Forum on Augmentative and Alternative Communication in Acute Care

This forum provides some insights into the process of initiating a clinical service to enhance patient–provider communication. It also provides a report of a large-scale clinical trial that introduced augmentative and alternative communication (AAC) tools in an acute-care setting.

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Improving Patient Safety and Patient–Provider Communication

Perspectives of the ASHA Special Interest Groups ◽

10.1044/2019_pers-sig12-2019-0021 ◽

2019 ◽

Vol 4 (5) ◽

pp. 1017-1027 ◽

Cited By ~ 1

Author(s):

Richard R. Hurtig ◽

Rebecca M. Alper ◽

Karen N. T. Bryant ◽

Krista R. Davidson ◽

Chelsea Bilskemper

Keyword(s):

Acute Care ◽

Augmentative And Alternative Communication ◽

Health Care Team ◽

Provider Communication ◽

Alternative Communication ◽

Patient Provider Communication ◽

Acute Care Settings ◽

Nurses Perceptions ◽

Communication Needs ◽

The Impact

Purpose Many hospitalized patients experience barriers to effective patient–provider communication that can negatively impact their care. These barriers include difficulty physically accessing the nurse call system, communicating about pain and other needs, or both. For many patients, these barriers are a result of their admitting condition and not of an underlying chronic disability. Speech-language pathologists have begun to address patients' short-term communication needs with an array of augmentative and alternative communication (AAC) strategies. Method This study used a between-groups experimental design to evaluate the impact of providing patients with AAC systems so that they could summon help and communicate with their nurses. The study examined patients' and nurses' perceptions of the patients' ability to summon help and effectively communicate with caregivers. Results Patients who could summon their nurses and effectively communicate—with or without AAC—had significantly more favorable perceptions than those who could not. Conclusions This study suggests that AAC can be successfully used in acute care settings to help patients overcome access and communication barriers. Working with other members of the health care team is essential to building a “culture of communication” in acute care settings. Supplemental Material https://doi.org/10.23641/asha.9990962

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Developing a Culture of Successful Communication in Acute Care Settings: Part II. Solving Institutional Issues

Perspectives of the ASHA Special Interest Groups ◽

10.1044/2019_pers-sig12-2019-0016 ◽

2019 ◽

Vol 4 (5) ◽

pp. 1037-1043

Author(s):

Sarah Marshall ◽

Richard R. Hurtig

Keyword(s):

Acute Care ◽

Augmentative And Alternative Communication ◽

Alternative Communication ◽

Shared Resources ◽

Institutional Barriers ◽

Successful Communication ◽

Institutional Issues ◽

Patient Provider Communication ◽

Communication Needs ◽

Institutional Challenges

Purpose Establishing services for hospitalized patients with complex communication needs (CCNs) requires identifying and addressing both patient-based and institutional barriers. Although the previous paper ( Marshall & Hurtig, 2019 ) focused on patient-based barriers, this paper addresses overcoming institutional barriers. Method We present a series of cases to illustrate the institutional challenges in meeting the CCNs of patients in an acute care setting. Results Each case illustrates how the deployment of augmentative and alternative communication tools required addressing institutional/systems barriers and how critical collaborations help patients with CCNs to more effectively communicate with caregivers and participate in their care. Conclusion Building a culture of improved patient–provider communication involves establishing a wider range of interprofessional collaborations and shared resources in order to effectively provide patients with CCNs the tools to summon assistance and communicate with their caregivers.

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Improving the final year of life at the institutional level: Quality dying initiative (QDI).

Journal of Clinical Oncology ◽

10.1200/jco.2014.32.31_suppl.124 ◽

2014 ◽

Vol 32 (31_suppl) ◽

pp. 124-124

Author(s):

Jeff Myers ◽

Tracey DasGupta

Keyword(s):

Acute Care ◽

Large Scale ◽

Care Setting ◽

Family Members ◽

Care Plan ◽

Acute Care Setting ◽

Improvement Project ◽

Implementation Phase ◽

Dying Patients ◽

Care Of The Dying

124 Background: For a tertiary academic health sciences and comprehensive cancer centre, care of the dying is a significant element of the institution’s overall patient and family care experience. The aim for this large-scale quality improvement project was to improve the quality of the experience for a patient in the final year of life and their family members. Methods: This is descriptive study involves one institution and the characterization of three distinct patient populations: A - Imminently dying patients for whom care goals have been clarified to be comfort, B - Patients for whom death “this admission” would not be a surprise and C - Among patients being discharged, death “within the next year” would not be a surprise, linking in the outpatient cancer care setting. Results: On average 19 deaths per week are in some way expected for the institution’s acute care setting. Phase 1 of the QDI included a review of evidence and best practices in care of the dying as well as comprehensive plans for both organizational engagement and communications. Phase 2 of the QDI (i.e. “Implementation Phase”) involved interventions for each patient population. A corporate-wide “Comfort Strategy” was developed to address Population A. Components include standardized order sets, standardized interprofessional “Comfort Assessment and Documentation”, the palliative care team’s “Coaching Consult”, a “Family Member Education” process and an evaluation plan that includes an experience survey routinely sent to family members following a patient’s death. The intervention was piloted on and subsequently rolled out to all inpatient oncology units. Interventions for Population B and C are the triggering of Goals of Care and Advance Care Plan discussions respectively. Key metrics have been identified for all three patient populations and are based on care elements considered important by dying patients and their family members. These now comprise a dashboard, which has been endorsed for roll out to all patient care units in the acute care setting. Conclusions: A quality framework can be effectively applied for the institutional context of developing an approach to improving the final year of life for a cancer patient.

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Taking Collective Action to Improve Patient-Provider Communication

Perspectives on Augmentative and Alternative Communication ◽

10.1044/aac22.2.69 ◽

2013 ◽

Vol 22 (2) ◽

pp. 69-78 ◽

Cited By ~ 3

Author(s):

Amy Wilson-Stronks ◽

Sarah W. Blackstone

Keyword(s):

Augmentative And Alternative Communication ◽

Good Practice ◽

Active Role ◽

Provider Communication ◽

Alternative Communication ◽

Patient Centered ◽

Raising Awareness ◽

Centered Care ◽

Patient Provider Communication ◽

Improve Patient

Abstract There are many reasons for speech-language pathologists (SLPs), especially those who work in the area of augmentative and alternative communication (AAC), to take an active role in improving patient-provider communication. Effective patient-provider communication is fundamental to patient-centered care and correlates strongly with better patient outcomes, as well as increased patient safety and patient satisfaction. It is not only good practice, but good economics. In this article, we introduce existing laws, standards, regulations, and guidelines that address issues related to patient-provider communication in hospitals and other medical settings and discuss how, armed with this information and supportive data, SLPs (especially those with expertise in the area of AAC), can become active in preparing their clients for future medical encounters. We also highlight a need to work collaboratively with other professionals who support communication, such as language interpreters and nurses. Finally, we advocate for SLPs raising awareness about available services, tools, and strategies that support effective communication between patients and providers during medical encounters.

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