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It’s a Tough Choice: Face-to-Face, Over-the-Phone, or Video Remote Interpreting?

VRI ASL Interpreter Blog

As hospitals and health care organizations continue to reduce budgets and consequently the hiring of staff interpreters, language services managers and coordinators face the challenge of reallocating resources in order to run a more cost-effective program.

Many hospitals are changing the paradigm under which language services programs operate.  Instead of the almost exclusive use of face-to-face interpreters (which has been the norm in the past), over-the-phone interpreting (OPI), and more recently, video remote interpreting (VRI) are options that are available to staff at many hospitals.

Hospital staff members now have the option to choose between these three modes of interpretation:  face-to-face, OPI, or VRI.  This choice can be a difficult one if no guidelines exist.  Let’s consider some of the possible factors that might be important in order to choose the most appropriate mode of interpretation:

  1. Estimated length of the encounter
  2. Time-sensitive nature of the encounter
  3. Content of the encounter
  4. Language availability

Estimated length of the encounter
The choice of OPI or VRI can be the most efficient use of resources when interpreting encounters are very short.

A good example is the use of “hourly rounding” by nurses on inpatient units, a practice that is becoming more common in many hospitals.  Nurses are required to check in with all patients once every hour to ask about the “4 Ps”: Pain (Is the patient in any pain?), Positioning (Is the patient comfortable?), Potty (Does the patient need to go to the bathroom?),Possessions (Does the patient have everything he or she needs?).  This encounter can take less than five minutes in many cases.

Calling a face-to-face interpreter to the bedside for such a short encounter may not be the most efficient use of resources.  Longer, more complicated encounters may justify the use of a face-to-face interpreter.

Time-sensitive nature of the encounter
Many times there is simply not enough time to wait for a face-to-face interpreter to arrive.  OPI and VRI interpreters can be secured in a matter of seconds, whereas face-to-face interpreters may take several minutes or even hours to arrive if they are not onsite.

For example, emergency room staff or ICU staff may use OPI or VRI until the face-to-face interpreter is available when dealing with unforeseen trauma cases or Code Blue situations.  OPI and VRI can also be more efficient during night and weekend shifts when the availability of face-to-face interpreters is reduced.

Content of the encounter
The seriousness of the content of the encounter is an important factor to consider.  Very serious cases may require the use of a face-to-face interpreter in order to provide more personal and intimate care for the patient.

Some examples of highly serious content include:  terminal diagnoses, end-of-life/palliative care, mental health, Do Not Resuscitate (DNR) orders, etc.  Less serious content encounters that may be ideal for the use of OPI or VRI include admissions, registration, billing, insurance, etc.

Teaching and educational encounters may also require the use of a face-to-face interpreter due to their hands-on nature; examples include respiratory therapy sessions, wound care, IV therapy, stoma care, etc.

Language availability
Hospitals must provide interpretation services, no matter the variety of languages spoken by the patient population.

One of the clear advantages of OPI and VRI is the large number of languages that are available.  Many times, depending on the geographic area where a hospital is located, face-to-face interpreters are only available for a very limited number of languages.  It can also be difficult to provide face-to-face interpreters for Languages of Lessor Diffusion (LLDs).

Creating the Optimal Balance
Taking into account these and other factors can help hospital staff to choose the appropriate mode of interpretation in a more conscious and deliberate way.  This, in turn, can help to reduce the scheduling and budgetary pressures on hospital staff interpreters and contracted agency interpreters.

Here at CyraCom, we are dedicated to helping our hospital clients find the optimal balance of modes of interpretation and combination of language services in order to better serve their patient populations.

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