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Published on May 12, 2020

Navigating care during COVID-19 pandemic, when you don’t speak English

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When the COVID-19 pandemic spread to the region, the Interpreter Services Department at Cape Cod Healthcare scrambled to meet the challenge.

“Overnight, I had to create a call center,” said Cecilia Phelan-Stiles, who oversees interpreter services in her job as senior manager of human resources communication.

The call center – an office with four computer stations for interpreters to use – was established in a medical office building adjacent to Cape Cod Hospital in Hyannis. Through phone calls and video calls, her team of full- and part-time interpreters are able to communicate with non-English-speaking patients. They can also connect deaf and hard-of-hearing patients with sign language interpreters. After-hour shifts at both hospitals for Portuguese and Spanish are covered remotely by staff.

The three most commonly requested languages are Portuguese, Spanish and Haitian Creole, according to Phelan-Stiles. Volume is covered by skilled staff, contracted video and phone interpreters, fluent in more than 300 languages, who assist in communication between patients and doctors. Every floor at both Cape Cod and Falmouth hospitals have iPads that can be used to communicate with interpreters, and EMTs in every fire department in the county can also call for contracted interpreter services, she said.

Services are also available to Cape medical offices.

“My Falmouth Hospital interpreter was the only one who initially worked remotely, she is now back at the hospital” Phelan-Stiles said. “She’s getting all the calls for doctors for telehealth.”

Interpreters are an essential component in this community and specifically to the clinical team. They act as a bridge between patient and physician either in person or via a conference video call, she said.

In mid-March, Cape Cod Healthcare and Barnstable County opened a drive-through test center in a tent at Cape Cod Community College in West Barnstable. After a week with no calls for assistance from the testing site, Phelan-Stiles said she realized something was amiss. She had a sign erected at the test site that gives instructions in Portuguese, Spanish and Haitian Creole, as well as through pictures, on what to expect and how to comply with the procedure.

Getting the message out about COVID-19

To provide people who are deaf and hard of hearing with some basic information on COVID-19, Cape Cod Healthcare’s main web page now has a video in American Sign Language, with audio and captions in English. Information on symptoms and prevention, the testing process and visitation restrictions are provided  in Spanish and Portuguese, said Phelan-Stiles.

Because immigrant households can be large, the risk of spreading infection is potentially high, she said, especially if all people in a home don’t self-quarantine when one member contracts COVID-19. Therefore, providing fact-based information to them is important, as there is much misinformation circulating, she said.

Phelan-Stiles’ staff also works with the Visiting Nurse Association of Cape Cod and the Barnstable town nurse to identify and assist homebound patients.

“They send us a list of patients,” she said. “We conference call with them and let them (patients) know what they can and cannot do.”

Phelan-Stiles and staff also visit patients at Cape Cod Hospital. Among them are new moms in maternity who need interpreter services.

“We’ve done maybe six to seven births in the last two weeks,” she said.

Staff has been successful at providing interpreter services to admitted COVID-19 patients via video and phone and has not yet found the need to enter the rooms, she added.  

Under normal circumstances, people who cannot speak or read English feel isolated when hospitalized. Nowadays, fear of COVID-19 and strict rules to prevent transmission of the coronavirus have only added to the problem, so help with communication has become more crucial. Phelan-Stiles cited the case of a patient who knew English but was hard of hearing.

“We brought in a pocket amplifier,” she said. “He was almost in tears because he could hear.”