays a central role, as medical decisions must be made immediately. Pre-planned forms of interpreting are less likely to be considered here, but they could be used if a stable communication framework emerges during a patient’s hospital visit.

In summary, this clinical example demonstrates how the indication-based guidelines help treatment providers in all medical departments to quickly and flexibly select the appropriate form of interpretation for any situation.