Bilingual health communicators: role delineation issues.

Managers of health care services are seeking new opportunities to improve communication with clients who have limited English proficiency. An increase in bilingual health staff and the frequent use of their language skills in patient encounters provides opportunities but also brings with it confusion surrounding the role of interpreters and bilingual health staff. Secondary analysis of transcripts from 18 focus groups with monolingual and bilingual health staff has provided a method of distinguishing the roles of these complementary communicators. This paper clarifies the roles of interpreters and bilingual communication facilitators using seven key features: scope of language, language proficiency, nature of communication/interaction, nature of the contact and relationship, client responsibilities, and relationship with other health care providers. We discuss differences in how bilingual health staff use language when providing care, and alternative types of interactions interpreters could adopt to extend their current role. A collaborative group of communicators located within a health team is proposed, that is able to identify need and select the best communicator for the task.