title: How to use interpreters in general practice: the development of a New Zealand toolkit.
abstract: BACKGROUND
  New Zealand is becoming more ethnically diverse, with more limited English proficiency (LEP) people. Consequently there are more primary care consultations where patients have insufficient English to communicate adequately. Because effective communication is essential for good care, interpreters are needed in such cases.
  
  
  METHODS
  The literature on the use of interpreters in health care includes the benefits of using both trained interpreters (accuracy, confidentiality, ethical behaviour) and untrained interpreters (continuity, trust, patient resistance to interpreter). There is little research on the actual pattern of use of interpreters.
  
  
  RESULTS
  Our research documented a low use of trained interpreters, despite knowledge of the risks of untrained interpreters and a significant use of untrained interpreters where clinicians felt that the communication was acceptable. A review of currently available guidelines and toolkits showed that most insist on always using a trained interpreter, without addressing the cost or availability. None were suitable for direct use in New Zealand general practice.
  
  
  METHODS
  We produced a toolkit consisting of flowcharts, scenarios and information boxes to guide New Zealand practices through the structure, processes and outcomes of their practice to improve communication with LEP patients. This paper describes this toolkit and the links to the evidence, and argues that every consultation with LEP patients requires clinical judgement as to the type of interpreting needed.
  
  
  CONCLUSIONS
  Primary care practitioners need understanding about when trained interpreters are required.
authors.affiliation: Department of Primary Health Care and General Practice, University of Otago Wellington, PO Box 7343, Wellington South, New Zealand. ben.gray@otago.ac.nz
authors.forename: Ben
authors.initials: B
authors.lastname: Gray
authors.forename: Jo
authors.initials: J
authors.lastname: Hilder
authors.forename: Maria
authors.initials: M
authors.lastname: Stubbe
mesh_terms: D003144:Communication Barriers; D054521:Cultural Competency; D058006:General Practice / Q000458:organization & administration; D006801:Humans; D019303:Multilingualism; D009520:New Zealand; D017410:Practice Guidelines as Topic; D011320:Primary Health Care / Q000458:organization & administration*; D011369:Professional-Patient Relations; D011785:Quality Assurance, Health Care; D014175:Translating