Howard County General Hospital should hire its own foreign language interpreters to handle the non-English speaking women giving birth there, said a local agency that works closely with foreign-born residents.
The hospital no longer should rely on volunteer interpreters, said Patricia Hatch, executive director of the Columbia-based Foreign-born Information and Referral Network, which has provided interpreters to the hospital in the past.
"Basically we're a place of information and referral," said Ms. Hatch, whose private, nonprofit agency offers interpreters and information on jobs, health care and other matters to non-English speakers. "We're not a place to fill in all the gaps in the county."
According to Ms. Hatch, the hospital in the past year has called some of the agency's 20 interpreters at home to help with women in the hospital to give birth.
Between July 1, 1993, and March 1994, she noted, FIRN provided interpreters for 26 Spanish-speaking women who gave birth at the hospital.
"It's the hospital's responsibility," she said. "They should be training interpreters in the ethics of medical interpretation and methods of interpretation."
She warned that FIRN can no longer meet the needs of its 2,000 clients while providing interpreters to the hospital. She also worries that FIRN and its interpreters could be sued for errors when they work at the hospital.
But F. John Walker, director of community relations for the hospital, said the hospital is improving services for its non-English speaking patients, and that working with FIRN is part of that.
"We usually call on FIRN when we've exhausted our own resources," said Mr. Walker. "We call on FIRN as a last resort."
Later this week, hospital officials are scheduled to meet with Ms. Hatch to discuss ways to improve interpreter services.
The hospital does not keep track of how often it uses FIRN interpreters, said Mr. Walker. Since November, however, the hospital also has used AT&T;'s Language Line, a service that provides interpreters over the telephone for 140 languages.
The hospital also maintains a list of doctors, hospital staff members and volunteers who speak foreign languages, and is forming a group to assess its services for non-English speakers.
According to a recent study by Woods and Poole Economics, the number of Hispanics and Asians in Maryland is expected to increase by nearly 13 percent during the next six years, from 4.8 million to 5.4 million. In Howard County, the number of Asians is expected to double from about 8,000 to 16,000 by the year 2000, Ms. Hatch said. For Hispanics, the number is projected to nearly quadruple, from 3,700 to more than 14,000.
Other hospitals and health maintenance organizations in the Baltimore area have kept pace by using bilingual staff members, full-time interpreters and AT&T;'s Language Line.
At Sinai Hospital in Baltimore, two Russian interpreters work Monday through Friday, helping patients to fill out forms, schedule appointments and fill prescriptions.
"When people come to the hospital and don't speak English, they don't have a way to explain anything to the doctor," said Alla Zhelenko, a Russian immigrant who has been interpreting at Sinai Hospital for the past four years.
At Columbia Medical Plan off Thunderhill Road, 18 bilingual employees interpret for patients during the day and evening.
For CMP member Hilario Martinez and his family, the interpreters are a vital part of their health care.
"If there was no one there, there would be real problems," said Mr. Martinez through an interpreter at the health maintenance organization yesterday.
When interpreters are not available, the health maintenance organization uses the telephone interpreter service. But Ms. Hatch said the telephone service is inadequate by itself in emergency situations.
"It might be helpful in admitting, where you don't have someone bleeding in front of you," Ms. Hatch said. "If you're in a life-threatening situation, it could be dangerous."
Ms. Hatch said she worries about liability risks when FIRN's translators work outside the agency -- at the hospital, for example.
When FIRN interpreters are used to interpret in the hospital, they are protected under the hospital's liability coverage in certain circumstances.
For example, if the hospital calls the interpreter, the interpreter is protected by the hospital's liability, Mr. Walker said. But if a patient calls in an interpreter, the hospital is not responsible for any omissions or errors the interpreter makes.
Not everyone agrees that the hospital needs full-time interpreters.
Karen Parker, a labor and delivery room nurse at Howard County General Hospital, said she frequently relies on family members to interpret and has encountered no problems.
"The majority of them are fine," she said, referring to patients. "They usually want as few people in the delivery room as possible."
But James Griffiths, a FIRN interpreter, predicted that an increase in non-English speaking patients will force the hospital eventually to rely on its own interpreters.
"This is something you have to acknowledge," he said. "You can't turn your back on it."