Many hospitals have been asking the IMIA about interpreter rounds and what they entail. This was identified as a best practice in Best Practice Recommendations for Hospital Based Interpreter Services Department by the Massachusetts Department of Public Health at http://www.mass.gov/dph/omh/interp/best_practices.pdf and has been adopted in several hospitals across the country. Inpatients are usually the most critically ill patients in a health care organization and thus require periodic communication during their stay, especially during the initial assessment and discharge instructions (Speaking Together Quality Measure ST2: see www.speakingtogether.com).

In addition to sending interpreters to an inpatient unit at a provider or patient�s request, inpatient rounds are essential and one of the few proactive services an interpretation department can do for the hospital in order to ensure safe communication and thus decrease liability for their hospital, not to count increase patient satisfaction. Unfortunately, there is still much misunderstanding of what constitutes an interpreter round. While many hospitals maintain that they provide their patients with inpatient rounds, often this consists of a quick visit to ask the patient how they are doing and is done sporadically at best, when the interpreter has down time, which is almost never.

Some hospital interpreters receive a daily inpatient report of the linguistically diverse patients they serve in order to identify and visit them in the inpatient units. Most protocols should include the main objectives of the inpatient round, which are:

1) to assess/confirm the language needs/preferences of the patient and communicate it to the staff nurse in charge of that patient. This can be a very useful corrective measure for language identification (Speaking Together Quality Measure ST 1, see www.speakingtogether.com)

2) to provide patient education on their language rights, how to access and working with an interpreter, the dangers of relying on unqualified individuals to provide them with accurate interpretation

3) to provide the provider and the patient with an opportunity to communicate at that moment, after the inpatient round is completed; and

4) to ensure that adequate language access has been maintained over a 24-hr period.

Medical interpreters are not being empowered to undertake this important patient advocacy role for patients in many hospitals, and there is still much misunderstanding about what advocacy is and isn't. Some hospitals don't allow their interpreters to speak to patients without a provider present, which does not empower the interpreter to work in his/her full professional scope of work. Professional interpreters who are well trained are able to do this important patient educational component while remaining true to the interpreting roles described in their standards of practice.

Patient education regarding language access and patient advocacy is an important activity in reducing language access disparities, and medical interpreters should be doing this at each opportunity. While each hospital has its own expectations of what an interpreter  should be allowed to do, please educate those that could benefit from this information. While this is ultimately one of their patient rights, few patients are aware of or understand the risks of not having a professional interpreter and are not usually able to tell the difference between a qualified and an unqualified interpreter.