CLAS standards and their applications

CLAS Standards

Non-English speaking patients present a challenge for those working in the healthcare industry due to the difficulty in accurately assisting and assessing the patient's needs. Because of this, it is required that interpreters be provided for patients who are non-English speakers.

Medical Language Interpretation Tools

There are six commonly used medical interpretation tools that hospitals can select from when serving patients. The first tool is a trained professional medical translator. This resource is optimal for larger hospitals that are serving a large amount of a certain group of people. For instance, an area with a large number of French speaking patients should have a French medical translator on staff. The second option is using a phone medical translator. When using a phone translator, the doctor, patient, and translator are all on the phone at the same time and work together to discuss the circumstances. The third option for areas that serve a wide array of international patients from differing backgrounds is using the AT&T translation line. This line provides translators for every background and is a much less expensive option when used occasionally.

The other three options are not considered ideal and can actually result in less than desired and even dangerous outcomes. The first option is using bilingual staff. While this option may seem less expensive to the hospital, there is a danger of the bilingual staff translating incorrectly due to compromised interests. The next unacceptable option is allowing a community volunteer to translate. In smaller communities this can be highly detrimental as the patient may not be willing to share information with someone they know from the community. Finally, family members are often used to translate. This option is by far the least optimal as both patient and concerned family member may alter the translation and information given to please the person translating.

Legal Responsibilities

Regardless of the cost, hospitals are required under the Civil Rights Act and CLAS to provide language assistance. Anything less by a federally funded hospital could be seen as discriminatory and result in loss of government funding. Further, U.S. Health and Human Services provides specific guidelines and standards as to the necessity of competent and appropriate language assistance.

CLAS Standards in the Case Story

In the case story, a hospital was being presented with a new group of English Language Learners that made care difficult. The CEO's first step was correct in evaluating how large the group was in comparison to the amount of people served by the hospital. The CEO did research into the community and determined that the patients were not simply a fluke. At that point, the decision was properly made to seek out competent language assistance. The CEO first sought a sub-standard technique of using community leaders who were at the time working through the process of becoming medical translators. In a normal circumstance a medical translator is ideal. However, because the group of patients was so tightly knit, the CEO realized that there is a high risk of patient reluctance because the people were also community volunteers. After realizing the problem, the CEO made the decision to use the translation phone line in order to ensure accurate translation and confidentiality with patients. The only mistake that the CEO then made was not fully communicating her concerns about confidentiality to the hospital staff, resulting in a separate campaign. Were her intentions given, the staff most likely would have simply cooperated.