Dear Rashelle: I’ve just been assigned the role of managing the interpreter services for our health system. I am not an interpreter. I do not speak another language, but I do value the work they do. We have a small team (3 FTE’s) and mostly contract with outside vendors. Where do I start? ~ a new ISD manager
This is a challenge that many people face. So rest assured that you are not alone. Interpreters are specialists as are many in the medical profession. So don't worry that you don't speak their language. You can do this!
Managing Your Team
It is important to have great clarity about your role as manager. It sounds like you're responsible for the FTEs and filling demand for appointment requests. You'll also want to know what the expectations are as they relate to vendors. Decisions regarding awarding or declining contracts, billing, grievances, reporting, audits, professional development and budget are just some of the responsibilities that should be made clear from the outset. If these things do not fall within your wheelhouse then you'll definitely want to know where to go when they come up.
One of the first things you'll want to do is assure your team that you are there to help them succeed. You want to be their cheerleader and remove any obstacles that come their way. Sounds like you're familiar with the healthcare system so who better qualified than you!
In a previous series, I covered how to create a positive work environment for an interpreter team.
You have the benefit of knowledge and experience from staff interpreters that are familiar with the many facets of your organization. Use that to your advantage. Sit with them and ask them how they think things are going. Ask them what they think works well and what things they think could improve. Let them help you shape the department. Who better to ask than those who are on the front lines every day?
This is a delicate matter. I urge you to move forward with caution. It is vital that if you seek feedback that you follow up. There is nothing worse than being asked your opinion and then feeling like it has fallen on deaf ears. You may not be able to make any changes or give them the things they ask for, but let it be known that you tried. They may want something that isn't possible because they don't have the whole picture. Paint that picture for them. Be transparent. Information is power.
Know Your Vendors
The bigger hurdle may be getting a grasp on the external vendors. Understanding who they are, how they work, the relationship they have with the organization and its employees, etc. may take some digging. If you're stepping into a pre-existing position this process may be easier than if you're starting from scratch.
It is imperative that your vendors know that they work for you and not the other way around. It is common for me to hear managers tell me that they are, in essence, at the mercy of the interpreting agency. Don't make it so.
Try and minimize the number of interpreting vendors you work with. This will help you maintain consistent relationships. You will know who to speak with when issues do come up, and your job will be much easier.
All business agreements must be negotiated and sometimes things don't work out as planned. But that should never be the norm. Have conversations that set clear service delivery guidelines that can meet demand and any audit needs should they arise. And please don't just consider cost. Vendors that only sell on price may not consider quality. You want to consider your return on investment. A low budget number may not indicate a low cost of service.
You have the benefit of an existing internal department. If existing vendors cannot meet overflow demand, you have two options. Grow your department or find a new vendor. You are the customer. Seek out vendors that have customer service standards that match those of your organization.
Volume is Key
Now, before you meet with your vendors you have to know what your expectations are. Most notable is your scheduling process. Knowing who will ask for, and attend, an interpreted encounter is a must for your organization.
Understanding your scheduling process is the primary metric for everything in your department. It can help determine FTE need, languages requested and, most importantly, billing. If you don't know how many appointments are happening on a daily basis you, have no control over your department.
If you're lucky, you'll have a trusting vendor relationship that can do this for you. Even still, you must know your volume so that you can control efficiency and cost.
Ask yourself these questions:
Who will request the interpreted encounter?
Where will that request go?
Who will determine if it will go to a vendor or staff interpreter?
When will that request be assigned?
Who will assign the interpreter?
How will we know the assignment has been made?
There are many more procedural facets that can be addressed but I think we've covered the most basic. The final piece I'd like to discuss is going into the field with your interpreters.
Take a Ride
You were chosen to manage the interpreting department because you are familiar with your organization and with health care. Going into the trenches with your team is the best way to see them at their best. Take a look at their schedule and pick an appointment to tag along on. You'd be surprised by how much more you know about interpreting than you think you do.
The sole purpose of interpreting is to facilitate communication. Interpreters are there to make communication effective and flow without awkward interruption. When interpreting is done well there is a seamless ebb and flow of thought and dialogue, as if the interpreter wasn't even there. You'll observe the provider and patient develop a report or continue on with an existing relationship. The provider will be at ease and the patient will be too. The interpreter will speak in the voice of the speaker, meaning you won't hear 'he said' or 'she said'. But rather 'I felt' or 'I'd like you to' and all will glide along with ease.
Some clues that things aren't going so well:
- Someone is talking for a long time and the interpreter only says a few short sentences.
- The provider says things like 'Oh, what a handsome young man' and the interpreter says nothing.
- The interpreter talks to the provider about the game last night and says nothing to the patient.
As you can see, you don't necessarily have to speak a second language to know if an interpreter is doing a good job.
Another way to measure the success of the interpreters is to ask the medical staff they work with. While the interpreters may not be at their front of mind, I promise that if asked they will tell you if they think things are, or are not, going well. Be sure to include all touch points. Interpreters are unique in that they are present through the patient’s entire journey through the healthcare system.
One word of caution here: You may have to structure the way you seek this feedback, or at least put the feedback into context. Just like your concerns, many of your colleagues may not know what interpreting is 'supposed to' look like. It may require you to read between the lines. Consider both the soft and hard skills you're looking for when seeking feedback on any one interpreter.
So sit back and enjoy. What a great opportunity to observe the beautiful and wonderful world of medical interpreting. Welcome!