With the increase in refugees from Ukraine during the war, it became evident that there was a need for additional translation tools in Molde, Norway. With Care to Translate they now have a way to solve language barriers throughout the patient journey, across many healthcare areas.
Molde is a municipality located in Møre og Romsdal county on the western coast of Norway. Like all municipalities in Norway, they are responsible for outpatient health services such as medical screenings, procedures, treatments, and minor surgery that doesn't require hospitalization.
Marit Teigen Hauge is the assistant municipal chief medical officer and advises the municipality about healthcare services. We had a chat with her about their implementation of Care to Translate.
After the war in Ukraine started, healthcare units in Molde municipality realized that the lack of interpreters was a problem. In total, there were only 12 authorized interpreters in Ukrainian. They were used frequently, but it was not enough to cover Molde's needs fully. Molde municipality had a need to communicate better during actual meetings with patients, but also afterward.
In some healthcare areas, the patients need to pay and arrange for their interpreters themselves. For example, physiotherapy, and dental care. Too often, this resulted in patients refraining from requesting to use interpreters, and the communication issues remained.
Molde municipality didn't want to rely on a tool like Google Translate, since the translations are sometimes incorrect (and there is no way to control accuracy). Similarly relying on family and friends to translate was not a safe or sustainable option.
The first time Marit heard of Care to Translate was when the Norwegian Institute of Public Health presented a pilot that Oslo University hospital had done.
Before settling on Care to Translate, Molde looked into some other translation options. For example, the refugee service used a translation tool, but it was too expensive for the municipality.
“Money is always an issue, and Care to Translate was a tool that we felt we could afford”
We also looked at other translation tools that the municipality used in childcare but needed something specially made for health care, she says.
Molde municipality uses the tool in reception, in drop-in appointments, and in emergencies. For planned meetings, they can usually book a phone interpreter.
After the visit, the app is also used to communicate with the patient. By screenshotting the screen with questions they can send that to patients via text message to reply. If the patient is analphabetic, they will play and record the sound and send that instead.
In the emergency room, it is not uncommon that family and friends were being used to interpret because it takes time to find an interpreter and the patient often need help immediately. The playlists used have been developed by ERs in other hospitals, so the lists are relevant to the area, and staff doesn't have to search to find specific phrases in the app.
“They [the playlists] are also a good reminder for us of questions we need to ask, for example when a patient has acute stomach pain.“
The KAD is a 24-hour unit where patients get admitted for treatment, observation, and care for diagnosis that can be treated by general practitioners and nurses in the primary healthcare service. In KAD, Care to Translate makes it possible to communicate at all hours of the day, for every interaction with a patient. “It would be impossible to have interpreters available for all of those interactions,” says Marit.
There is a tuberculosis center where patients with active tuberculosis are treated. In this center, it is very important that the staff is with a patient every day to make sure that he/she takes the medicine.
"There are many patients who don't know the language and are analphabetic. In those situations, being able to communicate with audio is essential to us."
There is a particular tuberculosis playlist that is being used in these interactions and Marit confirms that they are really helpful in their everyday work. “They are excellent. It is amazing that we can communicate so well with people that are analphabetic too”, she continues.
Understanding and getting started with the app was not an issue in Molde municipality:
“The app itself is very easy to use, very intuitive. It is clear that you have put effort into making it exactly that,” says Marit
She continues: “It is great for the healthcare sector, where we often have other digital tools, like for medical records management, that is not very intuitive. It’s easy to switch between caregiver and patient mode and to switch between languages. “
Molde municipality has been very proactive in implementing Care to Translate internally. “The issue with implementing it was to get people to know that we have the tool in such a large organization that we are. So we created videos to send out so everyone who needed it and so they can onboard in their own time, at their own pace. “ Marit says.
Marit's favorite feature is the search function and the playlists that came ready to use. “They are very specific. For example, we use a playlist when we need to inform patients about Vitamin D deficiency. Before Care to Translate, we used a lot of interpreters and resources to communicate this to patients. And there were many patients with vitamin D deficiency!” Marit says.
Another effect of using Care to Translate is the staff becomes more sure of what they communicate. After all, a part of their professional promise is making sure that patients are being understood. The result is an increased quality of care.
“We become more effective and there is a higher quality to what we do.”
People in the organization have become more aware of language barriers, and more motivated to also take good care for patients that don't have the Norwegian language.
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