Interpreter and Translator Resources

Effective patient-provider communication is fundamental to safe, high-quality, patient-centered health care. Many factors can affect communication including language, culture and health literacy. As the linguistic diversity of the U.S. continues to expand, it is increasingly important for health care providers to have the necessary tools and resources for effective communications. 

An interpreter is a person who converts one spoken language into another. A translator is a person who converts written material from one language to another. It is important to provide qualified medical interpreters to ensure both the patient and hospital staff correctly understand the patient’s medical problems. It is also important to have vital documents translated correctly to ensure patients understand their consent, rights, doctor’s orders and instructions for care.

Emergency Provisions
Use of Family Members or Friends as Interpreters

All patients should be informed they have a right to a medical interpreter in their native language free of charge. In an emergency situation, when seconds count, it may be okay to use a patient’s friend or family member as an interpreter.

It has been noted that some Limited English Proficient (LEP) persons may feel more comfortable using a trusted family member or friend to interpret for them. However, in many situations, it may not be appropriate to use a friend or family member as an interpreter because issues of confidentiality, privacy and conflicts of interest may arise.

In addition, the friend or family member may not be capable of providing accurate medical interpretations and the patient may feel uncomfortable or embarrassed to reveal information to a friend or family member.

Regardless of whether or not an LEP person chooses to use a friend of family member to interpret, the health care provider should make a note of that choice and the circumstances.

This point to picture medical visual language tool can be used to assist in communication when a qualified medical interpreter is not available and when natural disasters deem telephone communications inoperable.

This invaluable visual language tool enables instant communication with Spanish-only speakers, or the hearing impaired or those who speak in other languages, in situations where language barriers could seriously hinder effective emergency care and medical treatment in urgent situations.

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Every community is unique in the patient populations they serve. Vital documents must be translated into the non-English language of each regularly encountered LEP likely to be served by the hospital program or service.

Patient population is one determining factor when deciding which vital documents to translate. According to The Joint Commission, “the hospital determines which translated documents and languages are needed based on its patient population.”

The following resources can help hospitals understand their patient population:

  • MLA Language Map: Provides information from the U.S. Census 2000 and the 2005 American Community Survey. It is estimated that more than 47 million people in the U.S. speak languages other than English at home (MLA).

Translator Resources/Vendors

Sample Questions to Ask When Choosing a Qualified Translator agency for written documents

  1. Does your translation agency have a standardized evaluation process in place when hiring translators? (Listen for the use of standardized and objective certification practices – the gold standard is ATA Certified.)
  2. How does your translation agency ensure accuracy and quality when reviewing the finished translated product? (Listen for a team of translators who together proofread and edit the document. It is also helpful to have someone on the team who is native speaker in the target language.)
  3. Do your translators have experience with medical translations and are they native speakers to the target language?

Translation Services

  • Krames Custom Publishing Services – Offers a translation service
  • CareNotes Patient Education – Provides educational documents that are easy-to- understand about all aspects of LEP person’s health and care. Available in English, Spanish, and 13 other languages
  • CDC – Offers some patient education documents translated for free
  • MedlinePlus – Government Medical Library-National Institutes of Health’s Website for patients and their families and friends. Provides information about diseases, conditions and wellness issues in language that you can understand.
  • Lexicomp – provides patient specific education materials on medications, diseases, conditions and procedures in up to 18 languages. Written at 5th to 6th grade reading level.

It is important that documents are accurately translated into different languages for LEP patients. When possible, providing patients with documents in their native language can help prevent misunderstandings that could be detrimental to both the patient and the organization. 

According to, a Federal Interagency Website, “a document will be considered vital if it contains information that is critical for obtaining the federal services and/or benefits, or is required by law. Vital documents include, for example: applications; consent and complaint forms; notices of rights and disciplinary action and notices advising Limited English Proficient (LEP) persons of the availability of free language assistance.”

The U.S. Department of Health & Human Services provides guidance as to what are “vital documents.” Hospitals may have to translate such documents into other languages.

Office of Civil Rights Title VI Essential Documents:

  • Documents that must be provided by law;
  • Complaint, consent, release or waiver forms;
  • Claim or application forms;
  • Conditions of settlement or resolution agreements;
  • Letters or notices pertaining to the reduction, denial, or termination of services or programs or that require a response from the LEP person;
  • Time-sensitive notice, including notice of hearing, upcoming grand jury or deposition appearance, or other investigation or litigation-related deadlines;
  • Form or written material related to individual rights;
  • Notice of rights, requirements, or responsibilities; and
  • Notices regarding the availability of free language assistance services for LEP individuals.

In lieu of translated documents, vital information should be relayed via a qualified medical interpreter either by phone or in person.

Vital written materials could include, for example:

  • Consent and complaint forms
  • Intake forms with the potential for important consequences
  • Written notices of eligibility criteria, rights, denial, loss, or decreases in benefits or services, actions affecting parental custody or child support and other hearings
  • Notices advising LEP persons of free language assistance
  • Written tests that do not assess English language competency, but tests competency for a particular license, job, or skill for which knowing English is not required
  • Applications to participate in a recipient’s program or activity, or applications to receive recipient benefits or services

Nonvital written materials could include, for example:

  • Hospital menus
  • Third party documents, forms or pamphlets distributed by a recipient as a public service
  • For a non-governmental recipient, government documents and forms
  • Large documents such as enrollment handbooks (although vital information contained therein may need to be translated)
  • General information about the program intended for informational purposes only
There are several accrediting bodies and each have their own requirements as it relates to effective communications with LEP and other vulnerable populations who require communication aids, or who are otherwise impaired. For more information, consult these sites: