Translating standards in a World of languages

Goes de Souza, Carlos H; Rana, B.K.

"Looking through the current cultural movements worldwide, in times of high-speed data transmission, the translation of languages and the accurate interpretation of concepts seem to be part of the greatest contemporary challenges.

As the primary purpose of language is communication, variations happen, and rearrangements are usually based on the needs of those who use it. However, it is also widely known that linguistic diversity allows for different interpretations of the same concept.

According to the diversity and linguistic variations; the translation of any text should consider a suitable process, based on standard international rules, to entirely reflect the authors’ thoughts and the original concepts contained in the texts. It is also worth underscoring that the different conceptual interpretations must be considered as variations, and not as mistakes. When we treat variations as errors, we are liable to linguistic prejudice. The translation should aim mainly at allowing the reader to have a more accurate understanding of the context, and reduce as much as possible the number of possible linguistic variations.

Accreditation, as a world methodology for health care's quality and safety's assessment, is focused and based on written standards, which are commonly assembled in print or electronic manuals.

Currently, around 100 countries, in 5 continents, with all their linguistic diversity, locally develop their standards and systematically submit their manuals to ISQua's assessment criteria - The International Society for Quality in Healthcare - to acknowledging their validity and obtaining the due recognition of the international community. These standards are quite often developed and written in the native language or first language of each of these countries.

As a general rule, before being submitted to ISQua standard's assessment program, these sets of standards compiled in a manual are translated into English. Whether or not the accreditation is obtained depends on the understanding of surveyors who read and evaluate these groups of translated standards. In these cases, translation plays a significant role, not only for the evaluators' reading and interpreting but also for the entire chain responsible for deciding whether or not to grant the award/accreditation, whose institutional reference language is English.

Today, more than ever, the concept that a standard must be relevant, understandable, measurable, behavioural, and achievable has to be also considered in the process of transcribing the standards translated into English or vice-versa. This trend should be part of the cultural movement towards the search for a common international understanding of accreditation processes. The simple (not so simple) act of accurately turning a word, sentence or text from one language into another should be on the agenda of the contemporary debate on health literacy, especially from the point of view of those whose mission is to legitimise what has been written by others, in different languages.

What is worth contemplating is precisely how this process of translating accreditation standards might be regulated. The challenge is to preserve the context and fidelity of the original statement while ensuring that its interpretation is not leading to linguistic, error-inducing variations.

We face here the idea that we need to set the rules of the game.

Standards translations need to be done for international accreditation processes, and it is also increasingly evident that Accreditation Bodies wish to pursue the path of internationalising their services. This means that their standards’ manuals need, more than ever, to be available in English, one of the world's most widespread and propagated languages, spoken by 980 million people as their first or second language, or even in the mother tongue of their clients. Therefore, it is the organisations’ responsibility to be zealous in the grammatical and editorial review of their transcribed standards, allowing maximum clarity either for ISQua's assessments or their foreign clients. It is noteworthy that understanding the language in the context of continuous improvement in health is increasingly important for ensuring a consistent accreditation service provision.

It is evident that a good and clear communication with users depends on how we speak and write. The people's experience in health services is a combination of what they say and how they are listened, in a mixture of what they hear, see, and feel during their length of stay. The continuum of safe care tends to be much more efficient when communication facilitates a smooth patients experience focused in their plurality and diversity. Following this trend, it is observed that current quality standards' manuals are introducing precise criteria on the basic needs of foreign patients in countries with different native languages.

From a more individual perspective of the same issue, the evaluators who assess standards written in foreign languages, even in English, which is not always their mother tongue, need to work with well-decoded documents that do not lead them to linguistic misunderstandings. Above all, they need to be sure they are reading and clearly understanding their object of evaluation without misinterpreting it as a result of an obscure translation. Therefore, it is crucial that Accreditation Bodies have a consistent and well-established standards' translation process in place to ensure the integrity and clarity of their standards statements and purposes when applied internationally."

Annexe:

INFOGRAPHIC, 2015

SOURCE: Ethnologue-Languages of the World - CIA, US - UNESCO - UN - University of Dusseldorf