In-hospital Service

A patient comes in with an injury and is not mentally stable. You start asking questions, after numerous questions you realize the patient is Deaf. You ask them if they can lipread. They shake their head with confusion. You ask by signing \’need an interpreter\’. They nod yes. You go and make a call to arrange that.

I use the word \”Deaf\” as an inclusive term for all Deaf, hard of hearing,
DeafBlind, DeafDisabled, and late-deafened children.

Truth is, sadly that\’s not the normal practice. This is a common problem when Deaf patients attend the hospital and medical centre, lack of knowledge of accessibility and understanding the roles of an interpreter. I shared one of my experiences \’Disabling.\’ Too many stories of devastating experiences across Canada of miscommunication that caused physical and mental stress and oftentimes death.

Every hospital and medical centre has their own varying degrees of experience working with Deaf patients. Depending on your location, available resources and previous experiences, you and your hospital staff may have had a difficult time booking interpreters due to policies. There are a lot of possible factors to consider when trying to provide equitable services to your Deaf patients. So what do you need to ensure they receive the best care and to avoid liability? Yup, I\’m serious.

What you need is TATE: 

Type of communication access
Advanced notice and confirmation
Tech set-up
Explanation of why the interpreter is present

Type of communication access:
Deaf patients have various language access needs, whether that is having a sign language interpreter present, Deaf and non-deaf interpreting team, using VRS or VRI, or other approaches to communicating. Since they have more experience working with different forms of communication, ask the Deaf patient what works best for them. It is important to understand the needs of your patients and provide the kind of communication that will be the most accurate and clear to understand for them so they can receive the best possible care in your facilities. 

Never depend on family or friends to relay the message, they are not fluent or unknowably to you, they keep information from the patient or are a danger to the patient. This happens ALL the time!

Advanced notice and confirmation: 
Whenever possible, reach out to your Deaf patient via email, VRS or TTY to confirm the type of language access available to them upon their arrival. If you know the form of communication uses technology, such as a video remote interpreter, it helps put your patient’s mind at ease when they know the tech will be ready when they arrive. 

Email these days is the best approach to arrange appointments or discuss brief matters, there is a form of confidentiality agreement that can be signed to allow communication via email.

Tech set-up:
If you are using video remote interpreting, describe what the set-up looks like to the Deaf patient, including whether there is a computer or tablet set up, and if your staff have experience setting up and using the technology required. If there is a live interpreter, it is important that they have the right positioning to maintain eye contact with the Deaf patient throughout the appointment. 

Two things to keep in mind, technology can fail so in-person interpreters are the best first choice. 2-Don\’t expect the patient would have access on hand or provide it themselves. I learned from a patient that a nurse told them to return home, while on suicidal watch, to get their iPad to have access!?!

Explanation of why the interpreter is present: 
Your staff may not have experience working with Deaf patients or interpreters, meaning they may not know what an ASL interpreter is or why they are there. It is important that your colleagues are briefed that the ASL interpreter(s) present are trained professionals, facilitate communication between Deaf and hearing parties, that all information interpreted will be kept confidential, and that they are necessary for the patient’s appointment. 

It\’s a law to provide access, don\’t let either the interpreter services or hospital HR decide the patient\’s access. Provide interpreters when requested, no questions asked.

No one enjoys going to the hospital or clinic when they are unwell, least of all when it becomes difficult to communicate. Regardless of whether the patient is there for an emergency or not, these tips may help your hospital and staff be prepared for Deaf patients, and reduce common issues that could come up during the appointment. Keep TATE to put your patient’s mind at ease and lessen frustrations during an already frustrating time!

Let\’s work together to make the experience better, there are many more approaches to consider. TATE is just one of them.

Additional Resources: 

https://www.ada.gov/hospcombr.htm
https://www2.gov.bc.ca/gov/content/family-social-supports/services-for-people-with-disabilities/supports-services/american-sign-language-asl-interpreter-services/understanding-asl-interpreter-services